Knowledgeable vs. Caring Nurse

iwanna · Mar 18, 2009

llg -to shay Sorry, I know that I spelled it wrong, but I am sure you know what I mean. After putting more thought into this question, I can remember wondering how some nurses made it through nursing school and passed the boards. I think one possible answer is that they are good at memorizing and never actually learned much. To me, nursing school was tougher than college because I couldn't memorize in nursing school. But, of course, I used many neumonics.(sp)

Has anyone ever watched the show House? I love that show. House is an ass, but I would take him for a dr. anyday. So, I guess for nurses, in the end I would want one more knowledgeable. To have both is nice, but if I had to choose, I want the want that can asess, diagnose, plan, implement, and evaluate!

llg, PhD, RN · Mar 18, 2009

I find questions like this kind of irritating (no offense to the OP who was asked this in a school setting). They get us chasing our tails, when the real answer is to start with whichever side of the equation you come by most naturally, and go out and find and cultivate the rest.
QUOTE]
They often irritate me, too, because we too often get simply a series of relatively shallow statements from people who really haven't given it much depth of thought. However, I think this thread has included several strong posts that are offering more than the usual superficial drivel.
If discussed well, such questions can force us to dig deeper and confront key issues in our practice and in our lives.

Saifudin · Mar 18, 2009

The problem with this 'hypothetical situation is that it does nto represent a realistic situation and this is what I dislike about philosophical musings of this nature.

The fact that one makes it through nursing and becomes licensed means a certain level of knowledge and skill. At least, one would expect that a nurse would not be below an agreed upon standard. That's what supposed to be.

'Caring' and the degree to which one 'cares', how it manifests, etc., are personality and character issues.

Unless a person is as stated above abusive, rude or displays some other distasteful behaviors that are difficult or impossible to deal with then in the example given there is no reason for termination so the example is too extreme.

Years ago I worked in an ER in NYC and there was a first year resident doing a flex residency prior to entering anesthesia. He was the rudest person I ever worked with!! About 12 years later and after a return to the hospital after a 2 stint doing relief work I had knee surgery. I was waiting for anesthesia pre-op and who walks in but that former resident, now a an anesthesiologist. He remembered me and he was excellent. From the IV to the spinal, I didn't feel a thing. He found his nitch and maybe went through some changes along the way. But, I'll tell you, his previous rudeness would likely have caused some serious reactions had they continued, especially in the Bronx ER I worked in.

As a NP in past primary care practice, I learned that knowledge devoid of caring, feelings, etc., like the story above is counterproductive. Maybe if your lying in a hospital bed and very ill you don't care as long you get the right treatment. But in primary care where you often become an 'anchor' for people with all sorts of pscyho-social issues, if your cold and uncaring, at least in my experience, it can have detrimental effects, especially on people whose lifes are already precarious. That's in an inner city primary care OPD. But, even in private practice, a cold doc or NP would likely not keep patients for years. Long standing medical care is a relationship and it is difficult to practice 'patient centered care' only on an intellectual level. The lack of concern will show through. At least, that has been my experience as an RN, an NP and now a Diretor of Nursing.

Equinox_93 · Mar 18, 2009

IMO it IS ethical because holistic care is important and I would consider being 'caring' to be part of taking care of the whole person.

Being 'caring' doesn't necessarily mean being warm and "cuddly"- it just means showing the patient you give a damn and treating them as a person- not just a set of conditions. MHO. One can be efficient, knowledgeable and *caring* and yet not be overly touchy-feely or warm and fuzzy necessarily.

Valerie Salva, BSN, RN · Mar 18, 2009

I have known a lot on "nice sweet" nurses whom pts really like- who actually give pretty bad care. Most pts don't know any better, though. They prefer chatty, social, "nice" nurses over competent, knowledgable ones.

Equinox_93 · Mar 18, 2009

I have known a lot on "nice sweet" nurses whom pts really like- who actually give pretty bad care. Most pts don't know any better, though. They prefer chatty, social, "nice" nurses over competent, knowledgable ones.

