Nursing Diagnosis? Nursing Diagnosis? - pg.2 | allnurses

Nursing Diagnosis? - page 2

Hello, I got into an argument with my physical assessment lab instructor and I want some feedback. Okay, we did the "ear, nose, throat" lab last week and my partners tonsils were swollen, she said... Read More

  1. Visit  student4ever profile page
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    Quote from JessLpn14
    I think you are going nuts. Go to med school if you want to prescribe meds, or be a Nurse practitioner.
    I am confused by your response here. This is a forum where students come to ask questions and be supported in their schooling process. There is no cause for such inflammatory remarks here. This student is asking a valid question!!! It's very true that in the real world nurses suggest things to doctors - it is not always well taken, but it happens, often with the best outcome for the patient. This student is not saying that she is wanting to prescribe meds - she's just asking where she went wrong and asking how to do it better! Obviously, she knows that nurses do not prescribe meds - she is going on what she knows will most likely be ordered to be done. Just because she got a little off track in that on this one assignment does not mean she needs to be attacked.
  2. Visit  MIA-RN1 profile page
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    Can a nurse perform a throat culture as an independent nursing action, or does it need to be ordered?
    It seems grey to me.
  3. Visit  luvmy2angels profile page
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    Quote from Coopergrrl
    Can a nurse perform a throat culture as an independent nursing action, or does it need to be ordered?
    It seems grey to me.
    Any place I have ever worked it must be ordered by Dr. Don't know for sure if that applies to everyone, this is just my experience.
  4. Visit  Critical Care-Bear profile page
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    Thanks student4ever. Haha I wasn't too offended though about the remark. My school is actually gonna let me start the nurse practitioner program before I finish my BSN because I already have a BS in Bio. I just don't understand why or how it's a whole different ballgame being a nurse practitioner? I mean it's a "nurse" practitioner not a "medical" practitioner or general practitioner or family, etc. Yet, as an NP, all of a sudden you're suppose to think medically. You have to know how to diagnose and what to prescribe, what tests to do, etc. However, as a nursing student, who's going to be an NP, I get repremanded for trying to think like an NP. That doesn't make sense to me. So basically they want you to learn all this in a 2 year master program. The physical assessment book has abnormalities at the end of each chapter, I think they could have included a section on treatments.

    Anyway, thanks for all your responses. Coopergrrl, you have the same name as me, my last name is cooper. I'm not a "she" though. . .
  5. Visit  Tweety profile page
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    Quote from Critical Care-Bear
    However, as a nursing student, who's going to be an NP, I get repremanded for trying to think like an NP. That doesn't make sense to me. So basically they want you to learn all this in a 2 year master program. The physical assessment book has abnormalities at the end of each chapter, I think they could have included a section on treatments.

    You answered your own question. You are a nursing student. Now is the time to think like a nurse. When you're in the NP level courses, then you think like a nurse practioner. Crazy huh?

    Play their game Mr. Cooper, play their game. Life will be easier. Not that you can't be an independent critical thinker, because it's obvious you are. Just in your interactions with your instructors and on paper, think and act like a student nurse. Whether or not it makes sense to you.
    Last edit by Tweety on Nov 7, '05
  6. Visit  student4ever profile page
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    Quote from Critical Care-Bear
    Thanks student4ever. Haha I wasn't too offended though about the remark. My school is actually gonna let me start the nurse practitioner program before I finish my BSN because I already have a BS in Bio. I just don't understand why or how it's a whole different ballgame being a nurse practitioner? I mean it's a "nurse" practitioner not a "medical" practitioner or general practitioner or family, etc. Yet, as an NP, all of a sudden you're suppose to think medically. You have to know how to diagnose and what to prescribe, what tests to do, etc. However, as a nursing student, who's going to be an NP, I get repremanded for trying to think like an NP. That doesn't make sense to me. So basically they want you to learn all this in a 2 year master program. The physical assessment book has abnormalities at the end of each chapter, I think they could have included a section on treatments.

