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Assessment requires a head-to-toe check off at the end of the semester.  This is your chance to put all the things you’ve learned in a single semester into one, flowing procedure in under 30 minutes.  The head to toe is exactly what it sounds like: you have a patient (a fellow student) and you check all their bodily systems from head to toe (listen to heart, lungs, bowel sounds, assess skin, ears, throat, nose, eyes, neuro and muscle/skeleton).  It sounds like a lot because it is.  But the key to this is the key to ANY skill check-off: PRACTICE!

We were given an outline and the first thing I did was transcribe the outline (so, I basically made a script). For example, the instructions said: “Testing Upper cerebellar: assess finger to nose or rapid alternating movements.  Must have eyes close for performance of both tests.”  I transcribed this into what I would say as the nurse:

Place your palms on your lap, now turn palms facing ceiling.  Great, now close your eyes and do that as fast as you can.  Rapid alternating movements performed adequately and no lag or difference in arms.

I practiced it one section at a time.  I said it to myself over and over, while I was driving, cooking dinner, in the shower, etc.  I started with the intro.  Then I added the next section (skin assessment).  Then I went back and started from the beginning combining the intro and skin assessment into one flowing script.  When I got that down I added the next section, assessment of the head, and so forth and so on.  I practiced it 10 times before I could get through the entire thing.  Maybe 15-20 times before I got through it all smoothly, not missing anything and within 20 minutes.  This was over the course of 2/3 weeks.  I breezed through it.  It’s doable!

This is a good example of a head to toe.  Of course the requirements and techniques may vary depending on your school/instructor so don’t copy it exactly!