question on nursing assessment

[sydylo]

Hello. I am in my first semester of nursing school (loving it) and am just curious. I just got done with this weeks reading of nursing health assesment, going over how you would do a complete assessment of a patient. It goes quite in depth about checking the reproductive area of the patient out. (inspect and palpate interior and exterior lady parts and rectum) Is this something you would really do? Wouldn't a doctor do this type thing? I understand, for instance, if a woman has given birth and the nurse checks the area to make sure things look ok, but during the initial physical, would a nurse really be expected to do this? Just wondering!

[Daytonite, BSN, RN]

No. Remember that for your class you are learning what is ideal. If you are going to be assisting a physician, for example, you would ask him if he was planning to do a lady partsl exam and then want to make yourself available to be at the bedside when he is performing this exam (some states now require a female nurse to be in attendance when a male MD does a lady partsl exam). In the days when I was a student, we would have also been expected to have the gloves, KY Jelly, speculum and pap smear collection kit ready as well. I had one physician that made early rounds (I worked night shift). As he came on the unit he would sometimes tell me that he would be doing a lady partsl exam on Mrs. So-and-so and to please get the equipment ready for him. You have to know what is involved in the exam so you can get the equipment needed. In this physician's case, he would also want a bedpan (not a fracture pan) which he would turn upside down and have the ladies rest their hips on so he could perform both the lady parts and rectal exams. After he showed me this one time, I was expected to do this and have the ladies ready for him.

[DaFreak71]

No. Remember that for your class you are learning what is ideal. If you are going to be assisting a physician, for example, you would ask him if he was planning to do a lady partsl exam and then want to make yourself available to be at the bedside when he is performing this exam (some states now require a female nurse to be in attendance when a male MD does a lady partsl exam). In the days when I was a student, we would have also been expected to have the gloves, KY Jelly, speculum and pap smear collection kit ready as well. I had one physician that made early rounds (I worked night shift). As he came on the unit he would sometimes tell me that he would be doing a lady partsl exam on Mrs. So-and-so and to please get the equipment ready for him. You have to know what is involved in the exam so you can get the equipment needed. In this physician's case, he would also want a bedpan (not a fracture pan) which he would turn upside down and have the ladies rest their hips on so he could perform both the lady parts and rectal exams. After he showed me this one time, I was expected to do this and have the ladies ready for him.

Thanks for the response Daytonite, I was actually wondering about this myself. Seemed like it would be a bit odd to doing such an assessement routinely. :rotfl:

Adri

[MIA-RN1, RN]

Ya know, I was just thinking about assessments too. We have the nursing assessment, skin, vitals, I&O, lung sounds etc etc, done ea shift.

But then all the stuff they are teaching us in school, it doesn't seem in the scope of nursing in many cases. Ears, eyes, and such exams as noted above. We can do them, sure, but we can't diagnose anything. We can tell the MD our findings, but (s)he still has to do the exam anyway.

It seems kind of weird that in school we are taught to do more assessments that we actually will do.

This semester we actually have to test out on a neurology assessment. Do nurses really do them?

At work, when I room a pt w/ an earache, for example, I can look with the otoscope to see what the ear looks like, and I can tell the NP, but the truth is, she looks in the ear herself; she isn't going to diagnose based on my assessment. So its almost like putting the patient thru an extra exam they don't really need because its not very useful.

Just my rambling thoughts on the matter.

[stressgal, RN]

At the same time you, as the nurse, need to be able to assess the client's changing or altered status to report to the physician. Just call a physician once without all of the information on hand, you will not do it a second time.

[sydylo]

Thanks for the responses. Glad to know I wasn't alone in my thinking!