Only charting?

  1. I'm a first year nursing student and to be honest, the majority of what I've seen nurses do is charting and give meds. Is this all I will do?
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  2. 76 Comments

  3. by   Luckyyou
    Yep. All we do is chart and give meds.

    Dude, for real, this is so dependent upon the area you're in. Come watch me run an ECMO pump on an 1800 gram baby and then talk about just giving meds and charting. You know the thing about the duck, that the duck looks calm on the surface of the water but underneath you can't see that the little feet are paddling away? That's nursing.
  4. by   Lightning90
    Yeah i just got done with my first clinical semester and i noticed this to.. Nurses spend a significant amount of time just handing out meds... And documenting... And doing boring ass stuff. However i knew going into nursing school that I didnt want to be a bedside nurse... Youre literally a waiter is how i see it. Ive seen nurses fetching pitchers of water for clients. Smh. For all the knowledge you have...
  5. by   Niquolea26
    My first nursing clinical setting was a rehab hospital that was stroke certified, the therapists were all over but the nurses...weren't. They seemed so well robotic typing away it worried me. My next clinical site is for the hospital and in the med surg ward so fingers crossed!
  6. by   SopranoKris
    I agree with Luckyyou above. I'm an ICU nurse. We do much, much more than just pass meds and chart. You have to think 3 steps ahead all time. Does my patient have low blood pressure? Am I going to need fluid resuscitation or pressors? Are we heading towards possible intubation? What equipment do I need ready in case he tanks? Do I need to replace electrolytes? What are the most recent labs telling me? How is this patient's output? I'm constantly assessing & reassessing my critical patients.

    Any good nurse will always assess and anticipate what the patient currently needs and what they potentially need. If not, you're simply completing tasks, not critically thinking.
  7. by   NICUismylife
    That's because you can't see the nurse's brain working. A nurse is constantly assessing, analyzing, evaluating, and using their knowledge base non-stop. It's anticipating and preventing complications, it's recognizing even slight changes in status to catch that complication before it becomes a larger problem. And then, yes, there's the more complex stuff like running ECMO, checking wedge pressures, managing art lines, or titrating drips.

    But even basic stuff, like a med pass, it's not just reading the order and handing over a med, it's knowing which labs to check prior to administering the med, knowing what it treats, why the patient is taking it, is it a safe dose, what side effects and adverse reactions to monitor for, when to hold it, other drug interactions, etc.

    How far are you into your first year? Have you started care planning yet? Once you are a nurse, you don't fill out those care plans like you do in school, but you are constantly running them in your mind all the time. And not just one or two, but 5 or 6 or 10. Don't get me wrong, it's not that you're thinking them in NANDA format. But you're always looking for s/s of sepsis, skin breakdown, PNA, PE, dysrhythmias, IICP, ileus, bleeding, over-sedation (whatever is specific to your patient) and automatically performing those interventions that relate to those diagnoses. It becomes second nature. So that one care plan that took you an hour or two to put together? That nurse has half a dozen of those in her head all.the.time. And they may change or more be added as the shift progresses.

    While it may appear that the nurse is not doing much, I promise you, there is a lot happening that you don't comprehend yet. It will come.
  8. by   Guy in Babyland
    Like the other posters (with RN after their names) have said, follow an ICU nurse with an unstable patient and see what we do besides pass meds and chart. A lot of times our job is in our head. We are comparing how the patient looked from the previous assessment to the current assessment, are the vitals trending down, is the patient acting different. You need to be observant of changes in the patient's condition especially in the NICU. Babies are very good at compensating until they stop compensating and crash quickly. You need to realize they are "crumping" or as we call it "Trying to high five Jesus" before they crash and you are playing catch-up, then I am not passing meds, but pushing meds and a lot of them.

    crumping: slow change in a patient's condition (over a hour or hours).
    crashing: rapid change of condition over a few minutes.
  9. by   Mavrick
    So true, fellow RN's. It's what's running in the background that makes for real nursing. Many tasks​ may be visible but none of the critical thinking, evaluating, analyzing and anticipating are so readily apparent.

    My first wife (a Civil Engineer from MIT) said it thus, "A well engineered project just stands, it doesn't necessarily stand out." Meaning a well designed bridge, building or nuclear reactor doesn't end up in the headlines for falling down (or blowing up or leaking toxic material) and making news for its failure and calling attention to itself.

    I totally pride myself on a successful PACU shift when "nothing" happens. No re-intubations, rapid response calls, stat transfers to ICU etc. A surgical patient expects to wake up being told their surgery is over and everything turned out great. That doesn't happen just by doing tasks. So what may look like "just sitting on my azz and charting" is actually the tedious result of keeping my mind on the whole picture and using my skills to avert and prevent the disaster that I so often see my less experienced colleagues running around looking so busy dealing with after the fact. And then they spend 30-45 more minutes charting!
  10. by   AceOfHearts<3
    As others have stated, even just charting isn't necessarily just charting. I work on a very busy tele unit with 5 patients.

