How can the signs and symptoms of transurethral resection prostate (TURP) syndrome be identified by nurses? This study aimed to develop a nursing instrument to assess TURP syndrome. TURP syndrome is a complication that potentially occurs during TURP surgery. It is a water intoxication related to hyponatremia and acid‐based imbalance. This syndrome should be recognized early in order to prevent fatality. This pilot study employed a participatory action research combined with statistical analysis for validity and reliability testing. Twenty‐eight Indonesian urological nurses and one urologist medical doctor were engaged in this study. Informed consent was obtained before study outset. The study was entirely accomplished at Muhammadiyah Hospital I and II, Yogyakarta, Indonesia. Pearson's correlations test of each item was measured with correlation coefficient greater than 0·40 considered as evidence of satisfactory item convergence validity. The instrument reliability test was confirmed by Cronbach's α coefficients with score greater than 0·433 supposed as a reliable instrument. This study obtained a nursing instrument to assess TURP syndrome which involved 15 aspects as follows: disorientation, headaches, altered states of consciousness, visual disturbances, nausea and vomiting, hypertension, rhonchi sound, tachycardia, abnormal capillary refill‐time, tachypnea, hyponatremia, hyperkalemia, anaemia, increased urea and creatinine, and lower‐extremities oedema. A nursing instrument to assess TURP syndrome was established. Nevertheless, further investigation is required among patients who are suspected of having TURP syndrome to increase instrument accuracy.