NR 305 Week 7 Discussion: Assessment Techniques (graded)

Purpose

This week’s graded topics relate to the following Course Outcomes (COs).

CO 1 – Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO 1)
CO 4 – Identify teaching/learning needs from the health history of an individual. (PO 2)

Discussion

In Week 6 you demonstrated a head to toe assessment of an adult participant. This week you and your classmates will reflect on the assessment you performed for your video assignment, and also apply this week’s lesson on family assessment.

Please consider the following in your initial post:

Reflect on the assessment you performed for the video assignment. Perhaps you might compare your performance now, to how it might have been different when you were a brand new nurse? Or share something you learned (or were reminded of) by participating in this activity?

Based on your observations, do you feel that patient assessments performed in practice are as thorough as they should be? Explain your answer.

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This week’s lesson focuses on assessment of families and introduces specific assessment opportunities for racially diverse, same sex, and adoptive families. Select one of these three non-traditional families. How would your assessment technique change to be sure that you were competently caring for a member of this type of family unit? This may include questions you would add to the health history, or ways in which you would communicate.

Grading

**To view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric.

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Class,

As I mentioned in my week 6 wrap-up announcement, I greatly enjoy your assessment videos. Once an assignment like this is completed, it is nice to reflect so I love the follow up in the discussion this week. It will also be good for you all to see how your classmates viewed the experience. For those who completed the alternative assignment, you can apply the first question to completing this detailed interview. 

Remember that you can start posting Sunday for credit and use scholarly resources from class and an outside source to support your statements. Thank you for your continued hard work! 🙂

This week’s lesson focuses on assessment of families and introduces specific assessment opportunities for racially diverse, same sex, and adoptive families. Select one of these three non-traditional families. How would your assessment technique change to be sure that you were competently caring for a member of this type of family unit? This may include questions you would add to the health history, or ways in which you would communicate.

I did the alternative assignment and I believe that there is a time to gather all that information, but that inpatient during an initial assessment, we may not have that time. Our hospital system goes over a checklist. Half the time I am interrupted by a doctor coming in to do his assessments. Funny thing is that my background information may end up helping the doctors a bit getting to know the patient, but they have more patients than I do.

As a new nurse, I was more task oriented and focused on getting all my check marks done. Now I have the initial assessment memorized so that I could even ask the right questions if my computer was not functioning to fill in later. Attentiveness as well as trying to get through that assessment efficiently is important to getting into the care that the patient needs. I often find myself having small talk with patients to talk about where they are from, family life, etc. while passing meds or maybe just getting up to go to the bathroom.

If there is a way to address someone properly, that is a way to instantly build rapport. Let us say I have a patient who identifies as lesbian and her significant other is her “spouse”, “partner”, or “wife”, I can then respectfully and correctly honor that relationship. Simple validation goes a long way. Also recognizing these people as a family or couple is important in assessment. Something we always ask our patients about during our initial assessment is whether the patient is living in a safe and unthreatening environment. Those intimate questions are asked privately and without a domestic partner in the room (Weber & Kelley, 2018). A lesbian patient needs to be asked those questions just the same as a heterosexual patient. In fact, according to Mick (2006) “gay male couples and lesbian couples have similar prevalence rates and similar patterns of abuse as heterosexual couples”. Ignorance may make assumptions about the patient in the room, but we cannot know about a person unless we ask questions and actually assess that patient.

References

Mick, J. (2006). Identifying signs and symptoms of intimate partner violence in an oncology setting. Clinical Journal of Oncology Nursing 10(4): 509-523.

Weber, J.R. & Kelley, J.H. (2018). Health assessment in nursing (6th ed.). Philadelphia, PA: Wolters Kluwer.

Sorry for pasting some of the actual question!  Here’s what my post should look like: 

If there is a way to address someone properly, that is a way to instantly build rapport. Let us say I have a patient who identifies as lesbian and her significant other is her “spouse”, “partner”, or “wife”, I can then respectfully and correctly honor that relationship. Simple validation goes a long way. Also recognizing these people as a family or couple is important in assessment. Something we always ask our patients about during our initial assessment is whether the patient is living in a safe and nonthreatening environment. Those intimate questions are asked privately and without a domestic partner in the room (Weber & Kelley, 2018). A lesbian patient needs to be asked those questions just the same as a heterosexual patient. In fact, according to Mick (2006) “gay male couples and lesbian couples have similar prevalence rates and similar patterns of abuse as heterosexual couples”. Ignorance may make assumptions about the patient in the room, but we cannot know about a person unless we ask questions and actually assess that patient.

References

Mick, J. (2006). Identifying signs and symptoms of intimate partner violence in an oncology setting. Clinical Journal of Oncology Nursing 10(4): 509-523.

Weber, J.R. & Kelley, J.H. (2018). Health assessment in nursing (6th ed.). Philadelphia, PA: Wolters Kluwer.

Great reflection about your assessments and how you have changed over time. I do that same with  asking questions and charting later. I like to have the patient feel I am really listening and not just staring at the computer. I also appreciate the thoughts on caring for families. One thing I think about as I combine the idea of assessments and family is whether or not giving report on the family during a shift change is appropriate. I think sometimes nurses can tend to say too much and sway the next person’s opinion. For example, one might say “the father is at the bedside and he is very demanding with the staff” when instead they should simply share “the father is currently at the bedside.” Does anyone have experiences with this that they would want to share? 

Thank you for any additional thoughts! 

I think if they tell us that the family or the patient is really demanding, it either can skew your opinion or it can prepare you. It depends on how you approach the situation. If I have a “demanding” family member, I try to be overly kind and offer whatever I can while I am in the room. I also like to explain things to people that I am needed in several other areas and I do like to warn my patients/family’s if I am in charge so that they know I may need some time to return. 

If a patient or family member seems to always want a doctor in the room, I like to explain that they do not only work on one unit and cover many patient’s all over the hospital. They also may be responding to emergency situations, but will get back to you as soon as possible. 

I really enjoyed and related to your post. As a new nurse, I have often felt a bit anxious doing admission assessments as I often felt like I was forgetting something even if all of my “checkmarks” in EPIC were done. Much like your experience, now that I have been a nurse for almost 6 months I am feeling so much more confident in my admissions and can start asking the patient questions without looking directly at the computer checklist. I also definitely agree that is important to identify the person’s primary support people, spouses, children, etc. early on in the assessment as they are often vital to healing our patients especially if they need teaching or education on care after discharge or things of that nature. Great post.

  When I first began my assessments in clinical rotation, I was extremely nervous and often missed steps. I must admit I took a long time, and this really agitated the patients. There were times where I even had to go back into the room to assess the patient again because I skipped an important part of the assessment. In comparison to my performance today, I can now perform an assessment with confiden