The Hospital is No Place for a Sick Person, Part 3

Get 15% off saints scrubs with code "saints_sale"

Alright, after a brief hiatus so that I can focus on my final exams, we’re back at it! Here is my third observation from my recent hospitalization after surgery. If you missed them, you can read part 1 here and part 2 here. So, let’s get back to it.

3) Physical Assessment?
In nursing school this semester, we devoted an entire unit to the physical assessment. We learned what a full assessment entailed, we had to learn how to perform each individual part of the assessment from head to toe (along why it is done), and we even had to do one on a partner and be evaluated by our teachers. We were told in no uncertain terms that “a full physical assessment is done on every patient who is admitted to the hospital, regardless of the reason for admission.”

While I was in the hospital, yes, I was assessed. After shift-change happened, a nurse would come in, listen to my heart and lungs, and a CNA would get my vital signs. Once, a nurse listened to my bowel sounds. But never was I asked the questions to check on my level of orientation (Do you know what day it is, do you know where you are, do you know what happened to you, etc.). No one ever shined a light in my eyes to see if my pupils were equal, round, and reactive to light. My stomach was never palpated, my skin was never assessed, and no one ever measured the angle of my nail beds (hah!).

I understand that the physical assessment is not always applicable. I was awake, alert, and had appropriate responses, so of course the nurse could check a few things off right off the bat without having to walk through them step by step. Other things, such as measuring the angle of my nail beds, were excessive. I had no difficulty breathing, I am not a smoker, and I have no history of any major respiratory illnesses aside from some minor asthma. So, clearly, there’s no reason to suspect clubbing of my nails, as I have relatively normal lung function.

I want to point out that this is not a criticism of the nursing staff, it’s simply something I noticed. I’ve been hospitalized before, and noticed different things around this. For instance, when I was admitted for a concussion following a bad car accident, I was neurologically assessed every shift, but that was not the case when I had appendicitis or had my parathyroid removed. Another thing I found was that when I was admitted from the emergency room, rather than from surgery, I did get a full assessment. From the ER, I went to a pre-admit holding area where they did the full assessment. They asked about my religious preferences, dietary preferences, inspected my skin, looked in my eyes, etc. They provided a baseline assessment for the floor nurses to refer back to, but when coming from the operating room, this was never done.

Again, I’m not trying to say that this is something where the nursing staff failed me or anything like that. It’s just that as a nursing student, and having had an entire unit devoted to the physical assessment, I find it interesting to see that as a patient I only ever experienced a partial or cursory assessment during this admission.

What about you? If you’ve ever been admitted, do you remember the assessments that were done on you by the nursing staff? Nurses, on which ward do you work, and do you always do a full assessment on every patient? What criteria make you do a partial assessment versus a full one? I’m truly interested in learning more about this, as hopefully I’ll soon be doing this on a regular basis! Can’t wait to hear your feedback!

Stay safe out there,
Sam

Advertisement