Don't Stress, Assess!

Head to toe assessments are a huge part of your job as a nursing student, and when you're just starting out in nursing school, they can be intimidating. Did I just hear crackles? Did I check all of the pedal pulses? Are these pupils 3 mm? Can I check them again?

When you're just starting out in nursing school, your head will probably be buzzing with background chatter about what you did and didn't do while you're performing assessments on patients, because this is one of the first points in nursing school that you really need to pull everything together and ask yourself a large succession of questions at once:

• What am I seeing/hearing/feeling?
• Is this a normal or expected finding?
• What does this mean for my patient?

And you're thinking these things over and over again with every little thing you assess.

Knowing that, walking in to do your first few assessments can be awkward, even scary, because on top of asking all of these things to yourself, many times you're also trying to build rapport with your patient and keep them comfortable - you're trying to hold a real conversation while having an internal conversation with yourself.

Here are a few tips about easing in to assessments:

Small-talk first. Ask about how they're feeling. Ask their pain level, you'll need it anyway. Ask how they slept, how they liked breakfast, if they had water or coffee with breakfast. All of these things are also part of taking your assessment and help you just as much as pulling out your stethoscope and listening to bowel sounds in a lot of cases.

If you can, ask your patient if anything seems "off" to them. This gives you guidance to where you might want to do a more focused assessment.

Assess often. Ask the nurse you're working with if you can help perform assessments on their other patients. Get report on those patients to get a little background about what you would expect to find, then go in and find it. Get over your fear and listen to those lung sounds. You don't know adventitious breath sounds until you've heard them on a real patient - you don't just hear stridor or wheezing. You see them having a hard time breathing. You have them telling you what it feels like for them. No single part of the assessment stands alone. The more you practice, the more you pick up.

Discuss what you find with your nurse outside of the patient room. If you can find time that works for your nurse, let them know what your assessment findings were, and ask if there was anything you may have missed. Read more about the patient to see if there's anything you could look at in more depth for your next assessment.

Assessment skills are something that grow and evolve with you as a nurse once you get hands and stethoscope and eyes on more patients. Don't let the fact that you haven't done many assessments stop you from assessing. Jump right in, and remember that your patient isn't just a source of different sounds - they're a resource of information. You're there to treat them, in order to treat the, you need to know how they're feeling, and if you want to know anything they feel that you can't pick up with your own senses and your patient is able to tell you, by all means, ask.