Flip, Turn, Crush & Smear

Nurses General Nursing

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Just looking for some opinions here.

I am a nursing student and have been feeling like we do the same things everyday at clinical: assessment, bed, bath, adls, vs, meds, & the rare NG or foley. Today I asked my clinical instructor when we will be advancing to more complex tasks. She replied something to the effect of, "Honey this is it. This is what nurses do. We are here to flip, turn, crush, and smear." That caught me a little off guard.

I know how vital all of those things are to patient care, and realize that the things we have been doing in clinical are the building blocks of nursing, but our classroom instructors keep saying, just get through these basics and then we'll get to the "good" stuff.

So my question is: What's the "good" stuff? In your everyday lives as nurses do you feel like you do more of the "good" stuff or more of the flip, turn, crush, and smear?

:)

I've been a working nurse for 40 years and am still doing new stuff every day

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How are you supposed to get meds in someone who has difficulty swallowing or a gtube?

Vaseline? :D

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Specializes in Utilization Management.
Just looking for some opinions here.

I am a nursing student and have been feeling like we do the same things everyday at clinical: assessment, bed, bath, adls, vs, meds, & the rare NG or foley. Today I asked my clinical instructor when we will be advancing to more complex tasks. She replied something to the effect of, "Honey this is it. This is what nurses do. We are here to flip, turn, crush, and smear." That caught me a little off guard.

I know how vital all of those things are to patient care, and realize that the things we have been doing in clinical are the building blocks of nursing, but our classroom instructors keep saying, just get through these basics and then we'll get to the "good" stuff.

So my question is: What's the "good" stuff? In your everyday lives as nurses do you feel like you do more of the "good" stuff or more of the flip, turn, crush, and smear?

:)

I usually read all the posts before I post but this time I did not, because even if someone else said it, it bears repeating: the tasks you do as a nurse are not what makes you a good nurse.

What makes a skilled, experienced professional nurse is the nurse who combines relatively easy tasks with an assessment for each patient that complements and enhances the medical regimen and helps the person holistically resolve a personal health issue.

The nurse helps patients come to terms--intellectually, spiritually, emotionally--with illness by offering them strategies to deal with pain, disability, or illness.

Doctors, on the other hand, only fix the mechanical human parts.

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How are you supposed to get meds in someone who has difficulty swallowing or a gtube?

Maybe ya just shove the pill in and ram it down with a rod or something.

Oldiebutgoodie

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Specializes in Neuro.
Maybe ya just shove the pill in and ram it down with a rod or something.

Oldiebutgoodie

We could always try what we do with the dog -- stick the pill in the mouth, clamp mouth shut, and blow on her nose till she swallows it.

What would JCAHO think about that? :)

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Thanks everyone, this is all very helpful information!

:)

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Specializes in Community Health, Med-Surg, Home Health.

Maybe after trying to comply with all of the insane, stupid and frustrating paperwork to please regulatory agencies, we will have time to actually be paid for being the nurse we are trained to be.

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In our seriousness, however, once you get out of school, you will be doing a lot of critical thinking and decision making. You are the eyes and ears of the doctor, and you will learn to tell when a patient is not doing well, and suggest alternative plans to health care team.

Here are some true life examples:

1. New pt comes in, doc writes orders, goes home. (This is a community hospital). I read chart, see that pt has Hx of cardiac probs. I call doc, see if he wants pt on tele. ("Oh. Okay"). Put pt on tele, he is in Wenckebach rhythm. Call doc, see if he wants cardiac consult. ("Oh. Okay") Cardiologist comes in, makes all kinds of changes to meds due to heart rhythm. So, this seems simple, but sometimes we have to nudge the doctor to write certain orders.

2. New pt comes in, is a direct admit. Call doc for orders. The doc who told pt to come to hospital is now off duty, and I get on-call doc who knows nothing about pt and is peeved at original doc because he didn't tell her about this. She asks me what she should order. I tell her. (Obviously, basic stuff).

