i'm a nursing student about to start second semester, first clinical semester. i'm getting increasingly concerned about the content of nursing school. i like science and pathophysiology. i don't like busy work or brainstorming about the "8 holistic parameters" and how they relate to every little thing. i don't like reading a care plan for ob (2 semesters from now) that says things like "interventions: 1) provide a supportive atmosphere, 2) provide reinforcement for infant care taking behaviors, 3) provide opportunities for adequate rest", and so on. is that realistically what i have to look forward to? i guess i'm looking to find out how much science there is actually involved, compared to the more touchy feely stuff, when you are actually a working rn. i may be able to stand the whole "assessing for fall risk" type of thing if it's not really so much like that in the real world. i'm really resenting that we're being told, basically, how to be good human beings, not professionals. i'm feeling like i'm on the verge of a meltdown and school hasn't even started back up yet. i just pray that it gets way more difficult and way less feely (although that care plan i read is from 4th semester), ugh....
i gotta say, futuro enfemera, i feel your pain.......
i started nursing clinicals just as nanda and nursing diagnoses was getting off the ground. most of the diagnoses made me want to retch - "alteration in comfort - pain" (no kidding, sherlock, the pt. just had major surgery!) and my personal favorite, "knowledge deficit", which seemed to get assigned to everyone, because, hey, we can always teach 'em something!
spare me the lectures on patience and compassion, and please don't assume that i am not compassionate and empathetic with those entrusted to my care. i love being a nurse. i don't particularly care for a lot of the touchy-feely verbage and twaddle that seems to accompany my chosen profession. i've always been kind of amazed that you have to spell some of those things out on care plans (which, incidentally, i sucked at in school, but which in icu, i rather like, due to a little more physiology and a lot less fluff.)
i think you'll like nursing, fe. just remember that nursing school is not a lot like being an actual nurse and many of the assignments are hoops to jump through to get to where you want to be. develop a warped sense of humor and learn to roll your eyes when no one is looking. you'll do fine.
you are a godsend. words cannot begin to describe how relieved i am after reading your post! lol but i'm serious! i'm overjoyed to hear that someone who totally gets what i'm saying (and agrees) "loves" being a nurse. i, too, think i'll love being a nurse but like you say, i'm really going to have to figure out a way to grin and bear it throughout school while i'm wanting to puke! i had an incline that "real" nursing was different and much more my cup of tea. i so appreciate you confirming that! i'm pretty sure i'm leaning towards icu too.
most of the diagnoses made me want to retch - "alteration in comfort - pain" (no kidding, sherlock, the pt. just had major surgery!) and my personal favorite, "knowledge deficit", which seemed to get assigned to everyone, because, hey, we can always teach 'em something!
i wanted to add something about this too. our professors seem to take this stuff so seriously and i'm always sitting there thinking "how can you possibly be teaching this to a college class?" it just seems so dumbed down and almost condescending to the students and patients. i have this teacher who acts like a walking care plan and she just seems so reheorificed and phony. she's an msn with a phd in communication and counseling.
i'm really going to work on not taking it so personally and being so resentful.
Specializes in Jack of all trades, and still learning.
i may be able to stand the whole "assessing for fall risk" type of thing if it's not really so much like that in the real world.
just re-read this. have been in an incident where a fall ended up in a legal situation. i filled out the patients falls risk form on admission. i had always felt that this was an extraneous piece of codswallop. but it went missing. i had thankfully overdocumented, and there was a record elsewhere! i would have been in real trouble otherwise. remember - the smallest thing can be investigated. don't take documentation lightly
Specializes in med/surg, telemetry, IV therapy, mgmt.
Nursing is about working with patients and their response to their illness.
Care plans are nothing more than written documentation of the problem solving process that nurses use. Doctors, plumbers, car mechanics and lots of other professions also use the same problem solving process. Nursing has just given it a name (nursing process) and expounded on what we need to do in each step of the process. It's nothing more than that. However, nurses concentrate on how patient's are responding to what is happening to them and that is why we have some background in psychology and sociology. Behavior and our relationships with the people around us play an important part in our responses to illness. We incorporate science and pathophysiology into that. The nursing process is actually an extrapolation of the scientific process.
