I don't feel like I'll ever know enough

bakpakr · Jul 28, 2007

Not a nurse YET, But I did sleep at a Holiday Inn last night hehe. Just had to say it.

In any profession you can never know it all. Your always learning. I have been a mechanic for almost 30 years and am still learning. There are a few sayings that make it a bit easier to take when you run up against something you don't know or have never seen before.

The only stupid question is the one you haven't asked yet.

If you think you know everything it is time for a profession change.

I love to learn and I feel that nursing will help feed that addiction. Plus the fact that I get to feel that I am helping to make someones life a bit better. Man I can't wait to start nursing school.

deeDawntee, RN · Jul 28, 2007

This, I can tell.
Thanks, all.

Hey then you are already at least half way there!!!!! Can you tell when the BP is very low or very high??? Or the pulse? Or the temp? I'll bet you can!!! You know more than you think!! How about labs? are the abnormal values flagged through your system? How about adequate urine output??? You know these things, I will bet. Give yourself credit. Approach nursing confidently.

:yeah: :yeah: :yeah: :yelclap::yelclap::yelclap: being confident is not the same as being a know-it-all.

pagandeva2000, LPN · Jul 28, 2007

Every day I learn. Now, that's a good thing, but I wish I weren't learning such basic things.
Do you ever feel adequate as a nurse?

At times, I feel adequate, other times a complete imbecile. At this time, I work in a hospital clinic and feel as though this area is my calling, but I also wish to gain a bit of med-surg experience so that I can correlate. I started with 6 weeks of med-surg as part of my orientation, and didn't learn much because there was so much inconsistency. I was paired with an LPN (I am one, also) for the first two weeks to watch her, but when it was time to actually administer my own medications, I had to be paired with an RN. The disadvantage of this was that the RNs work 12 hour shifts and I had a different one showing me things her way each day. I asked for an additional two weeks to just to piggyback IV care and was denied, and then sent to my actual clinic assignment. I LOVE the clinic, but thought I was lacking basic nursing skills. Now, a year later, I decided to try and work per diem in med-surg, so, I partnered with the same LPN that tried to show me IV care for one day, and got it. You would have thought that I received my Master's Degree in nursing, I was so proud to understand piggyback care. Now, in a few weeks, I will be up on the floors every now and then, and I want to do foleys, ventilator care and some of the basic things that nurses do.

I do continue to read and come to this site as well as get nursing journals and take continuing education classes to learn things at my own pace. But, I do feel just as you are saying at times. I look at the other caring nurses and wonder if I will ever be like them with skills and knowledge. I am told all the time that I am a 'hell of a nurse" by many of the senior nurses, so I guess it is going somewhere...

SuesquatchRN, BSN, RN · Jul 28, 2007

Hey then you are already at least half way there!!!!! Can you tell when the BP is very low or very high??? Or the pulse? Or the temp? I'll bet you can!!! You know more than you think!! How about labs? are the abnormal values flagged through your system? How about adequate urine output??? You know these things, I will bet. Give yourself credit. Approach nursing confidently.
:yeah::yelclap::yelclap::yelclap: being confident is not the same as being a know-it-all.

These aren't all, "Well, duh!"? No? Maybe I just expect too much of myself?

i've never once thought "i'll never learn enough" but rather, "i can't wait to learn more".

That's a good view.

I guess what got me discouraged was that ystdy one of my residents, chronic COPDer in the end stage, was impossible to arouse. She's become increasingly somnolent and my charge nurse explained to her daughter that this is her body's way of expelling excess CO2. It took research for me to find out that COPD is primarily an EXPIRATORY problem. I mean, shouldn't I know stuff this basic? I figured she's just ancient, sick, and exhausted.

Thanks for the words of support and kindness, everyone. Boy, changing careers when you're old(er) is hard.

SuesquatchRN, BSN, RN · Jul 28, 2007

I am told all the time that I am a 'hell of a nurse" by many of the senior nurses, so I guess it is going somewhere...

