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Medically Independent?

Posted

I was reading through some recent threads and a topic that seemed to come up often was a disdain for the fact that nursing does not actually contain much "figuring out" of medical situations but was more of a task orientated situation where you simply do what you are told. Tho I am not a nurse, nor am I even a LNA at this time I understood what they where saying, but in my mind disagree with some of the sentiment...it may be a task orientated job where you mostly do what you are told...you still know whats what and I'm sure can act on situations that may arise when no MD is immediately present ;)

On to my question however, what type of nursing would you guys say is the most medically independent? more solving and less order taking? I know about NP however there seems to be a very broad spectrum of them.

Thanks

roser13, ASN, RN

Specializes in Med/Surg, Ortho, ASC. Has 17 years experience.

"I was reading through some recent threads and a topic that seemed to come up often was a disdain for the fact that nursing does not actually contain much "figuring out" of medical situations but was more of a task orientated situation where you simply do what you are told."

I disagree with your primary statement, thus cannot answer your question. I am, in fact, offended by your question. You did not need to mention that you are not a nurse: it is quite apparent. While I'm a little curious about your motive in asking the question, I'm not all that interested. And for the record, I certainly can figure out "what's what" and act independently. Even when there is NO MD PRESENT. Yes indeedy, I can do that!!

I don't (in your words) "figure out" my patients health concerns. I evaluate my patients by history, current health status, and diagnoses. I then implement MD orders, as I see fit. I do not implement orders that do not make sense, are not in my (yes, MY) patient's best interest, or that will harm my patient, no matter which or how many MD's placed the order. I also, by the way, implement my own nursing care plan in order to provide optimal patient care.

I do not require a NP behind my name in order to practice independently. I do that quite effectively as an RN, thanks so much for asking. For whatever reason you're asking.

Edited by roser13

I also disagree with your thinking. Not to sound rude, but maybe do a little research about the education, skills, autonomy, critical thinking, nursing interventions, etc etc etc that is involved with nursing.

Also, when you say "LNA", are you talking about a CNA? CNA's do not hold a license, but a certification through the state. They are called Certified Nursing Assistants.

Edited by nlitened
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JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 11 years experience.

I also disagree with your thinking. Not to sound rude, but maybe do a little research about the education, skills, autonomy, critical thinking, nursing interventions, etc etc etc that is involved with nursing.

Also, when you say "LNA", are you talking about a CNA? CNA's do not hold a license, but a certification through the state. They are called Certified Nursing Assistants.

In NH CNAs are licensed and called LNAs, however this is the only state that licenses nursing assistants.

Wile E Coyote, ASN, RN

Specializes in Critical care.

I'm reading that the OP did acknowledge a measure of nurse autonomy, thus can't see the need for the passionate disagreements that followed. To give my answer, I'll say prehospital and flight nursing, followed by critical care. I'll also add that off hours ( night shift and weekends to a lesser degree) encourages more independent actions.

I remember seeing a journal article a number of years ago that looked at that very question (independent vs. dependent nursing roles). The researchers looked at all the common nursing specialties (generalist nursing practice, not advanced practice), and divided the common activities of each into dependent and independent nursing functions (dependent functions were those involving following orders, algorithms, protocols, etc.; independent functions were those nurses can do by themselves without needing orders or direction from anyone else). They then mapped all the different specialties on a continuum from most to dependent to most independent, based on the proportion of dependent to independent functions in day-to-day, typical practice. I don't recall all the results offhand, but I do recall that the researchers found that the most dependent specialty was critical care nursing, and the most independent specialty was psychiatric nursing.

Yikes! things seem to have gone sour.

I would first like to apologize, I honestly meant no disrespect and I could probably have worded my question better. I wasn't saying that nurses do not have autonomy and cannot figure out what to do without a MD, I was simply paraphrasing some things I read on the "nurses eating their young" thread where such things where mentioned by some folks that didn't seem to happy with their career choice, and I even tried to hint at the idea that I personally believe you guys DO know what to do in regards to assessing patients (assessing..probably a word I should have thought to know...as someone not in the medical field I was just trying to figure out words as best as possible) I was TRYING to say I disagreed with that sentiment that I got from some posts I read.

In regards to LNA, that is what they are called her in Vermont....I honestly do not know what else to say on that front.

Also, the reason why I'm asking is because I am simply trying to get a bearing on what might interest me.....

Again, very sorry for how I phrased my question..my stomach literally sank when I realized that it was taken the wrong way.