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!
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