The Art of Assessment

There is a story about a nurse who was aboard a flight when one of the passengers collapsed with a heart attack. The nurse went into action and started CPR. A physician was also present on the plane, and he too, came forward to help. He stood over the nurse and the collapsed passenger directing the nurse to start an IV in the patient’s arm.

The nurse looked up at the doctor from the CPR kneeling position and said, “do you see any damn IV’s in this airplane?”

She then continued with CPR, helping to save the passengers life. The doctor stood watch providing advice, but he did not know how to do CPR nor administer care without the use of hospital equipment.

To me this story shows how far we have strayed from knowing the basics in our health care world. Some clinicians are unable to help someone, let alone assess and treat them, without the use of sophisticated tools. The art of listening, assessing, and diagnosing with nothing more than the ability to use one’s own senses is becoming a lost skill in Western Medicine.

I think this is why I am so fascinated with learning Chinese Medicine. In these classes, we are learning how different characteristics will manifest a vast array of different characteristics in the patient in areas of the body that in Western medicine we don’t even see as being connected. For example, in Chinese Medicine, the kidney is associated with early gray hair and insomnia means the blood needs to be fortified.

What we are learning in these classes is that it is not just the patient’s complaint and presenting history that are important. We have to look at the entire person, including their emotions, spiritual aspect, climates, tissues, vital substances, sense organs, external manifestations, fluids, odors, colors, tastes, sounds, orifice, time of day, season, as well as environment and history.

None of these observations require any fancy equipment. Everything is done through observation and just listening to the patient. We have to observe the WHOLE patient and not just the complaint point or where it hurts. After all, each organ is associated with different manifests in different locations throughout the body.

I can see this ability to pull all these subtle nuances together and come up with a diagnosis and treatment plan based on just listening and observing is pretty amazing. It is an art.

I feel lucky to be learning how to become a better assessment artist.

The Art of Assessment