A few things I have found helpful over the 20 years practicing as a nurse in med surg, ICU, Home Health Care, Medical Cardiology, as a Nurse Practitioner, and currently as nursing faculty: 1. Assess from head to toe instead of by body system as this is more efficient (you will still need to document the assessment in body systems. 2. Assess pulses and strength bilaterally at the same time ie feel both radial pulses at the same time, this makes it easier to compare the 2 sides. The carotid pulse is a notable exception (you don't want to risk cutting off the blood supply to the brain). 3. When assessing for edema it is essential to hold pressure for a few seconds, if there is pitting edema the finger will sink slowly into the tissue and leave an indentation. This will be missed if you only push for an instant.
I def do my head to toe assessment differently in respect to the order and doing things bilaterally to compare. Nonetheless, I appreciated this video and it was a refresher for the main areas to remember, also loved the beginning questions etc. thanks!
There is nothing in EMS that teaches that. Not sure what medical school taught you that. The only thing we do teach is to never perform an assessment on top of a patient. It can be left or right so long as it's a head to toe thorough assessment.
I think you mean all 9 pulse points. She did a good job, but I agree, rather than going to the legs twice and the chest twice, she could have accomplished these tasks together.
Listening to her abdominal sounds, she should start from the RLQ to RUQ to LUQ to LLQ. Too many turnings too. She should have inspected her back after listening to her lung sounds from behind. There are some good points tho
I taught that a nurse is suppose to wash her hands before touching a patient physically. I noticed you did not wash your hands before checking your patient's ID. Hence, this is a key element to infection control practices. Bibi Henderson RN/BSN
I really don't like the order that you did things, a lot of unnecessary back and forth. For example, when you listened to the apical pulse, you should have listened to breath sounds and bowl sounds after, so things would flow a little better.
I would have reminded my patient prior to the assessment of what it is exactly that I would be doing head-to-toe to make my patient feel comfortable rather than everything being awkward; the nurse just went right into it so stiffly. She also forgot to wash/sanitize her hands before touching the patient. I enjoy good conversation so I would've made it more relatable by eliminating all of that silence.
nena200able It just sounded weird, especially given that she would have had to give her consent before hand to be in a video. Why would she even ask why this was being done _after_ giving consent to be in the video?
No one is going to go at my head like she did. And why is she doing good this and not the doctor. I would refuse to allow her to do this. She is all over the place here. I think this total body skin assessment is just a way for them to make you feel assaulted.
S J are you crazy? This is part of a normal assessment that nurses do routinely. If you don’t want a nurse touch you just dont go to the hospital them !
I honestly can say this is the worst head to toe assessment I have ever seen. She santized her hands then touched the curtain and went back to the patient. There are 8 areas on the chest 2 on the side and 10 in the back to assess for lung sounds. She didn't note the landmarks etc. This would fail me at my school.
