Saturday, February 13, 2010

Health Assessment -- aaaarrrrgh

Health Assessment class -- the one class that strikes fear into every nursing student. In my case, I am in a distance learning program through Indiana State University. Trying to do this as a nursing student is already hard enough. Trying to do this online is like navigating a maze in the dark, with only glow in the dark stickers at every turn.

Of course I already know how to do a head to toe assessment. I went through it in LVN school. I partnered up w/ a fellow student nurse ( in my case, enlisted soldier) and we poked and prodded each other while observed by our clinical instructor/ Staff Sergeant G/ Sergeant First Class P. and Capt. S. I did it lots of times on fellow students, patients young and old, and yes, as an LVN working for a major hospital.

So why does it strike fear in my heart in a BSN program?

Because I'm rusty. LVN school and my LVN career was a LOONG time ago. Almost 17 to be exact.
Yes, I know all the steps. Yes, I know the rationales. Yes, I know how to do things.
But no -- I can't really "do" it. That means -- I don't really think that I can be relied upon to give an accurate assessment.
I mean really -- breath sounds? high pitch, low pitch -- HA! I don't know how high is high and how low is low.

Hyperresonance? How does one know (after not listening and percussing chests for 17 yrs) what hyperresonance is if you don't even know what the regular sound should sound like?

And how do I know how decreased breath sounds should sound when it has been years since I've heard one. And besides -- decreased is only decreased if you know that it should be as loud as it should be...except -- how loud SHOULD it really be?

Palpation of lymph nodes ---- hahaha. Yeah right....I couldn't find an enlarged lymph node till the person told me it was there. So much for finding them.

Vital signs - uh...yeah right. Nope -- you can't just stare at the bouncing needle. (come on, you know you've done it!).
Pulse -- yeah, you have to feel the pulse for 30 seconds and then seamlessly switch to counting respirations for the next 30 while concentrating on remembering the first number and then counting the person's chest rise and fall for the next 30 seconds. When it's done -- uh...what number was that again? LOL

Countless hours spent practicing on a willing subject -- hoping that the 'willing subject' doesn't get tired of being poked, prodded, palpated, auscultated and percussed to death.

So this coming Tuesday -- I am asked to demonstrate to a preceptor the follwing assessments:
Skin, Hair & Nails
Nose Mouth & Throat
Thorax and Lungs

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