I appropriate the TOS, because my intentions were not to make anyone argue or become upset. Unfortunately a lot of people don't know the hard work and dedication that it takes to work as a Nurse, as well as to become one. I am writing an informative essay to dismiss these misconceptions. I'm sorry to have offended anyone but those were not my personal opinions or questions. I researched most commonly misconceived ideas about Nurses, so I made questions that would give Nurses the opportunity to give their opinions and experiences that would combat those misconceptions.
Specializes in Complex pedi to LTC/SA & now a manager.
I've never heard nursing work referred to as "grunt work".
Be specific if you mean physician or medical doctor.
My sibling with a JD earned a doctorate but the challenges of prosecuting violent criminals are not the same as a DNP ACNP working in a CTICU or a cardio thoracic surgeon. Nurses have doctorate degrees too.
I had to word it that way because I had to include the misconceptions in my questions, while not asking a yes or no questions without being too broad. It's for my English 101 class. They are suppose to be "interview questions" based on a community of my choice. I am currently taking pre-requisites for nursing, so these are not my personal opinions. My questions are suppose to be geared towards licensed, working or retired Nurses. Also I will not use any questions that do not support the research that I have done.
You're not doing my homework. These are questions that are going to support my research paper. If you have nothing nice to say or are not going to help answer these questions, it's always best to say nothing at all.
1. What kind of person, challenges and or effort does it take to become a Nurse?
It takes a person with determination, intelligence, organization, abstract thinking, the ability to provide nonjudgmental care care to people who others may feel shouldn't get it (murderers, rapists, etc.), the ability to put personal beliefs aside when the patient's are different, patience beyond anything you've ever needed patience for (like this thread lol), physical strength, the ability to think quickly and maintain control when a patient is suddenly unstable, be able to lead, teach or guide, adequately communicate clearly (with patients of all demographics, with families, other staff, etc.), ability to challenge an order when it is recognized as inappropriate by the nurse, and honestly..... So many more traits. Nurses come in ALL varieties and bring all types of talent and skill to their practice.
2. What other work do Nurses do other than work beside doctors?
As you've discovered, this was a touchy question. If "beside" means collaboratively, then there could be truth to this. Understand, though, that doctors and nurses perform different functions and have different approaches to care. Doctors assess for, diagnose and treat disease. They write orders, which will be implemented collaboratively by all members of the care team. (I answer this with an inpatient background. Outpatient may have small differences.) PT, OT, RT, Pharmacy, ST, and anyone else I have forgotten, is part of the implementation of these orders. However, carrying out orders is not the only part of the job, not for any of the care team.
For nursing specifically, we look at the needs of the patient. We assess the patient from head to toe, sometimes with a specific focus on what their admission reason was. We discuss symptoms with them, needs they may have physically and emotionally. We administer medications and other interventions (such as wound care) after enduring the accuracy, appropriateness and safety of those treatments and medications. This is the tiny part of the list that many people generally believe is it. Nurses give meds. Nope, we do way more than that!
We deliver patient education so that they not only understand their state of health, but what changes they may need to make in their lives, what their medications will do (and what to recognize if one isn't working right or well), how they can assess themselves in the future for the need for medical care, etc. We discuss impact on quality of life, and how to get help if the changes they endure are too hard, or feel intolerable.
RNs in case management coordinate care so that when the patient is discharged, their outpatient care is arranged, from home health to insurance issues on medications. When we identify needs that aren't being met, we advocate for our patients with whoever may need to make changes, whether that be the MD, dietary, whoever.
And beyond those technical things, when nurses have the resources they need to be able to spend enough time with each patient, the nurse can be the shoulder the patient finds to lean on, or the audience to cheer them on. The nurse is the trusted one who hears the truth of a patient's struggle.
If we are able to do it "right", we're able to help a person with a new diagnosis (or many times old ones as well) leave the hospital with the knowledge, resources, medications and support they need to go home with a feeling of "I can do this". Or, at the least, "with my spouse/kid/friend's help, I can do this."
