I wish I'd have known....B4 nursing school - page 4

What is the one thing that you know NOW, but you wish you would have known BEFORE you started nursing school?:uhoh21:... Read More

  1. by   watersnake
    Hello:

    I didn't mean to ruffle a bunch of feathers out there. Any offense taken is unfortunate. I have my credentialing also, have 23 years of nursing in many areas under my belt. Never on probation, never counseled in a way that mattered so far as my practice goes, never fired. And I smoke Marlboros, and that's that. And I'm not trying to dazzle anyone. I was mentored by an MD who is one of the most brilliant people I've ever met, and I guess his ways of questioning rather than accepting on faith or conformance rubbed off. Unfortunately, he forgot to get haircuts or buy new shoes and such, you know the type. But he taught me a lot about a lot of things, some of which helps me to refrain from insulting you in kind.

    I find it ironic that I am criticized by people who don't know that ad hominum and straw man arguments are fallcious. I appreciate any correction if done in a professional manner.

    My point is this: you can know things, you can know how things act and interact, interperet labs, and we should all be held to that standard based on our skill and experience. So far we agree.

    Science: Now a baseball catcher, for example, has to know his team mates' strengths and weaknesses, know all the batters he is up against, essentially running the game while being a major participant. This does not make him, or the manager, or the team owner a scientist.

    A scientist objectively formulates and tests a hypothesis, observes and reports results, and those results must be reproduceable using similar method. We use someone's scientific results, but we do not in the clinical setting use the scientific method. I am well aware that there are research nurses, biomedical engineers, and all that. I am also aware that funding and support might be withdrawn if the results don't come out the way the money man wants. But that's a side issue.

    Any action or interpretation a nurse takes must be backed up by a doc to whom the nurse reports, who is backed up by standards of care, which are backed up by higher ups and so on. That is not creative scientific practice.
    It is technical skill. The scientist is the person who developed the test, procedure, intervention or whatever. Using a device developed by someone else does not make me a scientist, for if it did, reading a speedometer would grant us all that title.

    Art: I think I adequately addressed that in my post. Caring is not an art. It is a verb, an action, an affect. It is something that must be communicated to have an impact. If we agree, however, that the quality of caring is an art, and that nursing is by definition an art and science, then those few in the ranks who truly don't care, and simply do a job are excluded from being a nurse regardless of how well they perform. Also I am yet to know of a true scientist or artist who punched a clock, or was told how to arrive at his own conclusions, or which color of paint to use, except in the WPA days.

    Psychology and Psychiatry:A disease is defined and continues to be defined as an identifiable lesion or infective process which is troubling and/or threatening to the victim. We have yet to define anything anywhere which accounts for thought process, or thought disorder. As soon as a lesion is noted, it is no longer psychiatry, it becomes the realm of the science of neurology and the psychiatrist is no longer involved except perhaps forensically. To sum that up, give me one example of a reputable medical pathology book that identifies any psychiatric disorder out of the realm of neurology, such as neurosyphillis, tumor, endocrine disturbance and the like and I will be happy to read it. But I'm not holding my breath waiting.

    I respect your opinions and loyalty to the profession. I admire your zeal. I'm not what you seem to think I am. I love my patients as fellow beings. I just don't see that we have an artistic or scientific leg to stand on, or else we would be more highly respected and better paid.

    Respectfully-----Snake
  2. by   Ortho_RN
    That SOME of your fellow co-workers are always looking for something to get new people in trouble for... They think they are perfect.. Its just that when they make a mistake noone confronts them...
  3. by   jerseyRN
    That my BA in another field is virtually worth nothing in nursing. Went to a diploma school. Shoulda gone for a BSN.
  4. by   KarafromPhilly
    Quote from Hellllllo Nurse
    Stop saying that already, Tom!

    My name is Inigo Montoya. You killed my father. Prepare to die. :roll
  5. by   CHATSDALE
    A New Graduate Asked Be If She Should Take A Job She Wanted But That Is Was Only Part Time And Prn I Told Her That In Nursing That Meant 80 Hours A Week Until You Dropped Dead That Still Holds
  6. by   Q.
    Thank you GracefulRN I also found Snake's comments innapropraite and disturbing. I would also like to know if you are a nurse and if so, how many years do you have under your belt. Your comments sound very much like a medical receptionsit who gives out medical advise...useless!!

    Quite honestly, this attitude is what I feel contributes to our demise of the profession.

    Does someone's opinion really gain worth by how many years they worked in a particular field? I mean, honestly. What's the magic number? More than 5? More than 10? More than you?

    And the eliticism brewing from the medical "receptionsit" [sic] comment I find quite, um, what's the word? "Innapropraite" [sic] and disturbing. I've gotten better medical advice from my 89 year old grandmother-in-law than I've gotten from most nurses.
  7. by   Supercalifragilistic
    Quote from KarafromPhilly
    My name is Inigo Montoya. You killed my father. Prepare to die. :roll
    OMG - that is my most favorite movie line EVER!!!!

    Oh, now I know what I'll be picking up at Blockbuster this weekend.... :roll
  8. by   Hellllllo Nurse
    Quote from KarafromPhilly
    My name is Inigo Montoya. You killed my father. Prepare to die. :roll

    Lol, Mandy Patinkin, right?

