MN569 FIU Nursing Discussion

I’ve put 3 kids through high school and sports physicals. And reading our assignment this week was eye opening! Knowing the why’s and how’s of the sports physical helped me understand the numerous sports physical visits I have attended with my kids.

Accepting the challenge of the organization’s goal of doing 150 school physicals over the course of 2 days is daunting but a valuable community service for those that don’t usually seek sports’ physicals and an important health visit at a crucial stage in a young person’s life (Colyar & Dunphy, 2019). Because this is a community-based service and it is likely the providers will not “know” or be familiar with all or some of the patients, I think the office-based approach with 3 -4 providers each day would be the best option. This would allow each provider to see 15 to 20 patients each day. The key would be adequate staffing to assist the providers with screening, testing, and history taking and this could be done in more of an assembly or station type environment. The office-based format has each provider seeing a single athlete at a time (Colyar & Dunphy, 2019). It allows for thorough review of the history and giving consultation for young adult concerns. The station format for the screening portion would allow the patient to move through stations set up around a large space and keep distance for privacy.

Utilizing the large meeting space with private exam areas with just screens and tables would be cost effective and allow for the screening and nursing staff to be in the middle serving all the providers. This would still allow for forward movement through stations but counseling time with providers. The disadvantage to the assembly line format is how impersonal “being moved” through stations may feel for the screening procedures. And the lack of continuity from one staff member to another. Communication tools and participation for concerning screening results would need to be in place to assure adequate history and the proper screening is done (Colyar & Dunphy, 2019).

Division of tasks is very much like any other office visit. Clinic and nursing staff collect paperwork and history forms from patients. Screening items that can be performed by nursing staff would include vital signs, visual acuity exam, and history taking. The physical exam would need to be conducted by a licensed healthcare provider like a DO, MD, PA, or NP (aap.org, 2021).  The challenge in the large area setting would be visualizing the musculoskeletal form. Such as screening for scoliosis. Undressing the young adults to have bare torsos would not be possible with just screens for privacy. This would be the most limiting factor to this environment.

In preparing for the program offering, advertising should include the benefits of the sports physical. 3 of the main objectives include determining general physical and psychological health of the young adults, evaluating for disabling or life-threatening conditions, and counseling on healthy life-style habits for a high-risk population (MacDonald et al., 2021). These valuable encounters allow young adults and healthcare providers to come together to discuss healthy behaviors and lifestyle.

I always appreciate my kids ARNP provider. She does diet, exercise, and sexual health conseling. The later done only with their permission or myself stepping out of the room offering for them to have a private conversation if necessary. The text readings and articles helped me understand all the paperwork, screenings, and exams done during my kids encounters. And now I understand how really valuable they were!

References:

American Academy of Pediatrics {aap.org} (2022) Preparticipation Physical Exam (PPE) https://www.aap.org/en/patient-care/preparticipation-physical-evaluation/

Colyar, M. & Dunphy, L.M. (2019) Sports Physicals in Dunphy, L.M, Winland-Brown, J.E., Porter, B.O., and Thomas, D.J. (Eds.), Primary care: The art and science of advanced practice nursing. (5th ed., pp 1275-1280). F.A. Davis Company, Philadelphia.

MacDonald,J,. Schaefer,M., & Stumpf, J. (2021) The Preparticipation Physical Examination. Am Fam Physician. 2021 May 1;103(9):539-546. https://www.aafp.org/afp/2021/0501/p539.html