Basic Nursing Skills
What you must know
Basic nursing skills are the measurements and observations that get reported to the nurse. You must know the vital signs (temperature, pulse, respiration, blood pressure, and pain as the fifth vital sign), how to take them accurately, and which results are abnormal enough to report right away. You must also understand intake and output measurement, including the conversion 1 ounce = 30 mL; active versus passive range of motion; proper body alignment and turning schedules; safe transfers using a gait belt; and basic specimen collection, including labeling the container at the bedside in the resident's presence.
Observation is a skill in itself. Chart what you see, hear, and measure - objective data - and report what the resident tells you as subjective data. Never chart a guess, and never chart care you did not give.
Traps that show up in questions
- Taking an oral temperature immediately after a hot or cold drink. Wait about 15 minutes, then retake.
- Announcing that you are counting respirations. Instead, keep your fingers on the wrist and count breaths while appearing to count the pulse, for a full minute.
- Counting a pulse for 15 seconds and multiplying when the rhythm is irregular. Count a full minute.
- Recording an estimated blood pressure or temperature instead of re-checking and reporting.
- Charting an opinion such as "resident was difficult" rather than describing the behavior observed.
Worked example / rule of thumb
A resident finishes hot coffee and an aide takes an oral temperature two minutes later, getting 99.8°F. The correct action is to wait at least 15 minutes, retake the temperature, and record the later result. Rule of thumb: when a measurement can be distorted by what just happened, wait, repeat, and report - never estimate.