How did she/he get through nursing school?

Nurses General Nursing

Published

I have more than one coworker that I'm amazed that they got through school. I really like them, but marvel at their cluelessness. These are not new nurses, to say the least.

Specializes in ICU, LTACH, Internal Medicine.
I can see myself making that phone call. I would certainly feel dumb afterward bc it is so obvious. It's a duh moment I would just laugh about. It doesn't mean I don't fully understand the pathophysiology, pharmacology and HD process. Now, if concepts are often missed by the nurse and not just a single "duh moment" then there is a problem.

I would say that where I am (mixed acute med/surg - not ICU and LTC) calls are divided as below:

- 15 % housekeeping. Travel with/without tele, order continuation, consult opinion, etc. No problems with it.

- 5% or less true emergencies. No problem with it either.

- 30% - non- emergencies, at least borderline appropriate. Postoperative patient on high dilaudid is expected to be constipated, and if he is, it is not necessary to call at 11 PM for that. It can wait till tomorrow, I assure you.

The call about colchicine goes into this category. As well as majority of calls about "something for something" - after all, here everybody is truly powerless otherwise.

- the rest 50%:

- patient is on stable coumadin, INR 2.5, calling to let you know it at 3 AM

- ST elevation (chronic LBBB, no changes otherwise)

- BP 94/55 at 3 AM., HR was 60. Baseline when awake low 100th/60th, RR called already, bolus is going

- BP 80/40, patient lies on left side (as he always sleeps), BP was taken on the right hand, in this position. Reasoning: customer service

- something for cough after chest percussions. Preferably with codeine, please

I understand. I was there myself. But I would be so immensely happy if there would be less of those 50%.

Up Vote Up Vote ×
Specializes in ER.

KatieMI. Sorry, but you are coming off as pretty self-important some of your posts here. If you do that in real life you may be sabotaging yourself.

Up Vote Up Vote ×
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
But at least she asked!!! She had a patient on dialysis prescribed a nephro-toxic drug. She called to clarify if this was okay. It is not within our scope to make that determination. Now panicking was over the top of course but she at least had the sense to know about the med she was giving and its risks. And she asked. It's the ones who don't ask who are the problem. The ones who forge ahead and do things without thinking or reason or rationale. And these are the ones who are usually the least teachable because they believe they are The Best Nurse Ever!

Hear, hear!

Up Vote Up Vote ×
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
KatieMI. Sorry, but you are coming off as pretty self-important some of your posts here. If you do that in real life you may be sabotaging yourself.

YES, thank you for saying that first. Katie may well be as smart as she thinks she is, but the majority of people who think they're smarter than everyone else aren't.

Up Vote Up Vote ×
Hear, hear!

Why on earth would you bash someone for asking a question to learn? Now if that same nurse kept asking the same question over and over,without retaining the information, that is problematic. We all have duh moments. Those moments do not mean we are stupid, incapable of learning, insert whatever descriptive term here. The know it all new nurses are the scary nurses and the more experienced nurses need to remember they started somewhere too and didn't know everything. I have seen experienced nurses draw a blank on something and it never crossed my mind they were dumb or non-thinking, my first thought was they must be juggling several things in their head right now.

As far as new nurses, one way of learning is to ask questions. If they do not apply it then that is on the new nurse.

Up Vote Up Vote ×
But at least she asked!!! She had a patient on dialysis prescribed a nephro-toxic drug. She called to clarify if this was okay. It is not within our scope to make that determination. Now panicking was over the top of course but she at least had the sense to know about the med she was giving and its risks. And she asked. It's the ones who don't ask who are the problem. The ones who forge ahead and do things without thinking or reason or rationale. And these are the ones who are usually the least teachable because they believe they are The Best Nurse Ever!

My post was supposed to include this quote as well. 😁

Up Vote Up Vote ×
Specializes in Med-Tele; ED; ICU.
If a person is able to discuss for hours the minorest things about college football or golf or guns, then there are no problems about intellect or memory.

Memory pertaining to things of interest, perhaps... intellect most definitely not.

Sports and guns are two of the most prominent examples I can think of for which logic and reason are are often exchanged for passion and loyalty during discussions.

Up Vote Up Vote ×
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
My post was supposed to include this quote as well. 😁

Okay. I didn't think you got my point when I read the first one.

Up Vote Up Vote ×

To be honest,I think nurses that want to succeed have to be personable.

You could be the smartest,most knowledgeable nurse out there,but if you are not friendly and into gossip,well,you lose.

Also,some might say I am stupid when they see me trying to insert an IV.

I am not stupid,it is just that I have not started an IV ever in my nursing career of over 10 years. But i will always ask first,or refuse to start them.

All nursing skills are not universal.

I would not call the Rn in the ER who pulled out my patient's gtube stupid,because she is not used to them. She was just surprised that Rn's in homecare are allowed to replace them.

Up Vote Up Vote ×
Specializes in Hematology-oncology.
But at least she asked!!! She had a patient on dialysis prescribed a nephro-toxic drug. She called to clarify if this was okay. It is not within our scope to make that determination. Now panicking was over the top of course but she at least had the sense to know about the med she was giving and its risks. And she asked. It's the ones who don't ask who are the problem. The ones who forge ahead and do things without thinking or reason or rationale. And these are the ones who are usually the least teachable because they believe they are The Best Nurse Ever!

I wish there was a love button for this! Sometimes asking a provider, and talking through the rational brings the whole clinical picture together and helps us nurses understand the treatment plan.

Here's an example from my first few months in hematology. I had a patient with refractory DLBCL. We attempted a round of salvage chemo, and then started Neupogen a few days later per protocol. The next day the hematology team ordered a high dose steroid course in an attempt to halt disease progression. I understood that the WBC count was elevated, but wondered how they knew it was progression, and not a bump from the Neupogen. I paged the provider, and asked him if he could call to teach me, but only if he had time.

He kindly spent 5-10 minutes walking through the differential with me, and showing me the difference between a Neupogen bump (with associated bump in ANC), and disease progression with a high lymphocyte count, but low ANC.

Should I have already understood this? Maybe. But in 10 minutes he helped me understand the treatment of not just that patient, but other patients I have cared for since.

Up Vote Up Vote ×
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
Ok, sure. In your hypothetical situation, the nurse should get another career. In my hypothetical situation, the nurse has the basic knowledge to still be a nurse, but needs to find a specialty suitable for her at this point in her career. Sheesh.

When we ask ourselves "How the H did he/she get through nursing school?" it's because we see a sad lack of that basic knowledge. A lack that makes it difficult to succeed in any specialty. Because not only is there a deficient knowledge base, there is a lack of critical thinking and judgement and an arrogant attitude that won't be told anything by anyone.

We've all worked with these people. I've known several. They steadfastly block any input and management blows off the concerns of other staff members. It's a whiskey charlie foxtrot situation and it happens everywhere.

Up Vote Up Vote ×

Some people catch on quicker than others. Some never catch on. Rather than being derogatory toward them help them learn.

Up Vote Up Vote ×
+ Add a Comment