    What was the name of that movie?
  9. by   plumrn
    My first day on the floor as a student, standing in the bathroom of my very first pt, holding a bedpan with stuck-on poop wondering, 'what am I going to do with this now?'
    I honestly wondered, 'what have I gotten myself in for?'

    That was several years ago, and I've learned a few things since then. For one thing, emptying a pan with stuck-on poop is the least challenging thing I will do in a shift, and not nearly as troubling as it was that first time. I'm glad I was so naive about a lot of things we nurses do, or I might not have ever entered the field, because I really do love nursing. (When staffed well, that is.)
  10. by   Supercalifragilistic
    Snake,

    I am a new nurse and generally find that my work is much less "art and science" and much more technical skills and tasks to be marked off of a long to-do list. However, I disagree with the following arguments that you used in an effort to debunk the "art and science" idea:

    Quote from watersnake
    Nursing has no scientific knowledge base to stand on.
    Ever heard of "evidence-based nursing"? If you have not, you should definitely look into it!

    Quote from watersnake
    ...infective process or a somatic lesion, although that has been the definition of illness since Virchow defined it in 1858.
    (1) I NEVER heard this exclusionary definition of disease before.

    (2) I, for one, am glad we do not live by 1858 definitions/standards anymore...

    (3) Is diabetes a "lesion" or an "infective process"? As far as I know, it is neither...but I think we'd all agree it is a "disease." (And you use it as an example of disease, if I'm not mistaken.)

    Quote from watersnake
    I haven't recently seen any change in the definition of diabetes as a disturbance in metabolism of sugar.
    See my comment above regarding diabetes.

    Quote from watersnake
    Art? Art is self expression. It is hopefully fresh, original, and makes an impact on the listener, viewer, or taster. Aesthetics does not have to be beautiful, but it must convey or provoke an emotional response.
    And this is why caring IS an art - it requires EXPRESSING oneself in a way that makes an IMPACT, and doing this generally does convey or provoke an emotional response.
  11. by   Supercalifragilistic
    Quote from Hellllllo Nurse
    Lol, Mandy Patinkin, right?

    What was the name of that movie?
    The Princess Bride
  12. by   talaxandra
    Coming from a hospital-based background, and with my post-grad qualifications in health ethics, most of my contact with nursing theory has been self-directed. Despite my current academic supervisor's strong championing on nursing theory and professionalism, I must confess that I lean more toward Watersnake's position than that of the majority.
    One article I found particularly interesting was Jef Raskin's "Humbug: Nursing Theory" (http://www.jefraskin.com/forjef2/jef...ryForSite.html), and Quakwatch's on-going debate about therapeutic touch (http://www.quackwatch.org/01Quackery...Topics/tt.html) seems convincing to me.
    THis sounds to me like it could be a whole new thread - any takers?
  13. by   watersnake
    Quote from Supercalifragilistic
    Snake,

    I am a new nurse and generally find that my work is much less "art and science" and much more technical skills and tasks to be marked off of a long to-do list. However, I disagree with the following arguments that you used in an effort to debunk the "art and science" idea:


    Ever heard of "evidence-based nursing"? If you have not, you should definitely look into it!


    (1) I NEVER heard this exclusionary definition of disease before.

    (2) I, for one, am glad we do not live by 1858 definitions/standards anymore...

    (3) Is diabetes a "lesion" or an "infective process"? As far as I know, it is neither...but I think we'd all agree it is a "disease." (And you use it as an example of disease, if I'm not mistaken.)


    See my comment above regarding diabetes.


    And this is why caring IS an art - it requires EXPRESSING oneself in a way that makes an IMPACT, and doing this generally does convey or provoke an emotional response.
    Well, to answer you,
    #1. look up Rudolph Virchow. His definition stands...although ironically, he was responsible for the death of a high official because he knowingly treated him for the wrong disorder. He was afraid the official would not like hearing the truth.

    #2. The quantity Pi has been with us longer than Virchow. I still use it in calculation, how about you? Being old doesn't make it wrong, indeed it often gains validity during repeated use.

    #3. Diabetes can be identified as cellular dysfunction on biopsy, necropsy, and responds (hopefully) to a given treatment regimen. That is science. A lesion may be only a single dysfunctioning cell, believe it or not. This has been investigated in cardiac electrophysiology with profit.

    My point is, that the DMS (the Bible of Psychiatry) invents "disorders", diagnoses change from pathology to non pathology when the big wheels get together to revise it. Homosexuality was a disorder at one time. Now it is only psychopathology if the person is uncomfortable with it, i.e. 'ego dystonic'. And another tragic example: in the late 1840s, runaway slaves were "treated" by white physicians as 'mentally ill', the diagnosis being termed 'drapetomania' which could be 'cured' by frequent beatings. I agree with you there, I'm certainly glad we don't recognise some of the older diagnostic and treatment methods.

    #4. Evidence based? That sounds like emperical treatment, although I will look it up. If it can't be reproduced with the same result using similar method, it's not science. It is opinion. There are 3 sorts of lies: Lies, D*mn lies, and statistics.

    #5. Disclaimer....I love playing the devil's advocate. It keeps my mind fresh to hear different ways of seeing things. "Snake does not necessarily agree with all the viewpoints expressed."

    Keep your zeal.-----Snake
    Last edit by watersnake on May 20, '04

close