Published
Sometimes I find myself going blank as what I should do for care. Obviously chocking, and unresponsive comes easy. But I wish there was a quick reference book of what I should do if someone is more lethargic than normal. Stuff like that..
A couple of years ago, this was an internal conversation I had with a newly admitted psych patient:
https://allnurses.com/psychiatric-nursing/jacob-rockstar-rn-979458-page116.html
LOL, Davey, every psych nurse knows that conversation too well!
"HOW AM I SUPPOSED TO SLEEP WITHOUT A TV?" "...Ativan?"
We're not allowed to have phones
I hate this rule! If they don't want us to carry personal phones they should issue hospital smart phones preloaded with reference apps and supervised google search. You *cannot* practice safely relying on paper references anymore. Things change too quickly.
We need to know the basics down pat, so we can react immediately. We need to be deeply fluent in the common procedures/drugs/medical conditions etc we experience in our practice setting. But at least for me, hardly a day goes by where I don't encounter a less-than-common issue. Medicine moves quickly and it is bad practice to rely on a book printed 6 months ago. It is also bad practice to rely on memory when we are doing anything even remotely unfamiliar. Heck, we should be double checking even our most basic practices on the regular! We forget things without realizing it, and standards of care sometimes change more quickly than we can keep up with through CEUs/journals alone.
It's GOOD clinical practice to have a smart phone at the ready. Its GOOD clinical practice to look things up.
My "CNM" for dummies is my uptodate subscription haha. And my ASCCP app.
No book. There is experience...and it's very expensive. But you cannot put a price on it.
At what point do you accumulate enough experience that you no longer need to look things up??
We need to know the basics down pat, so we can react immediately. We need to be deeply fluent in the common procedures/drugs/medical conditions etc we experience in our practice setting. But hardly a day goes by where I don't encounter something I am at least somewhat unfamiliar with.
We're not allowed to have phones
I hate this rule! If they don't want us to carry personal phones they should issue hospital smart phones preloaded with reference apps and supervised google search. You *cannot* practice safely relying on paper references anymore. Things change too quickly.
It's GOOD clinical practice to have a smart phone at the ready. Its GOOD clinical practice to look things up.
Anyway, I rely on uptodate for general info and use it most every day for at least some little thing. I use my ASCCP app to double check *all* my pap/colpo follow up plans, no matter how straightforward. I rely on my medical standards and guidelines as well.
That being said, I do have a super old derm book with awesome pictures and a handy chart for all those weird terms whenever I need to describe an awesome skin lesion haha!
Gather up all your data and call the doctor on-call. Do a thorough assessment, vital signs, lung sounds and then paint an accurate overall picture of the patient for the doctor.
Nurses are pressed into a position well beyond their scope on a daily basis. Step back, look at what our standard of care, scope of practice is and then ACCEPT the fact that we are NOT doctors. I didn't go to all that schooling and that is why I don't get paid what they do. I'm a nurse.
I'm just a garden variety, all around RN with just enough knowledge to get me into trouble.
Stay out of trouble. Trust your gut. Keep it simple, ,stick to the basics. What is their blood pressure currently and how does that compare with baseline.
Nursing as a profession needs an overhaul. In our quest to establish ourselves as a recognized health profession we have pushed our boundaries of what we are responsible for far beyond our scope.
Basics.
Call the doctor.
Chart everything.
Collect your paycheck.
Go home and pet your dog.
Retire.
Wonder why you picked nursing for a living.
Keith.RN
3 Posts
I highly recommend Think Like a Nurse: Practical Preparation for Professional Practice. If you are looking for a straightforward, NEED to know nursing resource that provides a practice-based perspective of what must be deeply understood so you are better prepared for real-world practice this is it!
It has 4.7 stars on Amazon it comes highly recommended by both students and nurse educators! It was written by a nurse with 35 years of clinical experience who is also a nurse educator and remains current in practice and written in a conversational style, NOT like another textbook!
As the author, I may be a bit biased, but the reviews and comments speak for themselves!