Sure- *because* they don't know any better... However, just as it's 'part of the job' to be able to keep a poker face when dealing with things like bodily functions and other situations- it is important to be able to at least "fake" some social skills and interpersonal niceties when dealing with patients. MHO.

cardiacRN2006, ADN, RN · Mar 18, 2009

I am sorry to say there are a lot of nurses out there who amaze me with their lack of knowledge and/or intelligence.
They frighten me.

And I work with plenty of them! As I'm sure we all have...

They frighten me as well...

leslie :-D · Mar 18, 2009

interesting, in that i find that knowledge and caring, often overlap.

kicking out a bunch of loud, animated visitors, comes to mind.

knowledge, in that the nurse recognizes the need of a quiet, peaceful environment.

caring, in that the nurse wants the pt to recover w/o incident.

yet i'm quite sure the visitors may be offended and even consider him/her, UNcaring.

and so, how we perceive "caring" is indeed, highly subjective.

"warm and fuzzy" to me, often means enabling...

and enabling is not caring, if it's going to perpetuate a lot of undesirable behaviors/actions.

neither is enabling, "knowledgable", if one isn't understanding how the enabling is affecting the big picture.

i'm really struggling in explaining myself here, but i just know that knowledge and caring are truly congruent in meaning, action and outcome.

someone, help me out here.:chuckle

leslie

Valerie Salva, BSN, RN · Mar 18, 2009

Then there's the definition of caring. Is it warm fuzziness and hand-holding. Is it being a good listener. Is it fluffing pillows? How about keeping after a doc till the patient has orders for adequate pain management. Or kindly, but firmly, inviting guests to leave so the patient can rest? Maybe it's running to three other units to find red jello because that's the only thing that sounds good to the patient.
I really dislike the fact that we commonly use just the one word--caring--to describe both an emotion and a skill. Caring--the feeling--may help us to connect on some level, but what might feel good to some might irritate others. Caring--the commitment to meeting the patient's needs--can involve a very different set of skills and much of it might take place out of the patient's view.
I find questions like this kind of irritating (no offense to the OP who was asked this in a school setting). They get us chasing our tails, when the real answer is to start with whichever side of the equation you come by most naturally, and go out and find and cultivate the rest.
I want to be a nurse who knows how to balance warmth and wisdom. And if I'm on the other side of the bedrails, I want the same kind of nurse taking care of me.

Great post, and I agree.

Years ago, I had a ltc pt who would try to manipulate others into doing things for her that she could do very well for herself. My knick-name for her was "Blossom." Whenever Blossom saw a new face (agency or new employee) she would put on her sad-puppy face and ask that person to do things she could do all by herself- such as transfer her 200 lb self from her wheelchair to the toilet. She would make herself dead -weight and risk injuring a staff member.

One day, another resident's family member was at the nurses' station and overheard Blossom ask me to wheel her to her room. I said "No, you can do that yourself, Blossom."

The family member gave me a really dirty look, said "I'll do it" in a disgusted voice, and wheeled Blossom to her room.

This person saw me as uncaring- when I was actually being very caring in trying to help Blossom maintain her current level of functioning. If everyone did everything Blossom asked, pretty soon she'd just a be a lump in a bed, unable to do anything.

Sometimes what the public perceives as uncaring is just the opposite. A lot of people just are not aware of what nursing and "caring" are really about.

twistedpupchaser · Mar 18, 2009

i'm really struggling in explaining myself here, but i just know that knowledge and caring are truly congruent in meaning, action and outcome.
someone, help me out here.:chuckle
leslie

I dont think you struggled at all, I think you nailed it.

pedicurn, LPN, RN · Mar 18, 2009

Empathy, knowledge and intelligence are the qualities I value most.

None should be mutually exclusive of the others.

Too many nurses demonstrate a deficit in one or more of these qualities.

I love most of my co-workers but not all have all three of these.... some have lots of knowledge but adopt an impersonal manner with patients, some have lots of nursing knowledge but are of average intelligence and some have none of the above