3. Elderly pt, in pain, respiratory issues, is DNR. Moaning, etc. Has Roxinol ordered. Pulmonologist comes in, decreases dose of Roxinol, due to fear of respiratory depression. (Remember, pt is DNR, and is about 95). I call attending, suggest a palliative care consult so that perhaps poor pt can receive comfort care only and move on. Doc thinks this is good idea.

These are just a few examples. Whatever they teach us in nursing school, we are the patient advocate, we integrate the information from numerous data sources around us, we note changes in condition, and sometimes suggest to doc what to do. They are only human, too, and aren't here all the time.

So, it really is more than "flip, turn, crush, and smear". It just seems that way sometimes!

Oldiebutgoodie

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If pill crushing is a JCAHO issue, it's a new one because just last summer my last facility obtained brand new pill crushers for each department, and they are very "Is this JCAHO-approved?"-oriented.

From what I understand pill crushers are okay. JCAHO doesn't like the mortar and pestles -- understandably because they are usually dirty.

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Specializes in Adult SICU; open heart recovery.

That sounds like a bitter, burnt out instructor. I hope she doesn't describe nursing to non-nurses that way. I mean, people watching Grey's Anatomy or House already think nursing is simply about doing the simple, mindless and dirty tasks that physicians shouldn't stoop to do; we don't need nurses disparaging the profession too!

Seriously, clinicals in nursing school can really suck, but there is an end in sight! I remember being annoyed that the people with day clinicals basically spent much of the 7-1 shift giving baths and doing ADLs, while the people in evening clinicals didn't have to fill up so much of their shift with that stuff. And those careplans -- OMG! I don't miss those at all! So much of what they make you do in nursing school is a waste of time; you just have to hang in there. Don't hold your breath for the 'good stuff' in school; I don't remember getting to do anything too exciting in clinicals. Once you start your first nursing job you'll get to do the good stuff :)

Just looking for some opinions here.

I am a nursing student and have been feeling like we do the same things everyday at clinical: assessment, bed, bath, adls, vs, meds, & the rare NG or foley. Today I asked my clinical instructor when we will be advancing to more complex tasks. She replied something to the effect of, "Honey this is it. This is what nurses do. We are here to flip, turn, crush, and smear." That caught me a little off guard.

I know how vital all of those things are to patient care, and realize that the things we have been doing in clinical are the building blocks of nursing, but our classroom instructors keep saying, just get through these basics and then we'll get to the "good" stuff.

So my question is: What's the "good" stuff? In your everyday lives as nurses do you feel like you do more of the "good" stuff or more of the flip, turn, crush, and smear?

:)

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Too funny, although I know the OP is sincere.

Just be patient. Your instructor is basically kidding. She knows there are also mountains of paperwork, the ever-exciting admitting and discharging of patients, the wonderful interacting with all the lovely docs, techs, suits, and families, never-ending phone calls, all interspersed with running to Pharmacy and Central Supply for stuff they don't send you. Oh, and you can include a swing by the smoking area to hunt down your aides, too.

I'm just kidding. There are some challenging and frustrating times but there are lots of good times in Nursing, too. Some people are a joy to work with, most docs are great, some places are fine to work for. You will be a professional nurse and you will help many people, learn a great deal, and pass on your knowledge to patients, their families, and maybe students and new nurses someday. Keep the faith, trim your candle wick, and be a great nurse. :balloons: :lol2: :nurse: :smiletea: :pumpiron: :saint: :saint: :Melody: :smiley_aa :mortarboard: :heartbeat :loveya: :yeah: :yelclap:

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

The things you describe are sometimes important enough to save their lives, or you will be intervening in a rescue....the nursing actions save the patient from a certain bad outcome.

You may go through months and months and moths of just doing the routine and then BAM! You know why you're a nurse.

Sounds like med-surg might not be the place for you. Perhaps ICU, the ER or flight nursing. Good luck!

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