Taking clothes off for a head to toe assessment

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Hi i started my 2nd semester of nursing school and im really excited because i finally start clinicals. im learning the head to toe assessment and i was told that when hearing for lung sounds you have to take off your top because otherwise you wont be able to hear sounds. The problem is im body conscious because i have back acne and i don't want to go through that embarrassing moment when classmates are practicing on me. any thoughts on what should i do? any experiences will be helpful. thanks.

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Specializes in Trauma Surgical ICU.

Check with your instructor but we never had to remove our clothes to practice anything.

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Yea no you don't have to take clothes off. I can hear breath sounds just fine through one layer of clothing. That's ridiculous.

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We had to remove our shirts when practicing assessments on each other in lab. We were in curtained off areas with only our partner with the instructor popping in occasionally. My partner was female so she obviously had a sports bra on still. Like others have said I would talk to your professor about your concerns.

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Specializes in NICU, Trauma, Oncology.

We were never put in uncomfortable situations for labs. The instructor would have us demonstrate where we would place the stethoscope on top of the shirt or on the sim-man.

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I never had to remove clothing. We practiced on each other over tank tops. What is up with all these schools requiring students to partially undress in the learning environment? This is seriously insane.

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It's probably a good practice to remove clothing on clients when doing a head to toe assessment (especially for observing skin), but I don't understand why that would be necessary when practicing on each other.

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Specializes in Physical Medicine & Rehabilitation.

I think to be more accurate, you can hear lung sounds BETTER with a layer of clothing between the stethoscope and the skin. And NO, you do not need to take off the shirt to listen to lung sounds. Simply put your stethoscope under the shirt if you don't want your patient to strip. That's pretty messed up if they are forcing you to take off your clothes during the assessment. Then again, our program made everyone give baths on each other in bathing suits (men with men and women with women of course). It was quite funny/fun though haha.

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I think to be more accurate, you can hear lung sounds BETTER with a layer of clothing between the stethoscope and the skin. And NO, you do not need to take off the shirt to listen to lung sounds. Simply put your stethoscope under the shirt if you don't want your patient to strip. That's pretty messed up if they are forcing you to take off your clothes during the assessment. Then again, our program made everyone give baths on each other in bathing suits (men with men and women with women of course). It was quite funny/fun though haha.

See I just feel horrible for students who are insecure, who've suffered abuse, or who's religion requires modesty. I learned how to do a bed bath just fine on the sims. As far as lung sounds go, I learned where to place my stethoscope (fully clothed) and when I got to clinical, I asked lots of questions; if I wasn't sure what kind of adventitious sound I was hearing, I asked my instructor to listen with me. I still do. The lab sets you up for the real learning that takes place in clinical with actual patients.

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Specializes in Physical Medicine & Rehabilitation.
I think to be more accurate, you can hear lung sounds BETTER with a layer of clothing between the stethoscope and the skin. And NO, you do not need to take off the shirt to listen to lung sounds. Simply put your stethoscope under the shirt if you don't want your patient to strip. That's pretty messed up if they are forcing you to take off your clothes during the assessment. Then again, our program made everyone give baths on each other in bathing suits (men with men and women with women of course). It was quite funny/fun though haha.

Correction, I meant to say that you can hear lungs better WITHOUT clothes between the skin and the stethoscope. For the most part I always listen like this since 99.9% of the patient's on my floor in the hospital are in gowns. There have been a few times when a patient was in a regular shirt up to the neck where I would just listen on top of it.

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Specializes in ICU.

We wore sports bras or tank tops that somebody could easily get access to. They do have to listen on your skin. You guys are students and are learning. They have to be able to hear.

I know it's hard when you are self conscious but think of the profession you are getting into. You will having people remove their clothes. You have to get comfortable with the human body. Why not wear a loose fitting shirt that somebody can easily get under without having to take it off?

Somebody else will not be able to learn how to properly hear lung and heart sounds through a shirt. Later on, with experience you can, but not at first.

You are not the only self conscious one, I promise. And you will get through it. And believe me there are a lot worse things out there than back acne. But the bottom line is, you need to be comfortable with the human body, including yours. I used to have back acne. I still get it on my arms from time to time. It's mostly a hormonal thing that you have no control over. And people know that. If anybody were to judge you for that, they shouldn't be nursing students.

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Specializes in Med-Surg.

I would be comfortable with a classmate going under my shirt to listen but I would not be okay with taking my shirt off in front of a classmate.

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