Challenges in the Nursing Profession

azhiker96, BSN, RN · Mar 16, 2009

That's a pretty wide open question and I think you'll get a lot of answers, all of them valid. I'll just post a couple that I think are pretty important.

First, a nurse must be able to do critical thinking. She/He must be able to look at an order and determine if it's reasonable given the patient and not just blindly execute it. For example, I saw a nurse come close to giving 25mg of Demerol to a small child because the decimal point was not there or was obscured by the 5. The correct dose was 2.5mg. She only stopped because I saw what she was doing, told her it was wrong and then got the charge nurse involved when she was ready to proceed anyway.

Secondly, you should be ready to question an order that seems wrong. Do it respectfully and usually the order will not be changed but the question must be asked. This comes up most often with me on allergies. Patients will report an allergy to a med that the doctor orders for them. Many of these allergies are not true allergies but to cover your rear and protect the pt you need to clarify the order with the doctor. I had one patient who reported allergies to virtually every narcotic pain medicine. I had orders for demerol IV. The anesthesiologist told me the allergies were not real or at least she'd not reacted to fentanyl given during the procedure. When the pt was alert enough to report pain I asked about her demerol allergy. She said it only happened with PO demerol. (upset stomach) IV was okay with her. I documented the conversation and treated her pain with IV demerol and good results.

Another time I questioned an antibiotic order because the patient had a PCN allergy. The Dr. thanked me and ordered a different antibiotic.

*LadyJane* · Mar 16, 2009

LOL. Sounds like an essay question to go along with a nursing school application. Am I right?

laurenlynne · Mar 16, 2009

azhiker96 - thank you for your input!

*ladyjane* - you're absolutely right! this is part of an essay question that i was asked to answer for my nursing school application and since i'm not a nurse, i'm really not sure why they are asking me this? it's like asking a highschool student what the most difficult parts of college are! i figured i'd tap the wealth of knowledge on this website to hopefully get some kind of idea of what some common challenges are in this profession. hopefully some light will be shed.

i truly appreciate any insight any nursing professionals can give!

vashtee, RN · Mar 16, 2009

At the moment, I am a bit overwhelmed with junkie patients making me feel like a drug dealer.

Midwest4me · Mar 17, 2009

You asked for "ONE of the biggest challenges". First one that comes to mind is time management.

stressgal, RN · Mar 17, 2009

I think the biggest challenge is attempting to be everything for everyone and accomplishing everything on their schedule while knowing the answers to any question . Every other discipline places demands on nurses, have the patient here for this test or procedure, carry out this order by this time, write this order now, paperwork needs to be completed in a timely fashion. Then let's add the demands from patient's and families, allow time for teaching, therapeutic communication and all the nursing tasks that need to be acomplished. You could call it time management but I think some days it's more like hearding butterflies. Just aint gonna happen. Now we are in a "difficult financial era" and need to watch budgets so we do with less staff. I'm soooo tired. :) Love my profession though.

laurenlynne · Mar 18, 2009

Wow! You all have truly enlightened me to what nurses face, as very real challenges. I think it's so commendable that you all face these challenges and address them, as these challenges affect lives. This is very unlike the challenges faced in a corporate setting, for instance. Thank you all for your input, please continue to contribute to this thread if you feel any other challenges - I'm very appreciative to learn anything I can before heading to nursing school myself!

Thanks again.