Learning H&P - Ugh!

JDCitizen · Jun 14, 2009

I think this is a great example of how as nurses we totally think we can do the MD job and how sometimes it looks so easy. I mean, after all, they look the patient over and spout off the orders and go behind the desk while we are left behind to do "all the work." But the detail in which they cover things and the organized, systematic assessment is definitely a different procedure and one that has to be respected. It takes YEARS, in my opinion, to get this down right.

Hmm. Lets see they (MDs) had to learn and we are talking about someone in class learning. Most nurses in advanced degree programs have something that most medical students do not: prior contact with hospitals, patients and all the paperwork that goes with it. Medical students on the other hand do have vast more amounts of school/clinical time under their belt by the time they graduate.

Multiple hospitals over multiple years I have seen MD's sign off on physicals done by their RNs, NPs, PAs..... I know the background of H&Ps where the transcriptionist uses a preplanned layout were only the expeceptions that were found voiced were the only new words transcribed. I have seen MDs use previous H&Ps as well a consulting MDs use the admission H&P as their own verbatim. I have seen nurses call doctors about thrills, murmurs, ulcers, etc... that were no where documented of H&Ps...

Yep sometimes we nurses can do the MDs job maybe not replace them but work in conjunction with them. Just as the MDs work in conjunction with us.

As an advanced practice nurse and as a nurse that has worked with student doctors and new doctors and doctors with years of experience: I know for a fact that there is a learing curve and even after school there is a learning curve that never stops. Doesnt matter what field your in but with new drugs, new protocols, new techniques, new medications the curve keeps on growing.

You are right there are probably nurses out there that can do an MDs job and can't but on that point depending on the practice realm I have met some that can and even they would say they work "with" the doctors. You are also right that it does take YEARS to get things down right. But if one stops learning yesterdays right is not necessarily completely right today :-)

Oh fun did 7 of those H&P buggers yesterday :-)

allnurses Guide · Jun 17, 2009

And do you ever get better at percussion? Hah - I suck at it!