The
quintessential gift nurses bring to the delivery of healthcare is our assessments. Our
assessments provide clues; telling us if patients are getting better or worse. In
addition, assessments help us and others make decisions regarding care.
In
the ideal world, nurses would have ample time to do a comprehensive assessment
on every patient as often as needed. In the real world, nurses are lucky if
they get 5 minutes to do a “drive-by” making sure their patients are breathing!
If
assessments are our gift, how do we continue to “give” with the added demands
placed on us?
We do this by mastering the skill of
focused assessments.
For
every patient, ask yourself these questions:
1. What is the #1 complication of
this diagnosis/surgery?
2. What part of the assessment would tell me if they were
having it?
3. What would I do about it?
When
I became a neuro nurse, I had to learn how to do a comprehensive neuro exam.
This exam could take 15 minutes when done right. Again, in the ideal world, I
had all the time I needed; but in the real world, sometimes I had 5 minutes to
do a “down and dirty” exam.
How
did I learn what aspect of my assessment was the most important? I learned by asking
questions while rounding with the neurosurgeons.
For
example, when caring for a patient who had their pituitary tumor resected, I’d ask, “What
is the #1 complication of somebody have a pit tumor removed?” The surgeon
answered, “A pituitary hemorrhage.” I asked, “How would I know if the patient’s
pituitary gland was hemorrhaging?” The surgeon answered, “He would lose his
visual fields.”
Ah.
Okay, here’s how I would use this: When I only had 2 minutes to assess my pit
tumor resection patient, I’d check visual fields first. Why? Because I wanted o
determine if my patient was having the #1 complication from THIS surgery. Then,
I’d go back and complete the comprehensive assessment when and if time
permitted.
You will set yourself up
to fail if you think you can do a comprehensive assessment on every single
patient – every time.
By clearly understanding
what complications your patient are at risk for and what aspect of your
assessment indicates these complications, you can spend your timely wisely and
detect problems early.
Master your focused
assessments!
I hope this tip helps you
to become a successful nurse. Thanks so much for choosing nursing as your
profession. I’m cheering for your success!!
Take care and stay connected!
Renee
For more great tips, make sure you "like" me on Facebook,"follow" me on Twitter and YouTube and subscribe to my blog. Also, check out my new book on nurse-to-nurse bullying and my new eBook titled, Survive and Thrive: A guide helping new nurses succeed!
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