The Assessment station is a 20-minute station and the only one where you meet a real person. Every other station normally uses a mannequin, but here an actor plays your patient.

Before you start: the patient history form

You are given a patient overview history form. It tells you:

  • the patient’s presenting signs and symptoms, and why they were admitted
  • their diagnosis
  • previous medical, surgical, family and social history
  • current medication and any allergies

There is no extra reading time. Reading the form counts towards your 20 minutes, so once the assessor has briefed you and started the clock, read it first. You can keep using it throughout the station.

The station, step by step

  1. Scene safety. Make sure the scene is safe before you go ahead.
  2. Privacy. Draw the curtain or close the door.
  3. Hand hygiene in line with World Health Organization guidance.
  4. Introduce yourself.
  5. Identification check. Ask the patient for their details (their name, and their date of birth or hospital number), check them against the wristband, then against your documentation (the patient history form).
  6. Allergy check. Check allergies the same way: against the allergy band and your documentation.
  7. Explain and take valid consent.
  8. Pain. Ask for a pain score using the 0 to 10 scale and whether they have already had pain relief.
  9. Vital signs. Use the machine for blood pressure and oxygen saturation, and check the temperature. Count the heart rate manually for one full minute, then the respiratory rate for one full minute.
  10. Chart the vital signs and work out the score. Calculate and record the total score accurately. You will be given one of two charts:
  • NEWS (National Early Warning Score) chart for medical, surgical, pre-operative and community patients (at home or in a nursing home)
  • Neurological observation chart for neurological patients, where you also assess the Glasgow Coma Scale, pupil size and reaction to light, and arm and leg strength
  1. A to E assessment: Airway, Breathing, Circulation, Disability, Exposure, done systematically.
  2. Nursing needs. Choose two or three needs relevant to the scenario, based on the activities of daily living model. For example, a patient short of breath with pneumonia may also be at risk of malnutrition, poor sleep and reduced mobility. Include emotional, spiritual or religious, social and family needs too, because this is a comprehensive assessment.
  3. Close. Give the patient a chance to ask questions, dispose of your equipment (saying it out loud is accepted), do a final hand hygiene and finish professionally.

6 top tips

1. Do the ID and allergy checks for real. No pretending. Ask for the details, check the name band and allergy band, then check your documentation. This is a very common fail.

2. Take valid consent properly. Explain fully what you are about to do and give the patient a few seconds to say yes. Do not start until they have.

3. Chart with no errors. The chart is the document your assessor marks. Add your name, the patient’s details, the time, the date and your signature. If you make a mistake, cross through the whole column and start again in the next one. Practise both charts, because you will not know which one you will get.

4. Make your A to E systematic and complete. Use the vital signs you have already taken. Under Breathing, for example, give the respiratory rate and oxygen saturation, ask about cough, wheeze and shortness of breath, and look at the breathing pattern.

5. Keep the nursing assessment relevant. You do not need every activity of daily living. Focus on the main needs for this patient, use the history form as a prompt, and include emotional and social needs such as worries about family at home.

6. Bonus: build rapport. This is a real person. Listen carefully and show care and compassion. If the patient asks a question or raises a problem, deal with it straight away rather than leaving it until the end, even if it costs you time. It is fine to cover fewer nursing problems; it is not fine to ignore your patient. If the assessor asks you a question, answer it straight away.

Practise the Assessment station with a trainer and real clinical equipment on our hybrid course.