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Having difficulty in nursing school

Hello all,

I'm currently in an accelerated nursing program (BScN) and this is a second degree for me, as my first degree was in biology. I'm about half way through, and the greatest criticism I receive from my clinical instructors is that I am too task-oriented and should utilize relational practice more often, as the focus is on forming a 'connection' with the patients and their families. The theory courses that we're taking insinuate that the biomedical model should not be used in nursing practice (as it's more suited for medicine). However, I always felt that in modern nursing, it would be used more often. By nature, I tend to be very task-oriented and forming 'connections' doesn't come easily for me. Aren't we there to promote their health and well-being, by performing nursing tasks so that they can be discharged? I feel as if I don't understand what nursing is anymore. Is being task-oriented a bad thing?

TheCommuter, BSN, RN

Has 14 years experience. Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I am also task-oriented, so I feel you. Task orientation is excellent for getting things done and managing your time, but your patients and families do not give a hoot about all the tasks you need to accomplish in the limited time frame you have.

There's a saying: patients do not care what you know until they know that you care about them. Patients remember how they felt around you; likewise, they couldn't care less about your biomedical knowledge in their time of need.

Human nature is bizarre in that people will select the faker shaker over the real deal because the fake person fits neatly into their narratives. When the choice is between a real deal nurse who might have a dry personality, and a phony nurse who makes the patient and family feel safe and loved, the patient and family will select the phony nurse every single time. The phony nurse might not give a rat's ass about the patient, but what's important is that the patient perceives there is a connection.

So, yes, you need to build your relational skills. In nursing it's not about what you know. It's about who you know and how you make them feel.

xokw, BSN, RN

Has 5 years experience. Specializes in Public Health.

Aren't we there to promote their health and well-being, by performing nursing tasks so that they can be discharged? I feel as if I don't understand what nursing is anymore. Is being task-oriented a bad thing?

Nursing goes well beyond tasks. These are a part of nursing, but so are the other aspects. I encourage you to use the CNO as a resource as they have abundance of information available.

TheCommuter, BSN, RN

Has 14 years experience. Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Nursing goes well beyond tasks. These are a part of nursing, but so are the other aspects.
Yep, I concur. Nursing also incorporates fulfillment of the patient's psychosocial needs, safety, and spiritual needs. Ensuring the patient's emotional well-being through therapeutic communication, appropriate touch, and caring behaviors helps fulfill those psychosocial needs.

NurseGirl525, ASN, RN

Specializes in ICU.

You first need to understand the nursing model as compared to the physician based model. Physicians diagnose and treat the disease itself. The nurse treats how that person responds to the disease, whether it's the physiological or psychosocial aspect.

You are treating the person. Therefore, you need to develop a relationship with that person. I'm also a task-oriented person. I think though your instructors have phrased it wrong. Make sure you are listening to your patient and their needs. Diseases can be devastating. And the disease affects everything on that person. You need to acknowledge your patient while doing tasks to actually treat them properly. Having a good relationship with your patient is just as important as treating the physiological aspects of that disease process.

You need to learn that balance.

missmollie, ADN, BSN, RN

Has 4 years experience. Specializes in Neuroscience.

Work on therapeutic and nonverbal communication. Even if you are more task oriented, you can still learn how to listen and make others feel cared for. Nursing is sometimes more than just the patient, it involves the family. Often, the most important thing I do isn't pass meds or do a dressing change, although those are important. Sometimes it's giving the family a moment to tell why they are here, and letting them know that I'm here for them as well. Listening and providing education is a very important part of nursing.

I am an introvert and talking about tedious things like, "Oh the weather is so great today!" just sucks.my.soul. So at first, talking with patients was exhausting to me. But over time I was able to learn to have in-depth conversations that were actually interesting, and made us develop a connection. This was invaluable when I'd have another more critical patient and I'd be able to tell them I was still aware of what they needed and that I'd be back - they'd be able to trust that I would indeed come back.

As for where nursing is - my first semester I took an entire class called "Nursing as Caring" based on the book by Boykin and Shoenhofer and you guessed it, it was allllll about being a caring person. The class was terrible on all sorts of levels, but reminded us that nursing is not just checking off items on my list, it's about the actual people! Think about why you became a nurse. Was it the money or so you could feel busy at work? Or was it because you wanted to help people?

Edited by MountainBikeChick
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