    Anyway, thanks for all your responses. Coopergrrl, you have the same name as me, my last name is cooper. I'm not a "she" though. . .
    I appologize for assuming you are a "she." Congrats on going into the NP field! THat is my ultimate goal, eventually one day! As said above, the trick is to play by the rules. You will learn a lot from your nursing classes (and if you work as an RN before becoming an NP) that will help you to know what kinds of tests to order - nurses are on the front line in that department - they pay close attention to patients' symptoms, and communicate them with the doctor or NP. Watching what doctors order for the symptoms will help you develop that sense, along with the NP training you will receive. Good luck to you in all your endeavors!
  7. Visit  rn/writer profile page
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    Quote from Tweety
    You answered your own question. You are a nursing student. Now is the time to think like a nurse. When you're in the NP level courses, then you think like a nurse practioner. Crazy huh?

    Play their game Mr. Cooper, play their game. Life will be easier. Not that you can't be an independent critical thinker, because it's obvious you are. Just in your interactions with your instructors and on paper, think and act like a student nurse. Whether or not it makes sense to you.
    Well said, Tweety. It isn't only the skills, knowledge, and experience we acquire in school, but also an awareness of the social/professional behaviors expected in the working world. Because this education is interwoven throughout our programs, you won't find courses labeled "How to Keep Your Mouth Shut When You Know You Have Something Worth Saying," or "Communicating Tactfully With Pompous Blowhards." Nevertheless, you will be given ample opportunity to learn the material.
  8. Visit  Daytonite profile page
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    Quote from Coopergrrl
    Can a nurse perform a throat culture as an independent nursing action, or does it need to be ordered?
    It seems grey to me.
    Got me! The fact is that as a practicing RN I would probably do a throat culture, but I would also inform the doc, tell him what I had done and verify that it was OK with him that I had done that. If so, I would write a verbal order in the chart. If not, I would retrieve the throat culture and dispose of it. Besides covering yourself with a doctor's order, most insurance companies won't pay for any lab services without an accompanying doctor's order (just one of the business issues in healthcare), so it's best to get an order.

    However, as a student, you need to follow the rules exactly. That means you notify the doctor and get an order for a culture first, then take the culture.

    In actual practice you would often take a culture and then notify the doctor because the patient is going to be long gone along with his bacteria while you're still waiting for a return call from the doctor. But if this were a possible answer to a NUCLEX question it would be the wrong answer.
  9. Visit  N.S.46 profile page
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    Daytonite,
    Just wanted to thank you for your great SOAP description. I'm taking my pre-req's now but familarizing myself with things I'm going to need to know in the future. This is a big help. Again, thanx.

    N.S.46
  10. Visit  charlies profile page
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    You THINK the P is for plan? Hmmmm.
  11. Visit  Daytonite profile page
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    Quote from N.S.46
    Daytonite, Just wanted to thank you for your great SOAP description.
    You are welcome.
    Last edit by Daytonite on Nov 8, '05
  12. Visit  1Tulip profile page
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    I'm a little concerned about the notion that we have to think/act like nurses up until we get our MSN/APN and then we can think and act like doctors.
    This promotes the notion (that we've worked for eons to negate) that a nurse is a doctor-minus something, a lesser doctor, a doctor's helper. Maybe I'm a fossile, but I always believed that nurses and doctors have different frame-works on which to hang their professional practices even though the "things" we do have broad areas of overlap.

    Doctors approach patients focusing on the symptoms and the underlying disease and then they fix it where possible. Nurses approach patients from the standpoint of health (broadly defined) and identify processes that impair the patient's highest possible level of function.

    I know that sounds mushy and philosophical. But I can see a huge difference between the way PA's function and the way NP's address their patients and approach their work.

    Anyway, for what it's worth, there is a difference between nurses and doctors and it's a lot more than just scope of practice. It's actually how we think.

    Disagree? Agree?
  13. Visit  MIA-RN1 profile page
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    Quote from Critical Care-Bear
    Coopergrrl, you have the same name as me, my last name is cooper. I'm not a "she" though. . .
    heehee....Cooper's not my last name tho! Just a big Alice Cooper fan!

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