In a given day in a hospital, the nurse is at the center of everything that goes on during a day with the patient, ensuring other members of the team are doing their part. We are putting pieces of all data together (such as labs, specialties' assessments and recommendations, radiology, etc.) and making sure continuity of care is appropriate. We're sort of a final check and balance, making sure nothing is missed.
Now, it would be remiss of me to not mention that there are parts of what I have listed that do fall into the MD domain as well. They are hopefully paying attention to these components as well. But their focus is from a medical perspective, and ours is from a nursing prospective. MDs and RNs are by license held responsible for similar things. But we have completely different job descriptions that in a collaborative, respectful work environment, go together well and get the job done.
So if you mean "work beside the doctor" in a collaborative sense, I get what you mean. If not, hopefully I was able to help paint a picture. (And I'm sure I've left a lot out, if anyone wants to add.)
3. A doctor's work is very challenging but what is it that a Nurse does that is as equally as challenging?
Ouch. This one.... It stings.
I'll be the first to admit to you I've hesitated to go to grad school (even if it was my original plan) because having diagnostic and prescriptive authority is a scary amount of responsibility. Now that I see it from the inside, I know I am not ready for that step. It's intimidating.
A doctor has a huge responsibility and even bigger liability that hangs in the balance. They get about 10-15 minutes with each stable patient face to face. If they're able to track down the nurse, they'll get feedback from the nurse regarding events since their last visit. They'll spend a little while looking through labs, radiology, notes and recommendations. They'll put in their orders. They'll move on to the next patient. For a relatively uncomplicated patient, this may all be done in less than a half hour, the majority of which is in the patient's chart, in the computer, which includes a nice, warm chair. :)
Don't get me wrong - I in no way mean to undermine the work of MDs (let's include the NPs and PAs, because they perform in the same role). It's just different and hard in more of an intellectual, emotional sort of way. And, of course, personal liability way. (A nurse can be sued right along side a doctor, but the doctor stands to lose more because in the end, they call the shots.)
What is it that a nurse does that is equally challenging? Well.... While the MD/NP/PA gets to enjoy each patient for 30 or so minutes, we are with these patients 12 (usually more) hours. We certainly get our occasional gentle, sweet, easy one, the majority are rarely that combination of characteristics.
Now, to start, each individual patient represents one more person whose heart or lungs may stop working at any given moment, on any given shift. Even when you have someone who is otherwise healthy and comes in for something simple, like a knee replacement, may code on you that shift. You don't know when. You don't know if. The nurse must remain vigilant (some days, hypervigilant) to watch for that possibility.
If we work on a floor that staffs aides, we are responsible for the outcome of the care provided by them. We have to trust they will do vitals, ADLs, and other delegable things accurately and safely. Many of the things nurses do can depend on what is reported to us by our aides.
In a given shift, our day is usually filled with many medications due at many different times. We usually start the shift with patient assessments. We address symptoms and discuss plan of care for the day. We ensure the patient understands what is being done and why, and of course, make sure they have a voice in their plan. If they have questions, we make sure they have answers.
Assessment goes on throughout the day. Patients come and go for procedures and tests. If a patient is on critical drips, literally the entire day, their heart rate and blood pressure will be watched and drips will be titrate for accordingly. Some will be on insulin, which requires at least hourly blood work for titration. Some will go to procedures that require monitoring unique to that procedure afterward.
If a patient is unable to care for themselves in any capacity, the nurse and the aides will do care for them. This includes toileting, eating, skin care, bathing, movement, etc. probably doesn't sound like too big of a deal to the regular person. However, frequently (regularly) we will have multiple patients on the floor who are over 400 lbs, non ambulatory, with skin not properly cared for (and the infections and wounds that go with that), unable to hold either bowels or bladder. These patients typically will require multiple people at any given point in time to help them with care needs. And, every time you are in with them, you and those who help will be lift/pushing/pulling hundreds of lbs together multiple times over a good 20+ minutes depending on what is going on. That is a very conservative estimate of time. Depending on how much the patient has going on, each time with them can take up to an hour. This is especially true of those with antibiotic resistant organisms and multiple wounds in difficult to navigate places.
