cnmbfa 4,459 Views
Joined Jan 14, '06.
Posts: 159 (58% Liked)
Superb explanation. Thanks for making it clear that nursing is about THINKING and using information, in context, to address patient problems.
Memorizing will only get you so far. To excel at Pharm, you must understand the drug and then think through the implications of that.
Think Maslow's hierarchy of needs. This is a breathing and circulation issue that can threaten her life, so addressing it comes ahead of all else. Give the Lasix. The rest is distraction, and the issues can be sorted out later.
As a faculty member who teaches this topic, I have found a mostly successful strategy for mastering this. We work in small groups to write a backwards case study. I give them an abnormal lab value, and have them create a story for how it developed (diuretics without eating any K+ rich foods, ran a marathon drank plain water no sodium replacement; borderline renal function using magnesium laxatives, etc) Next they describe the presenting signs/symptoms and the nursing interventions. They end by saying not just what the normal lab values will be, but the other symptoms will resolve. They know they will be handed a lab value and have to create a case on the next quiz. Works well.
OP here, I'm NOT the person she was referring to. The person she was referring to took "it's just a job" and turned around to the person who stated that and launched into "I hope you're never my nurse" and other things of the sort.
Couple of ideas:
Debrief with a nurse you respect. Ask him or her what you could (if anything) do better next time. You may find out that you actually did all you could. That might help you realize that randomly bad things happen to patients that are out of our control. Just do the best you can.
Make a list of all the small early warning signs you caught and acted on in the last 2 weeks. Then make a list of all the kindnesses you showed, and/or how how ability to listen or provide comfort helped someone.
Ask to talk to the chaplain before or after work, even if you are not religious. This person will listen to you, support you, and help you cope.
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