As nurses, we are grateful for monitoring equipment. The equipment tells us what we need to know at the touch of a button. But, we also know that relying on these machines alone can take the skill out of nursing. In the absence of monitoring equipment, there is no need to panic. The human body possesses what we need to carry out a basic if not advanced nursing, life-saving assessment/judgement should things go wrong - our senses! A nurse needs to be able to tell if something is 'off' just by using their eyes, ears and hands. The following are some tips on how we can utilise these senses and act promptly, thus also being able to save lives.
1. The eyes.
There is no greater tool to a nurse than the eyes. You can tell a lot just by casting a glance at your patient. Straight away you can understand how critical they are only by observing their colour, the rhythm of their breathing, chest movement or lack of it, a bleeding wound, a swollen leg, urine colour and any other physical signs of distress you can think of. Once you've noticed an abnormality, you can proceed with caution.
2. The ears
If a patient is unstable, they will make abnormal sounds - sounds that indicate something is wrong with, perhaps, their airways such as wheezing, gurgling, stridor, etc. At other times, there are no sounds at all, which would also indicate a complete airway obstruction in some cases. So, using your ears, you will be able to ascertain whether your patient is making the right kind of sounds. If it is not breathing, they may cry/scream, or try to tell you something. Gather the facts with your ears, and from then on, you will be able to act accordingly.
3. The hands
If anything, nursing is a hands-on job. You cannot be a nurse and not get your hands dirty. When faced with a sticky situation, take the time to feel your patient. Feel their pulse, their breath and skin. Are they warm enough, too warm, cold or clammy? That alone can tell you all you need to know about your suffering patient.
4. Smell
There is a lot that a nurse can tell just by using their sense of smell. Be it the smell of your patient's urine, an infected wound or stools. Once you've established something doesn't smell right; a nurse can proceed with confidence.
5. Taste
In 1674, Thomas Willis described the taste of urine in diabetic patients as 'wonderfully sweet as if it were imbued with honey or sugar.' I know what you're thinking. Yacky right? Well, not according to those who nursed in the olden days. Before technology was developed, the way it has, doctors and nurses, in some parts, used to taste urine for infection. Thank goodness we do not have to do that anymore. We have advanced technology now, and we can diagnose at the press of a button.
6. Trust your instinct
Nurses have an uncanny way of using their gut to determine if/when something is not quite right with their patients. This, in my view, is what makes a nurse a bit special. Nurses can achieve this because they are the ones who spend the most amount of time with the patient and offer hands-on care, so, they can tell when a characteristic is out of the ordinary, even without medical evidence at first. So if you're a nurse like me and you get that feeling in the pit of your stomach, that something isn't quite right, then it probably isn't. Go with your gut and tell the doctor what you think and let them know what your concerns are. The worst thing that could happen is you'll annoy the hell out of the on-call doctor who was getting ready to take a nap after a long day at work. Better to be safe than sorry!
Although machines have made nursing somewhat 'easy' these days, I reckon we have all the tools, the machines we need to do a reasonably sound nursing assessment. Our eyes, ears, noses, mouths (okay maybe not so much now) and gut instinct provide us with all the information we need to prevent danger from occurring to our patient. Let's use them. Done enough times, the confidence and skill you gain from practising with your senses are indispensable. You will feel satisfied and glad, and so will your patient!
Here's to unleashing the excellent nurse in you! I am an Advanced Theatre Practitioner (Recovery) and the information in this article is both experience-based backed by my empirical knowledge.
Article by Bertha Mukodzani (Registered Nurse)
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