We also are usually the ones who do wound care and dressing changes. Not bad for an easy, pretty surgical incision that is healing nicely. Scary when it is in a bed bound patient with poor nutritional status, fluid overload (so, swelling) and diabetic (so, no healing that infection). Skin breakdown can be unbelievably horrible. The only times I've ever been stopped in my tracks, asking someone to grab a charge nurse, is when I've unwrapped some of these wounds and have been left completely speechless, unable to figure out where to even start. (Admittedly, wound care is not my strongest area.)
Quite literally, we are NEVER able to get through everything we hope to in an entire day. Some days, just sitting on a chair to chart is a beautiful surprise. We spend every hour on our feet, we hit the ground running and don't stop, and at the end of the day, we run out of time. Always. It is emotionally, physically and intellectually exhausting.
We all have our own "hardest thing of all". I've had a few that have been up there, and I will never forget. The dementia patient who punched me in the head and refused absolutely everything. The severely depressed man who was seen by his mom for the first time in years - after he drank himself into liver failure and laid on a couch for so long his neck was contractured to the right and his legs drawn up permanently. Last time she saw him, he was her beautiful boy, but that day, he was hairy, dirty, nails with 12 months growth, and absolutely no will to live. A mid-40s guy with a wife and young kid who couldn't afford his blood pressure medications, killed his kidneys completely. A mid-50s guy who had a bone infection that left him paralyzed after he'd already destroyed his liver. He decided he wanted to die, and after he almost did, his mom sent him to us to make him not die. His skin was falling off him, his brain was destroyed by ammonia, and we had to bring him back. In the end, he still went home to die. We just prolonged his suffering.
The doctors... They are part of these patients' stories and care, but they are not there for 12+ hours each day with them. We know our patients. We see their joys and sorrows. Occasionally we feel them, too, if we can't stop ourselves. (I say "if we can't stop ourselves" because if we felt every single one, we'd be crushed by the weight of it all.)
Then there is night shift. At my small community hospital, we have one MD in house (the ED staffs their own, so I don't count them), and we have 2 RTs on the floors. The hospital is held up and together by the nurses. If a patient takes a turn downhill, we work together. We don't have ancillary staff right there. It's on us.
If you are a patient in a hospital and you need something in your care, it's the nurse you turn to. And it's the nurse who gets it. If something is amiss, it is the nurse who sees it first. If there is a problem in your lab results, the nurse sees that first. If there is an error in your meds, it's the nurse who will catch it. And if there is something that could be better for you, it's the nurse who advocates for that.
4. What is it that makes Nurses different from one another or what sets them apart?
We all have different strengths and weaknesses. And we often know who can do what, and we work together on it. Beyond that basic thought, nurses work in all areas of our world. You'll find them in hospitals, schools, industrial settings, in communities - everywhere. That is one of the most awesome parts of USA nursing. In the states (and other countries), we are given what is called a "generalist" education. We are given a baseline level of knowledge to be able to go into whatever specialty we would like. That is also helpful because as an inpatient nurse, I know what an outpatient hospice nurse might do (just as an example), so I can help my own patients and their families understand how beneficial hospice could be to them. Nursing is probably the most versatile industry there is, and so nurses are able to find where their talents are best utilized, and their minds kept engaged.
5. What other work is performed that makes a Nurse's job more than just grunt work?
This is another not-so-pretty question that I've hopefully answered in some detail.
I am a school nurse and closest MD is approximately 10 miles down the road at the Minute Clinic located inside CVS. Take a left by Big Larry's house and then a right beside the Piggly Wiggly. CVS is in that shopping plaza.
;-) Tell Thelma over there that I said, "Hey girl, Hey!"
vnvelez90
9 Posts
I appropriate the TOS, because my intentions were not to make anyone argue or become upset. Unfortunately a lot of people don't know the hard work and dedication that it takes to work as a Nurse, as well as to become one. I am writing an informative essay to dismiss these misconceptions. I'm sorry to have offended anyone but those were not my personal opinions or questions. I researched most commonly misconceived ideas about Nurses, so I made questions that would give Nurses the opportunity to give their opinions and experiences that would combat those misconceptions.