Excellent! I'll bet you are, too.

leslie :-D · Jul 28, 2007

I guess what got me discouraged was that ystdy one of my residents, chronic COPDer in the end stage, was impossible to arouse. She's become increasingly somnolent and my charge nurse explained to her daughter that this is her body's way of expelling excess CO2.

with all due respect, your charge nurse is wrong.

your pt's somnolence is r/t co2 retention: she's not expelling any excess.

a decreased loc is a classic sign of late-stage copd.

hypoventilation retains the co2.

excess co2 (hypercapnia) diminishes respiratory effort.

it's cyclical.

the final sign will be respiratory arrest.

just wanted to set you straight, sue.

leslie

deeDawntee, RN · Jul 29, 2007

with all due respect, your charge nurse is wrong.
your pt's somnolence is r/t co2 retention: she's not expelling any excess.
a decreased loc is a classic sign of late-stage copd.
hypoventilation retains the co2.
excess co2 (hypercapnia) diminishes respiratory effort.
it's cyclical.
the final sign will be respiratory arrest.
just wanted to set you straight, sue.
leslie

Oh I see, so there was an incedent that made you feel inadequate and as leslie so eloquently stated, your charge nurse was blowing smoke. My posts were to point you back to the, as you put it, "well duh" things you already know. (not every nurse puts it all together). You will not know the pathophysiology of every disorder, but now I bet you'll know COPD. We all learn by experience, and speaking for myself, there is nothing like having a patient with some disease to learn about it compared to reading about it in a book!! I'll bet if I asked you to list a dozen examples of how you are a competent nurse you could do it, even though our competencies don't stick with us as readily as our perceived incompetencies. Let it go, and remember that even if someone acts like they know what they are talking about, they may not!!

SuesquatchRN, BSN, RN · Jul 29, 2007

with all due respect, your charge nurse is wrong.

Oh I see, so there was an incedent that made you feel inadequate and as leslie so eloquently stated, your charge nurse was blowing smoke.

Well, smack my butt and call me a pony.

Leslie, thanks for the info re: COPD. I knew none of that. It makes sense, now, that her sats have been dropping into the 60's. She stops breathing.

And yes, my charge was blowing smoke up the dau's butt.

leslie :-D · Jul 29, 2007

Well, smack my butt and call me a pony.

:lol2: :lol2: :lol2:

whenever i hear/learn something new, i check it out when i get home.

(and yes, i'm very anal like that.)

i have a gazillion links that will bring me to anything i want to learn.

i just learn the basics so i can understand the process.

i remember in nsg school, i was at a clinical when one of the nurses told me "all you have to do is follow doctor's orders. you don't have to understand the whys or whats....just make sure it's safe."

that was one of my many turning points.

i NEVER wanted to be a nurse like that.

so i've always made it a point to understand and follow the big picture.

it feeds my natural curiosity but also enables me to understand the whats and whys, thus making me perform more efficiently.

but remember what i said:

i'm anal like that.

not everyone will appreciate my personal neurosis. :lol2:

leslie

deeDawntee, RN · Jul 29, 2007

Well, smack my butt and call me a pony.
Leslie, thanks for the info re: COPD. I knew none of that. It makes sense, now, that her sats have been dropping into the 60's. She stops breathing.
And yes, my charge was blowing smoke up the dau's butt.

Hehe:deadhorse

pagandeva2000, LPN · Jul 29, 2007

:lol2:
whenever i hear/learn something new, i check it out when i get home.
(and yes, i'm very anal like that.)
i have a gazillion links that will bring me to anything i want to learn.
i just learn the basics so i can understand the process.
i remember in nsg school, i was at a clinical when one of the nurses told me "all you have to do is follow doctor's orders. you don't have to understand the whys or whats....just make sure it's safe."
that was one of my many turning points.
i NEVER wanted to be a nurse like that.
so i've always made it a point to understand and follow the big picture.
it feeds my natural curiosity but also enables me to understand the whats and whys, thus making me perform more efficiently.
but remember what i said:
i'm anal like that.
not everyone will appreciate my personal neurosis.
leslie

I do the same thing. I often leave work with a list of things to look up in my leisure. Sort of became a hobby that I really enjoy. And, like you, I want to understand WHY the physician placed in certain orders for my own growth and it may increase the way I teach the patients.

Medic/Nurse, BSN, RN · Jul 29, 2007

Do I feel competent?

Yes. And even when I'm not "feeling it" - I still often have to appear calm, in control and competent. Sometimes I think I'm in the running for an Emmy, Oscar and Tony - often in the same shift. (Small screen, big screen, singing & dancing! - LOTS less $$$)

Do I feel like I know it all?

Never. I ask questions until comfortable. I read 5+ journals as they arrive, attend conferences, keep all certifications UTD, complete competencies, do required continuing education AND try to quell the natural inquisitive streak --- and even then I still learn new things. I may make mistakes, but in 16+ years, I've never made the same one twice.

Knowledge IS power!

Study on!

:)