Sunday, March 2, 2014

The True Importance of Assessment

I'm still thinking about my experience during my first medsurg shift, with the patient I described yesterday. I cannot help but wonder how the situation could have been very different, had I not gone it at the time I did, to assess him. That's part of the nature of the job, I guess. 

And just from entering into his room, I could already tell by looking and listening to him, that things were not right. That's a pretty good feeling, I must admit, for an inexperienced, novice student nurse ("snurse"!). I'm doing some "critical thinking" here, folks! Its all a question of building up confidence over time and experience.

I keep thinking back to my pediatrics rotation, where it seemed all we did was do vitals q4h or q2h, depending on the patient. I even had one pediatric patient with a head injury, that I was doing neurovitals on every q15 mins, I believe.

I remember expressing a bit of frustration to my nursing prof, saying that it seems that all we do is take vitals. Luckily, my pediatric patients were all stable, and we were clearly doing all those assessments just to practice doing assessments. She tried to explain to me how important doing those VS assessments were, as part of the ongoing care for our patients. It just seemed very routine to do, and we had to go through the motions of taking those assessments. It felt tedious at times.
Now I know better.

Now I can really see the importance behind doing those assessments. They provide so much information about the patient, that I didn't realize back then.

Our clinical instructor told us that she's never had a patient unexpectedly crash on her. She does a complete head to toe assessment on every single patient at the start of each shift. Any deviation from that baseline assessment is noted, and potential predictive trajectories of decline can be spotted on follow up checks. That's not to say she's never had a patient crash on her, she has, clearly, its just that its never blindsided her.

And speaking of clinical instructors, my teacher this term could not be better. She is very tough and very demanding, yet very approachable and enthusiastic about teaching us as much as she can. We are going to learn to much -- actually, in just two shifts (one on the floor, one in a classroom) with her, I've already been able to apply so much theory I've learned since year one, to practice.  She's making the theoretical portion of nursing school come to life.

And she's only been a nurse for 7 years.  That is maybe the part that amazes me the most. If she can be that awesome, intelligent, efficient and capable a nurse in that amount of time, you can be sure I'll be right up there with her, in seven years.  She's shown me it is 'do-able' to be such a great nurse, in a relatively short period of time. 

If she can do it, so can I.
Oh, and how could I forget to mention...glory be, the nursing theory paper is d-o-n-e!!!!!! Whew.

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