Can Someone Be a Nurse Without Jean Watson?? - page 16
Ok now, as I delve back INTO nursing philosophy and theories, I come across, again, the theories of Jean Watson that have been hailed as the greatest thing since polyurethane IV bags - The Caring... Read More
Sep 25, '02OK, Quick questions.
1. How many RN's, LPN's, and LVN's respectively, in the USA?
2. What source would be the most feasible if no one can answer
3. How is change initiated? First procedure to do that is...
Sep 25, '02I have known some very technicly talented nurses that dident seem to care much about the patients.
In my opinion they were not good nurses. Technical skills are important but careing is the very heart of nursing. If you dont care about your patients and people in general then you should not be a nurse.
It is true that science intelegence and technical skills are important but these are simply tools the nurse uses to express compasion for their patients and bring them to their highest possible level of health (becuase they care).
In the begining of nursing it was less about outcomes and more about comforting the sick. We live in a wonderful time where many of our patients can return to a very high level of functioning and now we can use the nursing proccess to heal as well as comfort.
Please, If you have reached a point were you no longer care about your patient, get out of nursing. Become a legal nurse or a drug rep or heck go back to school and become a Doc. I cannot see why anyone would stay in nursing if they dident care. The money isent that good hours are demanding and wow does it get busy not to mention getting yelled at by everyone from houskeepers on up to doctors.
Sep 25, '02Hey, you can care about getting an excellent outcome without caring specifically about one patient. Think about how you cared for the last person your found personally repulsive.
I would argue that an RN skilled and aware of meshing all aspects of care will take a look at what we are doing as a health care team from the patient's point of view and make adjustments. That could be interpreted as "caring" about the patient that no other profession currently does.
I also think that LOS/costs would be justifiable if we looked at the outcomes when an RN with these skills is doing direct bedside care, not just in a resource management committee. For example- the RN knows that for a septic pt the labs are the most critical result as opposed to Xray, and they take the most time to get back, and that pt does not look like an easy IV stick. So he/she will call lab to draw before Xray takes their picture, and then instruct lab to draw with a butterfly if possible and will stand by to give whatever abx can be pushed through their site. Also will watch for VS changes with position changes and needle sticks and will start fluid, hold meds, while procedures are taking place. No other profession knows and uses info from so many different depts to get needed care to the pt more efficiently. In fact I think we can all agree that someone just running through the "to do" list on this pt might not get the abx in for an hour (if anesthesia was needed to start the line) and the nurse in question did it immediately. Plus all the ongoing monitering of changes in the meantime.
How many professionals/family members notice when you as a nurse see a dropping BP, lower the HOB, stop/hold a med, repeat vitals after a minute, started O2, get IV started just in case, draw the needed lab tubes from the IV cath, and report all this to the MD? They see a vitals check, and then the MD comes in and says that based on vitals and symptoms we are going to do XXX.
BUT THE NURSE JUST CUT 30 MIN OFF THE ASSESS/INTERVENTION TIME, AND MAY HAVE AVERTED A PT CRASHING!!
We need to get credit for this, and teach new RN's that this is the difference between a UAP doing tasks and a professional nurse.
Sep 25, '02Originally posted by Dayray
Please, If you have reached a point were you no longer care about your patient, get out of nursing. Become a legal nurse or a drug rep or heck go back to school and become a Doc.
In addition, I think physicians get a very bad rap. They DO care.
Sep 25, '02Originally posted by Glad2behere
OK, Quick questions.
1. How many RN's, LPN's, and LVN's respectively, in the USA?
Sep 25, '02To: Glad2behere: I think I have some of the data to answer the questions you asked in my file cabinet somewhere. Later this morning, I will look for and post it. The government and the state boards of nursing keep those stats and I have been saving them as I find them.
"talk" to you later,
Sep 25, '02Thank you Suzy,
That's a lot!
I hope llg's figures confirm that. I read that figure somewhere too, but an unable to find my source. I put them in one of those special places....if you can find the documentation please post it.
Sep 25, '02Forgive me for holding onto the words but not the speaker. Somewhere in the last 4 days of discussion nursing was described as the highly skilled, scientifically based, problem solving, multi-task, competently confident guardianship of the patient. It seems like a good and defensible definition of nursing.
As llg said using a problem solving method does not distinguish nursing from the other professions. The human and theoretical premises which underlie the utilization of the problem solving method are precisely what distinguish nursing from the other "caring" professions. I had the great good fortune to have had all of my basic nursing education guided by the Roy Adaptation model of nursing. What this meant was that every instructor in both the classroom and clinical area spoke within the intellectual framework of the model. The model was not simply something we tacked onto a nursing care plan as an afterthought, but was an integral part of the thinking process we were taught. Over the years I have found that I think far less about the categories of the model than I did as a student. That is probably to be expected. But, when I find myself confronted with a problem or issue that demands analysis I fall back immediately to applying the model. The activity of focusing on the behaviors and the immediate, secondary and tertiary factors that support the behaviors helps me work through the problem.
