QUESTIONS from a new Nursing Student

  1. [quote=drysolong]
    my post could also be titled " things that make you go "hum?"
    or "everything i ever wanted to know about nursing" here goes,

    in my experience as patient, i know that when a male physician does certain exams, a female nurse is called. approximately how old is this practice? i can see the need for it, but what happens when a male is examined by a female doctor, nurse practitioner, etc., also, does the witness have to be a member of the same sex as the patient?

    also, lately when i visit friends in the hospital, i only see nurses working at the nurses's station. what are they doing? and, it "seems" that the only personnel that go into the patient's room are the doctors, cna's, pct's, lab, etc. i don't know if i'm observing correctly. but as a lpn student, who eventually wants to be an rn, i'm already trying to figure out ways how i as an rn can maintain close patient contact. i may change my mind once i'm really in the field, but right now, patient contact is very important to me any thoughts? (also, i hear comments from lpns, cnas, ptcs, that they do all the work and the rn's just give orders and medications)
    Last edit by Drysolong on Jul 1, '04
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  2. 5 Comments

  3. by   RN4NICU
    [quote=drysolong]
    Quote from drysolong
    my post could also be titled " things that make you go "hum?"
    or "everything i ever wanted to know about nursing" here goes,

    in my experience as patient, i know that when a male physician does certain exams, a female nurse is called. approximately how old is this practice? i can see the need for it, but what happens when a male is examined by a female doctor, nurse practitioner, etc., also, does the witness have to be a member of the same sex as the patient?

    also, lately when i visit friends in the hospital, i only see nurses working at the nurses's station. what are they doing? and, it "seems" that the only personnel that go into the patient's room are the doctors, cna's, pct's, lab, etc. i don't know if i'm observing correctly. but as a lpn student, who eventually wants to be an rn, i'm already trying to figure out ways how i as an rn can maintain close patient contact. i may change my mind once i'm really in the field, but right now, patient contact is very important to me any thoughts? (also, i hear comments from lpns, cnas, ptcs, that they do all the work and the rn's just give orders and medications)
    well, to your first question, if the witness were not the same sex as the patient, it would defeat the purpose. wouldn't you feel a little more comfortable, if you were the patient, having someone of the same sex in the room rather than two people of the opposite sex observing you in all your glory? plus, it protects the practitioner from allegations of "misconduct". if two men were doing a pelvic on a female, the allegation would probably be "gang rape" rather than "misconduct".

    and your second question - keep a few things in mind:
    1 - when visiting friends you need to realize that the rn taking care of your friend has more than one patient (if on a medical/surgical floor, it could be closer to 6-7). just because the nurse doesnt sit in the room all day, doesnt mean he/she never goes in there.
    2 - everybody has their own little song of sorrow about how they work hard and everyone else just sits around. everyone works hard or they wouldn't be there - hospitals would find a way to eliminate the position of someone who just sat around...they are all about cutting costs.
    3 - if you become an rn, you will have patient contact out the yin-yang so don't even worry about it. you will have other responsibilities as well, which leads to:
    4 - the nurses at the station are taking off/reviewing orders, calling physicians, calling ancillary departments to coordinate care, calling other disciplines regarding a patient's needs (paging resp. therapy for a tx or a blood gas, calling lab and asking about a result that should have been ready an hour ago, calling dietary to ask them to stop sending your diabetic patient up a tray full of fruit juices and milkshakes because it makes their glucose go thru the roof - duh.) and charting. the chart is the legal record of the person's medical treatment, which makes it just as important as anything else the nurse does for the patient. it can also be very time consuming.
    5 - there are other people at the station, not just rns -- the unit secretaries tend to hang out there, as do the cnas, lpns, etc.

    good luck to you.
  4. by   Drysolong
    Quote from rn4nicu
    well, to your first question, if the witness were not the same sex as the patient, it would defeat the purpose. wouldn't you feel a little more comfortable, if you were the patient, having someone of the same sex in the room rather than two people of the opposite sex observing you in all your glory? plus, it protects the practitioner from allegations of "misconduct". if two men were doing a pelvic on a female, the allegation would probably be "gang rape" rather than "misconduct".

