Made a fool of myself to board of nursing rep - page 4

So, a representative from the California Board of Registered Nursing visited our school and asked us for feedback on our program. We had been encouraged to be on especially good behavior during the... Read More

  1. by   Susie2310
    Quote from Jules A
    I personally would have loved getting beefed up didactics if it was not at the expense of skills that are useful and necessary to practice safely upon licensure. That employer and coworkers are responsible for teaching the most rudimentary tasks is embarrassing. Then again I started as a LPN where we actually got and were accountable for hands on skills.
    In addition to the skills, it's the whole critical thinking part of nursing that's getting lost. Using the Nursing Process: Subjective/Objective assessment, nursing diagnosis, planning, implementation, and evaluation. When I was in nursing school we were taught this and expected to do this during our acute care clinicals on our assigned patients. This is a measure of the quality of nursing care from a legal standpoint, and it seems as though many nurses don't even know this.

    A lot of the nurses I see in facilities I am familiar with don't seem to know that as nurses they are required to think independently and advocate for patients when necessary, not just follow orders unquestioningly when they carry out the medical and nursing plans of care.
    Last edit by Susie2310 on Dec 1
  2. by   canoehead
    I think the OP has made an important point. It makes sense to start people with basic nursing skills, and move up. Approach every task knowing why it is done that way and how each part affects the patient. There are nursing only responsibilities that the OP should be comfortable with before she tries to predict physician orders. The school is doing you a disservice if they try to dump you in the deep end (NP) before you have some time to get comfortable with RN responsibilities.

    I think the patho/assessment should be part of every task we do, and you should know your meds and why they are appropriate for your patient. BUT as a new RN, you need to concentrate on nursing issues before physician issues. We coordinate every department for the patient's benefit. Yes, that includes making med suggestions, but the nurse is expert in knowing what else/who else could help besides drugs. Almost any symptom can be treated with something besides a pill.

    OP you have a valid point.
  3. by   Orion81RN
    Quote from Susie2310
    In addition to the skills, it's the whole critical thinking part of nursing that's getting lost. Using the Nursing Process: Subjective/Objective assessment, nursing diagnosis, planning, implementation, and evaluation. When I was in nursing school we were taught this and expected to do this during our acute care clinicals on our assigned patients. This is a measure of the quality of nursing care from a legal standpoint, and it seems as though many nurses don't even know this.

    A lot of the nurses I see in facilities I am familiar with don't seem to know that as nurses they are required to think independently and advocate for patients when necessary, not just follow orders unquestioningly when they carry out the medical and nursing plans of care.
    Then exactly how is it that you are disagreeing with me? Everything you stated here is my belief, is what I have been stating that you claim to be laughing at. Your statement here does NOT appear to be OPs belief. So which is it?
  4. by   FolksBtrippin
    OP,

    For what it's worth, you did not make a fool of yourself. You were speaking what a lot of student nurses are thinking. It was a fair question.

    That having been said, you will be the one with the patient and you will need to make a lot of decisions and be able to ask for and anticipate orders.

    You learn most of the technical stuff on the job. You pick up some of it in nursing school, but not necessarily and you certainly don't master it there.

    We don't really know what nurses actually do until we get there and do it. But we start to get an idea in school.

    So, now you know. You've got to have a basic understanding of patho, pharm, and excellent ability to prioritize needs. Cause thats what you will be doing.
  5. by   Coloradonurse1983
    Patho and critical thinking are required in our job. But not at the expense of not learning basic nursing skill and using them in school. This is why staff nurses are putting their feet down and refusing to precept. Nurses are graduating without a basic concept of how to work the floor. They have to be hand held too much.
  6. by   Kooky Korky
    Quote from klone
    Gone are the days when nurses are physicians' handmaidens and we blindly follow orders. You need to know much of what the physician knows so you know whether or not it's an appropriate med/treatment/intervention. If you carry out an inappropriate order, YOUR license is on the line.

    And yes, pathophysiology is incredibly important to know. Nursing is not tasks.
    Isn't Nursing tasks plus knowledge? Certainly there are tasks to learn, to master.

    Nursing professionally includes understanding why we do what we do, why the docs order certain meds and procedures.

    The nurse if the backstop, the last person who can catch wrong med orders, wrong or incomplete various other orders. So there is a great deal you must learn.

    Best wishes.
  7. by   RNbubu
    It seems to me you don't have a good understanding about the roles of an RN. You need to know all of this. Knowing pathophysiology is a must. Knowing how to do nursing skills is only one part of the job. Everyday physicians are asking for my input when developing the plan of care. I always ask myself, why are they ordering this (whether it is med, a new treatment, or a diagnostic lab) and is this appropriate for my patient. And countless times I questioned orders that were inappropriate. Countless times I also questioned orders and the MDs helped me understand the reasoning behind it. It is a partnership between nurses, MDs, RTs, PTs, and everyone else. The more you know the better - better outcomes for your patient too.
  8. by   fauxbadbitch
    This sort of learning will eventually help you in the long run. Nursing "tasks" are things we all do and probably have learned, for the most part, on our first job. It seems you are getting an above average view on what physicians will want and that is a great skill to have directly out of school; it will help you much more than you believe at the current time. Deal with it and learn from it while you are a student because these learning opportunities will not come around as often later when you are working on the floor. I graduated from a very intensive nursing program and, looking back, I wish I would have paid more attention in school and learned what they were teaching me about the different diagnoses and treatments commonly ordered than I did. My first year on the floor would have gone much more smoothly than it did had I done that.

    Listen to everything and anything you are taught regardless of how it may seem to you at this time. You have no clue at all about what actual nursing is and need to absorb these things while you can fall back on being a student. Listen to everyone you come into contact with during clinicals and lecture time; believe me, you can learn so much from the experienced techs on the floor than you think you can. Don't ever think any task is "below" or "above" the scope of a registered nurse because very soon you will find that you are responsible for many, many things that you never knew were in your scope of practice or job description.

    Bottom line: Be extremely humble and absorb anything and everything you are taught, don't complain about having too much to do or learn, and especially, don't put off learning opportunities because it isn't in your "scope"...you will find these things to be at most important to you when you are working on the floor and will value how hard people have been on you during your journey to becoming a nurse...STOP COMPLAINING and I wish you the best

    BTW I have found nurses to be some of the biggest ******* alive today, learn to be able to contend with them!

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