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Nursing assessments are taught thoroughly in nursing school and utilized at the bedside every day for many nurses. Nurses use their senses to gather important information regarding the status of their patients. They are trained to pick up on seemingly insignificant changes in the patient’s status and incorporating it into their overall assessment. Whether it is a change in the patient’s complexion, swelling in their ankles, the new onset of a cough, or the slightest change in a patient’s vital signs, nurses process more information that can be caught by a keen observer.
Yet when taken out of the patient room, nurses often feel like a fish out of water. With an increase in technology utilization, nurses are more commonly taken away from the bedside. Telehealth is becoming more common for nurses to utilize in a variety of care settings. Whether you are looking to improve your assessment skills or are considering a job that requires telehealth, below are a few tips for assessing patients over the phone.
Many aspects of a nursing assessment are often contained within the mind. Given the fact that you are on the phone, you must translate the normal assessment at the bedside to a verbal conversation. Nurses often don’t understand how much of their assessment isn’t verbal but is visual at the bedside. When mentally working through your telehealth assessment, start to verbalize your assessment to your patient over the phone, especially regarding assessments of things that you would visualize (e.g., appearance, behavioral changes, swelling).
When assessing a patient over the phone, you must be descriptive. Often patients have difficulty describing things. As a nurse, you have many adjectives that you use that are helpful. Plus, you need to get into the details. You cannot settle for vague generalities such as, “I had a loose bowel movement” or “I’m in pain.” You can facilitate the conversation by asking things like, “Was your pain sharp and stabbing or was it dull and achy?” and, “When you passed blood in your stool was it black and tarry or bright red?” The better you can describe common descriptors relating to what the patient is telling you, the better you can accurately assess what they are actually experiencing.
Listening intently can uncover many valuable details that otherwise might get overlooked. Since patients can have difficulty explaining their symptoms, giving them space and time to get out what they are trying to say can go a long way in understanding what is actually going on. Remember, you are the assessment expert, not the patient.
You are completely dependent on what you can get from the patient during a telehealth assessment. Be sure to speak out loud, use descriptors, and when all else fails, let the patient talk in order to get a thorough assessment.