NURS 210 Week 2 Student Assessment Video 1 Example

Student Assessment Video 1: A Narration Script for the General Survey, Vital Signs and the Skin, Hair and Nails

Setup Before Recording

Equipment: stethoscope, aneroid or automated blood pressure monitor with a cuff sized to the volunteer's arm, thermometer, pulse oximeter, watch with a second hand, penlight, gloves, a ruler for lesions and hand sanitizer. Room: a quiet, well-lit space with a chair with back support, a table at the volunteer's heart level for the arm and an exam surface for later steps. Camera: placed on a tripod about six feet away, angled so both my hands and the volunteer's upper body are in view. The volunteer wears a short-sleeved shirt and shorts, and a sheet is available for privacy. Before pressing record, I confirm consent again and remind the volunteer that the video is for my instructor only.

Segment 1: Introduction and Hand Hygiene (about 2 minutes)

Action: Introduce myself and the volunteer by first name only, explain the exam and perform hand hygiene in view of the camera.

Script: "Hello, I'm Rachel, a nursing student. Today I'll be doing the first part of a head-to-toe assessment, which includes a general look at your overall health, your vital signs and your skin, hair and nails. I'll explain each step as I go, and you can ask me to stop at any time. I'm cleaning my hands now."

Segment 2: General Survey (about 3 minutes)

Action: Observe and state appearance, behavior, mobility and communication. D'Amico and Barbarito (2016) describe the general survey as the first impression of a client's overall health, gathered from the moment the encounter begins.

Script and findings: "The client is an adult woman who appears her stated age, is alert and oriented to person, place and time and responds to questions appropriately. She is well groomed and dressed appropriately for the setting. Posture is upright, gait is steady without assistive devices and movements are coordinated. Speech is clear, and she makes eye contact. She shows no signs of acute distress."

I will ask the volunteer to state her name, the date and where we are, so the orientation finding is demonstrated rather than assumed.

Segment 3: Vital Signs (about 7 minutes)

Temperature: "I'm taking an oral temperature. Temperature is 98.2 degrees Fahrenheit."

Pulse: "I'm palpating the radial pulse for a full 60 seconds. Pulse is 76 beats per minute, regular and strong, plus 2 bilaterally." I will palpate both radial pulses to compare.

Respirations: Counted while my fingers remain on the wrist so the volunteer does not change her breathing. "Respirations are 16 per minute, regular and unlabored."

Oxygen saturation: "Oxygen saturation is 98% on room air."

Blood pressure: The volunteer sat quietly for five minutes before this segment, back supported, feet flat on the floor, legs uncrossed, with her bare upper arm supported on the table at heart level. I measure the arm and choose a cuff whose bladder fits it, place the cuff on bare skin with the lower edge about an inch above the antecubital space and do not talk during the reading. "Blood pressure is 136 over 84 in the right arm. I'll take a second reading in a minute and check the left arm." Muntner et al. (2019) recommend this preparation, positioning, correct cuff size and averaging at least two readings, because errors in any of these can raise or lower the reading by several points. Because the volunteer's history included a high kiosk reading, I also state: "I'll share these readings with you, and you may want to mention them to your provider."

Pain: "On a scale of 0 to 10, do you have any pain right now?" Finding: "Client denies pain, 0 out of 10."

What to Do If Something Goes Wrong

Mistakes will happen, and the recording cannot be edited, so the plan is to correct them aloud and continue. If I forget a step, I say, "I'm going back to check the left radial pulse, which I missed," and do it. If the automated cuff fails, I switch to the manual cuff and say why. If the volunteer needs a break, I state the time, pause my actions with the camera running and resume when she is ready. If a finding is abnormal, such as a blood pressure well above the earlier reading, I state the finding accurately, recheck it after a minute and tell the volunteer in plain words, without diagnosing. Faculty grading the video can see good judgment in how a student handles a problem, and a calm correction is far better than restarting a recording that is close to the time limit.

Segment 4: Skin, Hair and Nails (about 8 minutes)

Action: Inspect, then palpate, working from head to toe with gloves on if any lesion is open. The volunteer remains seated and then stands so I can view her back with the sheet for privacy.

Skin inspection script: "Skin color is even and appropriate for ethnicity, without pallor, cyanosis or jaundice. No rashes, bruising or open areas. I'm inspecting the back now."

Lesion: The volunteer has a mole on her upper back. "There is a single round, evenly brown macule on the upper right back, measuring about 4 millimeters, with a smooth, regular border. Using ABCDE: it is symmetric, the border is regular, the color is uniform, the diameter is under 6 millimeters, and the client reports no change over several years." I measure it with the ruler on camera.

Skin palpation: "Skin is warm and dry to touch. Turgor: when I pinch the skin below the collarbone, it returns immediately. No edema in the lower legs."

Hair and scalp: "Hair is evenly distributed and of normal texture. The scalp is free of lesions, flaking or tenderness."

Nails: "Nails are pink with a nail angle of about 160 degrees, so no clubbing. When I press and release each nail bed, color returns in less than 2 seconds, fingers and toes alike."

Ending the Recording (about 1 minute)

Action: Thank the volunteer, perform hand hygiene again and state that the segment is complete. "Thank you. This completes the first stage of the assessment. I'm cleaning my hands." I stop the recording only after this statement, so the video shows the complete stage without cuts.

Rehearsal Plan

The segment timings add up to about 21 minutes, leaving a margin under the 25-minute limit. I will rehearse twice, once with the script in hand and once without, and time each segment. Huber and Epp (2022) note that video recording and peer evaluation are useful strategies for learning physical assessment, so I will watch my rehearsal recording and check it against the course checklist before the final take. In an unedited video, the best protection against a missed step is a rehearsal that has already found it.

References

D'Amico, D., & Barbarito, C. (2016). Health and physical assessment in nursing (3rd ed.). Pearson.

Huber, B. J., & Epp, S. M. (2022). Teaching and learning focused physical assessments: An innovative clinical support tool. Nurse Education in Practice, 59, 103131. https://doi.org/10.1016/j.nepr.2021.103131

Muntner, P., Shimbo, D., Carey, R. M., Charleston, J. B., Gaillard, T., Misra, S., Myers, M. G., Ogedegbe, G., Schwartz, J. E., Townsend, R. R., Urbina, E. M., Viera, A. J., White, W. B., & Wright, J. T. (2019). Measurement of blood pressure in humans: A scientific statement from the American Heart Association. Hypertension, 73(5), e35-e66. https://doi.org/10.1161/HYP.0000000000000087