Before the First Obs
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How much information does an experienced nurse actually gather before taking the very first set of obs?
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HODA-A™ Clinical Insight Series · Publication 011
Before the First Obs
Why better observation matters more than better charts
Dr Jo Abbott, PhD — Clinical Biomechanist · Anatomist · Clinical Nutritionist · Independent Musculoskeletal Researcher
How much information does an experienced nurse actually gather before taking the very first set of obs? Not just from the chart, but through the trained eyes and hands that develop over years at the bedside — and that almost nobody has ever been taught to examine, train or refine.
Nurses are healthcare’s early-warning system. Scoring charts and track-and-trigger systems have made observations more standardised than ever — and yet ward experience keeps teaching the same lesson: it is so often a nurse’s sense that something isn’t right that comes before the numbers change. That perception is real. It is clinical information. And it deserves to be trained rather than left to chance. In this eleventh publication of the HODA-A™ Clinical Insight Series, Dr Jo Abbott draws on eight years of doctoral research into how skilled clinicians become measurement instruments.
Written for nurses, nurse practitioners, community and practice nurses and healthcare assistants, Before the First Obsexamines the clinician as instrument — how attention, expectation and context shape what we notice; why experience alone is not calibration; and why recognising deterioration is rarely just a question of numbers. Its central argument: before we test reliability, we must stabilise the instrument.
Includes written feedback from HODA-A™ participants across the hands-on professions, selected further reading, and an introduction to the Level 1 Perceptual Calibration Certification — including private team cohorts for groups of eight or more, well suited to ward teams and community nursing services.
Format: Free PDF download · 10 pages · may be shared in full and unaltered
Series: HODA-A™ Clinical Insight Series, Publication 011
Published: July 2026 · © 2026 Dr Jo Abbott
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