I have never thought of the Roy Adaptation model as providing a theory of nursing though I am aware that Calista Roy would disagree with that statement. I am also aware that there are a lot of people who find the Roy model cumbersome and unwieldy. And at the beginning it was all that and more, but so is any system where you have to do a full bio-psycho-social careplan for a person having minor surgery. That's school. In the real world, I find I selectively use the categories of the model to deal with issues of concern. What the model provided me as a student and minimally experienced nurse was a framework for critical thinking. Those areas of thought that so many people have to learn by trial and error, and through the longsuffering patience of preceptors and coworkers, I found to have been facilitated by having learned to think about physical, as well as psychosocial needs, in a systematic manner, i.e., according to the categories of the model.
And, yes, I learned the model in a two year AA program.
To those who would say that they don't like or believe in models or theories, I would have to say that it is quite possible to become a good nurse and never have learned a specific model. But, my suspicion is that you had to learn how to think like a nurse on your own. My question is, why do it the hard way, when it is possible to teach people to think like a nurse using a model?
And lest I fall into the trap I identified, I am using the term model to mean a framework that describes the step-by-step process a human being goes through to accomplish an end.
Sep 25, '02To SuzyK:
The most comprehensive source I know of for information about RN's is the US Department of Health and Human Services -- the Health resources and Service Administration -- Bureau of Health Professions -- Division of Nursing report that come out recently. That data is from the year 2000 and makes a lot of comparisons between 2000 data and 1980 data. That 121 page report can either be purchased in book form (which might be available in a library) or can be downloaded and printed directly from their web site.
The specific web site for the document is:
If that doesn't work, go to the "hrsa.gov" site and then to the Burea of Health Professions, etc. to get to the report. If you go through their "information center" pathways, you can buy it but not view it online.
As for LPN data, I don't know. The information I have about my state came from the State Board of Nursing's web site. However, when I went to the National State Boards of Nursing (nsbn) web site, I was very disappointed.
Sep 25, '02llg,
Thank you for the site!
This will be very useful. 2.2 million RN's ! Doesn't include the LPN's or LVN's! Woweeeeeee! Much better than I thought!
I think 2.2 million people as an organized body around one central philosphy may seek and initiate beneficial advances for healthcare. Wow! A new frontier.
Sep 26, '02Ok, I am posting again to keep this thread alive and well! Part of my caring inherent in my infrastructure as a nurse. (laugh)
Food for thought. If the above figures are reasonably accurrate, anyone care to postulate what they would be factored by a reasonable multiple of ten? X 10?
Have a good impact on nursing and healthcare. Any pet research projects having difficulty obtaining funds for? Perhaps if your request was duly submitted in a democratic fashion its merit and funding could be open to discussion in the next county meeting where it could be presented on a state level.
Any mind enriching ideas?
Sep 27, '02Glad2behere:
You seem to have a lot of good ideas about converting our musings into political action. I am a bit curious ... are you currently an active member of any nursing organizations that are already trying to do some of things you are suggesting? Many organizations try to fund research projects, etc. ... but can't seem to find the members to keep their efforts going.
Sep 27, '02llg,
Answer to your question, NO.
Reason if there is a good one and I agree there really isn't.
I should join a minimum of the ANA, and today I will.
However, even though I do take issue with the structure and command of an organization, my primary apathy regarding membership of any organization is the net effect of their dismal recruiting efforts as you stated, directly observable in the membership tally.
I can never remember a representative of such organization visiting a workplace to recruit. This is common in virtually any other business. Open a new independent business and wait to see how long it takes the NFIB to visit...and they always leave with money and renewed memberships, and a very comprehensive detail of groundwork being done and projects completed, and very good information on lobby efforts, who the friends and enemies are. When they leave, one feels a sense of unity and focus, participation and belonging. And what is really great is when they come by totally unsolicited to ask ten minutes of time to write down what new concerns may have arisen. Open the briefcase, and wow, 150 pages of haphazard notes scribbled by other business owners. Upon the next visit, complaints by other business owners are categorized and presented as a percentage. A poll is constructed to verify and emphasis of the organization are directed to resolving the higher percentage issues.
We do not have that intense leadership. When our kind have to join the AFL-CIO to be heard, it means one thing. We are having to borrow leadership. That is being done because ours is obviously being perceived as ineffectual. To expect a purely volunteer membership with any power to initiate philosophical changes is flawed and no directional. There is no way with this system to unite the burned out nurses or the new grads, and the end product has no coherent voice.