If you can't deal with the "feely" stuff, maybe you ought to re-think your choice of careers. Chances are you won't be working in OB anyway.
if you can't deal with the "feely" stuff, maybe you ought to re-think your choice of careers. chances are you won't be working in ob anyway.
i appreciate your response. i'm not sure if you read my other postings so i just wanted to reiterate that i'm a very feely person. my issue is with the phoniness of being "taught" to be feely. like others have pointed out though, there may be those that need more guidance and find it much more helpful than i do.
Specializes in med/surg, telemetry, IV therapy, mgmt.
there are going to be many times when you have to put on a facade of being caring when you are feeling sick or just down in the dumps and working. you just have to because the patients expect it. it goes with the job. it's kind of like acting. i worked with my mom for a while and watched her do it all the time. she could be like judge judy at home and i was constantly amazed at how she could be so tolerant and kind to patients and get home and unleash her frustration. believe me, if you were in the patient bed, you'd appreciate the effort.
i am currently getting chemotherapy and see my oncologist every two weeks. i don't know what to think of him. between the hugs and "sweeties" and "you're a cutie", i don't know if he is really being sincere or not. he gave me a kiss before my birthday and christmas. i imagine he says and does these same things with all his other patients. however, i have to say that it is much nicer than someone who is cold and clinical and doesn't pay any attention to me. at least he is giving the semblance of caring. and, he really is a nice man.
there are going to be many times when you have to put on a facade of being caring when you are feeling sick or just down in the dumps and working. you just have to because the patients expect it. it goes with the job. it's kind of like acting. i worked with my mom for a while and watched her do it all the time. she could be like judge judy at home and i was constantly amazed at how she could be so tolerant and kind to patients and get home and unleash her frustration. believe me, if you were in the patient bed, you'd appreciate the effort.
i am currently getting chemotherapy and see my oncologist every two weeks. i don't know what to think of him. between the hugs and "sweeties" and "you're a cutie", i don't know if he is really being sincere or not. he gave me a kiss before my birthday and christmas. i imagine he says and does these same things with all his other patients. however, i have to say that it is much nicer than someone who is cold and clinical and doesn't pay any attention to me. at least he is giving the semblance of caring. and, he really is a nice man.
this post comes close to what i'm thinking on the topic. not so much the facade aspect, but i think it's important to find the demeanor that suits the patient. so much of therapeutic communication is done with your mouth closed! some patients like to be hugged and called darling, but others may find it condescending or crossing boundaries. some want to you come across crisp and professional--not brusque, but they want to feel confident that you know what you are doing. i think all patients want to know you care, but you really have to individualize how you model that care.
no nursing student ever hated careplanning more than i did. (clearly, some have hated it just as much.) in my first semester of med/surg, i was making straight a's and in real danger of flunking out because my careplans were inadequate. (it proved to be a blessing in disguise--i learned an early lesson that triage applies to everything a nurse does. if you have to settle for a b in pharmacology to spend the time and energy it takes to bring a careplan up from unsatisfactory to needs improvement, you bite your lip and do it.)
i seriously question whether any nursing student ever learned more about nursing from those (insert tos violation of choice) careplans than i did. these days, my paper care plans are checks in boxes, and my inner nursing diagnoses might make nanda roll in their graves. i haven't thought about adpie in over two years, but i use it all the time, both consciously and intuitively.
as a previous poster noted, common sense isn't all that common. as has long been said, if caring was enough, anybody could be a nurse.
not long ago, i intervened with another nurse's agitated patient (in cooperation with the assigned nurse) by calling three big guys from security to help me manhandle him back to bed and into hard restraints. this is not an action i would typically think comes under the heading of common decency, but the patient was big, strong, confused and combative, and all attempts to de-escalate were just making him more agitated. now, i didn't want to get hurt. i didn't want my friend to get hurt. but i swear my number one reason for calling in overwhelming force was that i did not want the patient to get hurt, and it was the only way i could see to keep him safe. if we had tiptoed around, he'd had wound up on the floor, bleeding, almost certainly. and every step of this process, as quick as it happened, followed the nursing process--although i'd still probably only get a c if i was writing it up.
i think just about every working nurse will agree that school doesn't teach you how to be a nurse--it prepares you to learn how to be a nurse. the "touchy-feely crap" isn't so much about learning to be touchy-feely as it is about doing so in a systematic way that is consistent with nursing ethics and appropriate to the patient's individual needs. i don't tell my patients "i love you." i almost never tell them "you're going to be fine." my love, if you will, for my patients is more on a par with my love for all humankind and not nearly as personal as my love for my cats. many of my patients do recover fully, or at least nearly so, but typically when they are under my care, the issue is far from certain. some don't recover, and i'm not really qualified to reliable predict which will and which won't. i'm not clueless, but i'm not their doctor, and i've seen patients i thought were circling the drain walk out of the hospital a couple of weeks later, and ones who seemed to be doing well abruptly die.
