In the course of your work as a health care assistant, you will take hundreds, possibly thousands, of clinician observations. It is probably no exaggeration to say that the main reason for all of these observations is to spot a change in the patient’s condition quickly and accurately – a rise in body temperature that might denote an infection, or a reduction in the amount of fluid taken that might indicate a general deterioration, for instance. We then report these observations to the registered person in charge and he or she is able to determine the next steps – whether to escalate concern to the rest of the team, or continue (or increase) the observation schedule.

But we don’t need to rely on specific times and specific activities to observe for changes in patient’/clients’ conditions. We should be observing all the time for these changes.

Many things that happen to patients/clients that might indicate a change aren’t necessarily captured in formal observations. You might notice that a baby is taking longer to feed than normal, a child is more reluctant to play or eat, an older man is going to the toilet more frequently than usual, a wound dressing seems to smell stronger than it did the last time you looked, a patient who is unable to speak is grimacing and writhing in his seat, a person who has experienced depression in the past seems to be becoming a bit more withdrawn. Some of these things may not be significant, but some may highlight a change in condition that requires closer examination. By constantly using your eyes, ears, nose, touch and knowledge of what is ‘normal’ for the people you care for, you can identify potentially serious changes early and, by reporting them to the registered person in charge, make actions taken to counteract them more effective.

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