Tuesday, August 30, 2016

Assessment of the heart

If there's one word a nurse learns in nursing school and lives by on the job it is the word


Assess, assess, assess....assess again.

For example, the patient says they are short of breath.  A prudent nurse would then get an oxygen level to determine the oxygen saturation, a set of vital signs, and also note whether the patient has complaints of pain and where.

He or she would then determine a host of other minute details, including, but not limited to checking their medication record for respiratory treatments, the positioning (are they laying flat on their back?) If they are on oxygen, is their tubing crimped?)

A nurse looks at as many details as quickly as he or she is able before calling the doctor for orders that go beyond what is in her scope of practice or already ordered.  A nurse is constantly assessing the people under her care.

Is this drug working?  Are the right precautions in place for a confused patient?  Does a patient need something to calm their nerves when they can't smoke?

Assessing is the number one role as a patient advocate.  If a nurse's assessment skills are weak then those patients may not get the best care available.

It takes practice to develop good assessment skills.  It doesn't take a lot of knowledge to take vital signs, but it does take a critical eye to assess whether a low or high blood pressure is critical for a patient who has just had surgery, versus a patient who has chronic high blood pressure but is taking their prescribed medications to keep their numbers within normal limits.

Assessment is something that all nurses are trained to do from day one of nursing school, and their skills are constantly being perfected throughout their career.  I have only been a nurse for six years.  My assessment skills are better then they were six years ago, but they are not on the same level as a nurse who has been assessing for thirty years.

Assessment skills come with practice, with making mistakes, and with studying the differences in your patients.  A good nursing assessment is what the doctor is waiting for when they are called in the middle of the night to make a decision for a patient whose health is deteriorating.

So what does that have to do with anything?

I'm so glad you asked!

Pretend you are a nurse.  If you were to take a moment or two and assess your spiritual well being, what would you find?  (Be honest, no one will ever know what you're thinking).

Are you closer to God today then you were last week?  Last month?  Last year?  Five years ago?  If not, why not?  Where or when did you sense you were drifting away?

What about your fears?  Has maturity taught you that much of what you worried about five years ago never came to pass or are you still worrying about the same scenarios that have yet to happen, but you're sure they will?

What about your courage?  Are you braver than you were last year or do you still find it difficult to speak up when you disagree with someone, risking the loss of the friendship or the respect you are afraid you'll lose if you do?

What about your faith?  Is it stronger, weaker, or about the same as it was when you took your confirmation vows thirty years ago?

Do you have more peace with the way your life has turned out or do you wish you could redo the last twenty years and start over?

What is your best honest assessment of.....you?

See, if a nurse were taking care of a patient who had an infection and the only antibiotic available were amoxicillin, he or she would be forced to take a wait and see attitude when it appeared the infection was not getting better, even when the lab work showed that the white blood cells were not decreasing but rather increasing.

But when there are better antibiotics available specifically designed to attack a specific bacteria, he or she may quickly call up the doctor and say, "Maybe we need to try a different antibiotic.  The lab results say this is the bug that is causing the problem."

Maybe things are great in your life and you are making baby steps each and every day and you are nodding your head thinking, I am better off than I was a year ago.  I do have better control of my emotions.  I am braver!  I do believe my faith is stronger than it was last year.

Great!  Praise the LORD!

But then again, maybe you're telling yourself things are good, you're taking the amoxicillin  just like the doctor ordered, but you can honestly say you are stagnant, nothing is better, in fact, things are getting worse.

See, if we don't assess ourselves, how do we know if we're taking the right antibiotic for our infection?

If we only take amoxicillin by mouth once a day, when what we need is vancomycin IV every eight hours, and we wonder why we're so anxious or afraid or depressed or worried, then maybe it's time for an honest assessment.

Maybe it's time to do some spiritual vital signs.

Is your spiritual blood pressure pumping the right amount of oxygenated blood to your spiritual heart?

Are your respirations calm and even, or are they shallow and fast?

Does your spiritual pulse race too fast because you're always going here, there, and everywhere for the LORD, or is it bordering on needing resuscitation because you are too depressed to do anything and what could I do for God when I'm such a mess?

Are you getting enough oxygen to your spiritual cells?  Does the oxygen go to every corner of your spirit and breathe new life into the smallest of faith?

Only you and God know these answers.  Maybe you've been hiding from them, but God hasn't.  Maybe it's time to talk to him about them.

I don't know.

But God does.

When a medical team gets all the vital signs, and the lab work, and the other test results, they then can see the big picture of what exactly is wrong with a patient, and a treatment plan can be made.  The right medicine can be given, the wrong medicine can be stopped.  Maybe medicine won't help, but sunshine and singing or playing with children is what will cure the soul.

But, until it is assessed, the plan can't be made and it won't ever be implemented.

So.....how about it?  Give it a try.  No one has to know the results except you.

God already knows what you need, he's just waiting for you to ask him to search.

Search me, O God, and know my heart; test me and know my anxious thoughts.  See if there is any offensive way in me and lead me in the way everlasting.

Who knows?  Maybe once a good assessment is done, you'll be able to find a better treatment for what is making you____________________________________.

But any good treatment starts with a good assessment.



Psalm 139

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