    While taking and charting morning vitals on a patient in with persistent diarrhea I look at the trend since the morning BP is low. I then see it has been trending down over the last 3-4 vitals. What's a person with diarrhea at risk for? Fluid volume deficit- so I page the doc and get an order to start some IV fluids. Every time I assess them after that I'm making sure I'm not seeing signs of fluid overload- listening for new crackles in the lungs, assessing for edema, etc. I'm "charting" and reviewing labs for the morning since electrolyte imbalance is also a very big risk- yup, the high potassium from the day before is now WDL, but hmmm- there's no magnesium level today and yesterday's level was borderline with no replacement. Add it to a list of things to talk to the doctor about. But oh crap- it now looks like the patient is having a massive run of vtach. Now I'm taking more vitals, checking the patient- they are totally fine. I'm now paging the internal med doc (attending service), calling in a consult for cardiology after getting the order, holding the prep for the GI procedure ordered until cleared by cardiology and notifying GI what's going on. I'm adding on a serum mag to morning labs- calling the lab to have it added on to what was drawn earlier so the patient isn't stuck again unnecessarily by phlebotomy. Oh good, the internal med doc is here and the serum mag results just came back low (like I thought), so now I'm hanging a stat order of IV piggyback mag sulfate. All of this happening by 10:30am and while I have 3-4 other patients to take care of as well.

    That was really how a morning went for me in the last month. If I'd had a student I'm sure it would have mostly looked like charting and giving meds, but it certainly wasn't all that was going on.
  11. by   Extra Pickles
    Quote from Lightning90
    Yeah i just got done with my first clinical semester and i noticed this to.. Nurses spend a significant amount of time just handing out meds... And documenting... And doing boring ass stuff. However i knew going into nursing school that I didnt want to be a bedside nurse... Youre literally a waiter is how i see it. Ive seen nurses fetching pitchers of water for clients. Smh. For all the knowledge you have...
    This is extremely misleading, and even though you have only one semester in nursing completed it shows your ignorance of what nursing is actually all about. Ignorance as in you don't know what you don't know. You say "you're literally a waiter is how I see it" and that tells us that you haven't seen much of anything. Maybe it's because you have been on the floor at very stable times with very stable patients or maybe you aren't noticing the nurses who are killing themselves keeping on top of the unstable ones or the ones who require a lot of care. Maybe as a first-semester student you did not see wound vacs or a CBI or a CPM or those in traction, maybe you didn't see PEGs, either clamped or with feedings, maybe you didn't see patients who had multiple antibiotics and wound care being juggled round the clock, maybe you didn't see trachs, ostomy care, a score of dressings and drains. Maybe you didn't see TPN, or heparin drips. Maybe you didn't see patients on telemetry, which require consistent monitoring. Or maybe you did, but didn't know what you were looking at. Because you didn't recognize what the nurses were doing doesn't mean they weren't busy as all getout. It means you don't know what you don't know yet, you don't yet have "all that knowledge" you speak of. When you do you will look back on this and cringe a little I think. Meantime, pay attention to what you see and learn from those who make it looks so easy it's the same as a waitstaff job
  12. by   Wuzzie
    Quote from Lightning90
    Yeah i just got done with my first clinical semester and i noticed this to.. Nurses spend a significant amount of time just handing out meds... And documenting... And doing boring ass stuff. However i knew going into nursing school that I didnt want to be a bedside nurse... Youre literally a waiter is how i see it. Ive seen nurses fetching pitchers of water for clients. Smh. For all the knowledge you have...
    This is not just a little insulting. Wow!
  13. by   AliNajaCat
    Well, Wuzzie, ya gotta consider that as a new nursing student the OP doesn't know anything more about nursing than the average lay person, which is to say, not much at all. This is why one of the things we can -must- all do is educate everybody we know about the difference between what tasks nurses do and what's running in the background (nice analogy).

    Students particularly get hung up on the lab check off theory of nursing education ("Ooh, you're so lucky, you got to do a ..."), think it's cool to mock planning care based on science and good assessments, and think they're being grownup and sophisticated when they sneer at nursing theory. The smarter ones will keep their mouths shut when this sort of banter gets tossed around in the cafeteria (or on AN by people who should know better). Those smarter ones will grow to be the best nurses because they get what nursing really is, as opposed to the tasks nurses do in the course of many a hospital shift.

    So, OP, here's your challenge: Think about why intelligent and hard-working people would choose this profession, what they put into it, and what they get out of it. You don't know yet. Learn.
  14. by   Pepper The Cat
    Quote from Lightning90
    Yeah i just got done with my first clinical semester and i noticed this to.. Nurses spend a significant amount of time just handing out meds... And documenting... And doing boring ass stuff. However i knew going into nursing school that I didnt want to be a bedside nurse... Youre literally a waiter is how i see it. Ive seen nurses fetching pitchers of water for clients. Smh. For all the knowledge you have...
    Frankly, I think its important to supply my pt with fresh water so they can remain hydrated, have something to take their meds with, and be able to rinse their mouth after using puffers.
    Next time you take a swig out of your water bottle think about how you would feel if you were thirsty and stuck in a bed where you couldn't get out to get some water.
    As for that "boring ass" stuff - I think you've been watching too much Grey's Anatomy.

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