in all my many...er, months...as a nurse, i have never checked a box on a careplan about addressing a patient's spiritual needs. i have no idea during an admission what, if any, my patient's spiritual needs may be. i prudently resisted the temptation to use altered energy field as a nursing diagnosis for my careplans in school, and i don't even think about it at work. i have discussed with a terminal patient what growing up without a mother was like for me, and that he kids will likely survive it as i did, sad at times, but happy with their memories, and maybe a little more attuned to the idea that life is fleeting and precious. school didn't teach me to do that, but it did teach me that it usually isn't therapeutic to share my own life experiences, so if i make an exception, it's for a good reason. intuition is important, but without critical thinking, it's basically just guessing.
one of my favorite clinical instructors told us at the beginning of our psych rotation that we would learn more about ourselves than about our patients. it was during my psych rotation that i found the nurse inside me. the science of nursing is hard work, and you need a good brain. the art of nursing has to be found in your soul. the key to nursing is to be able to apply both the art and the science with caring and objectivity, with one goal in mind--the patient's well-being. my nursing mentors, in school and at work, have skills and knowledge far beyond mine, and still work to balance those sides of nursing every day. usually, they make it look easy, but it reminds me of watching a master carpenter plane a board--it looks effortless because they have long since learned to avoid all the extraneous stuff and focus on what they are doing.
it's gonna be so cool to be able to do that, someday.
i just pray that it gets way more difficult and way less feely (although that care plan i read is from 4th semester), ugh....
what am i really in for?
a big mix of things, but the main deal is that all nurses are real nurses. they're all as different from each other as can be imagined. so are their employment settings. once you get through school and get licensed, you're going to be a real nurse too. your job will have its own special demands, and you're going to have your own approach. don't box yourself into thinking you have to like school. you can think of it as an extended hazing if you like. tough it out and you win. quit and you lose. that's all there is to it.
A big mix of things, but the main deal is that all nurses are real nurses. They're all as different from each other as can be imagined. So are their employment settings. Once you get through school and get licensed, you're going to be a real nurse too. Your job will have its own special demands, and you're going to have your own approach. Don't box yourself into thinking you have to like school. You can think of it as an extended hazing if you like. Tough it out and you win. Quit and you lose. That's all there is to it.
Just want to clarify.... I mean "real" as in not student. I totally get what you're saying.
my first week in nsg school, the instructor asked the class, "how many of you appreciate the value of a therapeutic relationship w/your pt?"
myself and another student, raised our hands....out of a class of 70.
now, what does that tell you?
leslie
??? Maybe that a lot of people didn't understand the question?
Anyway, original poster - you aren't alone. Lots of students resent the "touchy-feely" paperwork, even if we enjoy the interaction with the patients. Just look at the whole experience like boot camp... you've just got to get through it.
Specializes in med/surg, telemetry, IV therapy, mgmt.
nursemike. . .you rock! I like the way you think. I bet you're great to work with. Don't sweat the spirituality or energy field nursing diagnoses. Leave them to the people who do want to use them and know what they are doing with them--they're kind of specialized diagnoses anyway. There are a lot of nuances to the nursing diagnoses that most people are not aware of unless they have had contact with some of the people from NANDA to get input. But, for the common use by working nurses--just the basics works just fine.
Believe me when I say that you will not spend hours formulating care plans when you hit the real world. There will be standard care plans on the front of the patient chart, but they are usually computer-generated. They are trying to teach you critical thinking and assessment skills, which is a big part of what you will be doing. You will look back at care plans as "common sense" for planning your clinical care. We all had to suffer with care plans - I even use them now in case management, but the computer does it for me.
FuturoEnfermera
144 Posts
you are a godsend. words cannot begin to describe how relieved i am after reading your post! lol but i'm serious! i'm overjoyed to hear that someone who totally gets what i'm saying (and agrees) "loves" being a nurse. i, too, think i'll love being a nurse but like you say, i'm really going to have to figure out a way to grin and bear it throughout school while i'm wanting to puke! i had an incline that "real" nursing was different and much more my cup of tea. i so appreciate you confirming that! i'm pretty sure i'm leaning towards icu too.