Performing health assessments is a key portion of a nurse's training. Honing one's skills in this area prepares nurses for the various patient scenarios they'll encounter throughout their career. However, it's important to keep in mind that an assessment represents more than just a "checklist" of exam processes.
By taking a more holistic approach to health assessments, nurses provide their patients the best care possible.
Understanding the Different Types of Health Assessments
The "clinical" nature of health assessments really sets the stage for all other aspects of care. After all, the patient wouldn't be in the emergency department, physician's office, hospital room or any other healthcare setting if not for some medical need.
From a physiological perspective, health assessments are typically divided into two primary categories:
- Complete health assessment: The examination involves a thorough health history and comprehensive head-to-toe physical exam.
- Problem-focused assessment: This patient analysis is reflective of certain healthcare goals and is often used in a "specialty" type setting (for example, for cardiac/heart or respiratory/lung care). It uses a methodical approach to uncover the problem and not unrelated areas.
In certain situations, nurses may perform what's known as an abbreviated assessment. The same level of thoroughness is involved, but providers can generally complete the assessment in a shorter period of time. One example where this is appropriate would be if a patient has been under the same nurse's care. Or, if a patient is being transferred to another wing within the same hospital or health system.
Depending on the sub-specialty a nurse chooses, they might be required to perform "special population" assessments. These exams often require skills and knowledge specific to a certain patient population (like pregnant, elderly or infant patients).
Hard Skills vs. Soft Skills
While the collection and documentation of vitals represents a hefty portion of patient examination, the scope of a health assessment is much broader. For example, Valerie Dziados, MSN, CRNP, ANP-C, AGACNP-C, describes the difference between "hard skills" (IV insertion, medication administration, wound care) and "soft skills." She says the latter encompasses attributes such as communication, professionalism, critical thinking/problem solving, empathy, and adaptability — all of which are integral to performing health assessments.
For example, good communication is foundational for ensuring top-level care, and it's multifold. Nurses need to understand the importance of interprofessional collaboration and know how to effectively communicate with patients and their family members. Empathy and patient approach also count as essential competencies when leading health assessments, particularly if patients feel vulnerable or frightened.
Nurses also need to be aware of non-verbal or subtle clues that may reveal what a patient isn't saying. Nurses need to consider the appearance, demeanor, silence and facial expressions of patients as non-verbal cues. A patient's reluctance to answer questions, avoidance or hesitation to make eye contact can be quite informative.
Key Courses for Optimizing Health Assessment Skills
Of course, nurses aren't expected to develop these skills on their own. As a result, nursing education has evolved to embrace the holistic approach to nursing care. For registered nurses (RNs) who are thinking about pursuing a Bachelor of Science in Nursing (BSN) degree, the online RN to BSN program at St. Thomas University (STU) incorporates several courses that reflect this approach.
For instance, the Health Assessment & Promotion course builds on nurses' previous knowledge surrounding health assessments. However, it enhances their skill set even more by considering physical, cultural, psychosocial, spiritual and nutritional variables. STU refers to this as a "lifespan" approach.
The Aging and End of Life course in STU's online RN to BSN program also includes assessments as does the Community Health Nursing course.
Another valuable course specific to health assessments is Nursing Practice in Multicultural Society. This course is described as providing "… an overview of the influence of culture on healthcare practices and the delivery of nursing care for individuals, groups and communities. Emphasis is on increasing awareness of culturally diverse nursing care and the impact of cultural beliefs, values and practices upon health and health care delivery."
Why is such a course so meaningful? As the United States becomes even more of a diverse place, nurses need to be informed about the impact cultural attributes have within healthcare. This instruction prepares nurses to be comfortable in any care situation — ultimately resulting in the best outcomes for their patients.
The Crucial Link Between Patients & Providers
The assessment is not the end of a nurse's responsibility; it's just the beginning. Nurses represent the crucial link between patients and physicians or other care providers. By perfecting the healthcare assessment, nurses can help everyone on the healthcare team provide the highest quality of care.
Learn more about St. Thomas University's online RN to BSN program.
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