In Home Health we do comprehensive head to toe assessments on every admit and reassessment. We see most geriatric patients, they always have so many different systems affected, I would say we do a head to toe assessment every visit. There are some visits they will refuse a thorough skin assessment; at that time, we educate the importance and if still refused we document the refusal. As home health nurses we also must assess the family/caregiver situation or availability. A lot of home health nursing is educating the caregiver to get the patient back to the prior level of function or better, and that is established in the assessment as well. According to Chamberlain (2018), “When a client assessment reveals a family caregiver is involved in their care, the nurse should attempt to assess the needs of both the client and the caregiver (lesson 7). We assess these needs of both to benefit the patient and to prevent caregiver burn-out. If the caregiver has the resources, they need to provide care, the patient will likely have better outcomes.
I do feel our assessments are as thorough as they should be, that is if they are done correctly. There is a lot of times if another nurse admits and it is a few weeks before I see the patent I will hear a murmur, or find a suspicious skin lesion etc.; and then not know if it was there on admit because nothing was documented, so I have to assume it is new issue.
The assessment for the video in week 6 was awkward being on camera, videoing myself. Trying to remember the list of things to do was hard, when there was stuff on there that we normally do not perform. Also, I had planned to do it on a nurse friend, but she got sick, so my daughter volunteered (she is 18), at the last minute and did not feel well herself, so I was very out of sorts. I think it was different also because there was nothing to focus on and I usually start by talking and gaining insight, then move to vital signs and let the patient get comfortable before I just walk in and start the physical part. I learned about the Romberg test in this activity and the over all review of landmarks was good refresher, since we don’t say or think about them often, we just do them. It was a good reminder of what we are doing that is second nature now.
Chamberlain College of Nursing. (2018). Health Assessment for the Practicing RN; Week 7 Lesson. Downers Grove, IL.