So, yesterday I had my Physical Assessment Assessment. This is where you pair up with a classmate and perform a head-to-toe physical exam (minus examining the boy and girl parts) while the clinical instructor sits in the room and stares at you with arms folded, occasionally flipping through the Physical Assessment Assessment Guide to check off each correctly performed task, and tells you whether you passed or failed.
We’ve all had (or should have had) physical assessments in our lives. Most likely, it has been a physician inspecting, palpating (feeling with the hands), percussing (tapping with the fingers) and auscultating (listening to) our bodies. I think it’s pretty neat that with a few simple instruments such as a stethoscope, a tongue blade (the Popsicle stick that is put on your tongue when you say “ahhh” actually has a name), blood pressure cuff and a watch can tell you a lot about the body and its illnesses. As a nurse, I will likely never perform a complete physical assessment, but it is important to know what to do and so when a physician asks me to pass her a tongue blade, I won’t look at her funny and say “Oh, you mean Popsicle stick!”
P & I were the last pair to perform our assessments on the last day of assessments with a tired instructor. Watching students auscultate for bowel sounds and check capillary refill hour after hour in a cold room has got to be boring.
We both forgot a few things, but we also both passed our Physical Assessment Assessments! Relief!
After I correctly pointed out the male and female anatomy on rubber parts, the instructor told me her assessment of my Physical Assessment. She told me what I need to improve, what I completely omitted and what I performed incorrectly.
First, I need to be more precise in auscultating the valves of the heart, I forgot to check P’s range-of-motion in her arms, and I need to watch my language.
No, I wasn’t dropping f-bombs to my patient.
When I was inspecting and palpating P’s chest, I explained to her what I was doing. “Now, I’m just feeling your chest for thrills,” I said. Thrills are vibrations in the chest that can be felt if a person has a murmur.
“Telling a patient you’re ‘feeling her chest for thrills’ should be avoided,” the instructor said. “We really need to avoid words like ‘feel’ and ‘touch’ when palpating or inspecting. It’s makes the patient uncomfortable. And most patients won’t think of a thrill the same way you do.”
Yeah, that would be awkward. Ooops.