    and your second question - keep a few things in mind:
    1 - when visiting friends you need to realize that the rn taking care of your friend has more than one patient (if on a medical/surgical floor, it could be closer to 6-7). just because the nurse doesnt sit in the room all day, doesnt mean he/she never goes in there.
    2 - everybody has their own little song of sorrow about how they work hard and everyone else just sits around. everyone works hard or they wouldn't be there - hospitals would find a way to eliminate the position of someone who just sat around...they are all about cutting costs.
    3 - if you become an rn, you will have patient contact out the yin-yang so don't even worry about it. you will have other responsibilities as well, which leads to:
    4 - the nurses at the station are taking off/reviewing orders, calling physicians, calling ancillary departments to coordinate care, calling other disciplines regarding a patient's needs (paging resp. therapy for a tx or a blood gas, calling lab and asking about a result that should have been ready an hour ago, calling dietary to ask them to stop sending your diabetic patient up a tray full of fruit juices and milkshakes because it makes their glucose go thru the roof - duh.) and charting. the chart is the legal record of the person's medical treatment, which makes it just as important as anything else the nurse does for the patient. it can also be very time consuming.
    5 - there are other people at the station, not just rns -- the unit secretaries tend to hang out there, as do the cnas, lpns, etc.

    good luck to you.
    [color=#339966][font='times new roman']thank you for taking the time to reply. your info is very helpful. i just know i am going to love being a nurse, even when i'm tired and overworked[font='times new roman'].
  5. by   Drysolong
    In one of my classes, we learned the basics of Vital signs and Infection Control. My questions is about taking Blood Pressure and pulses. I am a novice, so even the simplest duty was rather new to me. I've gotten the radial pulse down. But my real problem is finding the other pulse sites. I passed on demonstration of my skills, but I don't feel competent. I know I will have time to practice these skills, but I would like to know this really good now.

    I and my classmates were making a big deal about finding the brachial artery to take the pulse with stethoscope and our teacher told us not to worry so much about that, but to just take the reading. But I can't hear the sounds, and I think it's because I don't have the stethoscope positioned on the brachial artery. What am I missing? Also, how often do you in real world take pulse at all the various sites? Also how many of you use stethoscope to take blook pressure? Thank you
  6. by   RN4NICU
    Quote from drysolong
    in one of my classes, we learned the basics of vital signs and infection control. my questions is about taking blood pressure and pulses. i am a novice, so even the simplest duty was rather new to me. i've gotten the radial pulse down. but my real problem is finding the other pulse sites. i passed on demonstration of my skills, but i don't feel competent. i know i will have time to practice these skills, but i would like to know this really good now.

    i and my classmates were making a big deal about finding the brachial artery to take the pulse with stethoscope and our teacher told us not to worry so much about that, but to just take the reading. but i can't hear the sounds, and i think it's because i don't have the stethoscope positioned on the brachial artery. what am i missing? also, how often do you in real world take pulse at all the various sites? also how many of you use stethoscope to take blook pressure? thank you
    pulses and blood pressure - can be difficult at first, but get easier with time and provide critical information about your patient (many people think of them as mundane "chores" but they are important parts of the assessment).

    i take pulse at all the various sites at each assessment, but - to be fair - i work in an intensive care environment. if you felt a distal pulse at 8 and do not feel one at 12 - red flag - where's that doppler? i guess it is not done as frequently in med/surg, but it really provides important information about cv function, hydration status, bp (as systolic bp drops, you lose your distal pulses - patient may start exhibiting s/s shock - if you can feel a carotid pulse, sbp is usually at least 60. if you can feel carotid and femoral, sbp usually at least 70. if you can feel the radial, sbp usually at least 80) and perfusion (has your patient had a recent fem/pop? did you lose your pedal pulse in that foot all of a sudden? better call the surgeon!!)

    dont mistake the position of the antecubital vein for that of the brachial artery - a common mistake i see is people going for dead center with their stethoscopes. the brachial is on the inner 1/3 of the arm (closest to the body).

    i never use a scope to take bp (haha - try that procedure on a squirming 450 gram infant! that would be one for the nursing olympics!). with adults, i would be ok with accepting the dinamap readings for med/surg patients (although i would recommend checking a manual if you get a funky reading).

    i accept the art-line reading for icu patients (as long as the wave form is ok) and palpate the bp for patients in shock - for really shocky patients, may have to doppler the bp, but hopefully the patient would have an a-line at that point.

    manual bp is a good skill to master. if you need a bp and the dinamaps are in use/not working/not available, just slap that cuff on and get to it. it really does get easier the more you do it - just like anything else.
  7. by   Drysolong
    [quote=rn4nicu]pulses and blood pressure - can be difficult at first, but get easier with time and provide critical information about your patient (many people think of them as mundane "chores" but they are important parts of the assessment).

    thank you. i've printed your response. helps a lot!!

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