Need a reality check

Cuddleswithpuddles · Oct 12, 2011

Absorb as much of it as you can, in my opinion. Expand your toolbox for the future. You will not use all of your knowledge at all the times but you never know when you will need that footnote no one in nursing school tested you on.

As for assessments, I feel that most practicing professionals streamline them but do not permanently lose their ability to do the head-to-toe assessments that nursing school wants you to learn. How to streamline the assessment is each professional's judgment call, and that judgment comes from time and practice. Some teachers may overemphasize or overanalyze certain aspects of physical assessments but, overall, I think it is important to practice and master all the skills you can while you are a student.

Fluid/electrolyte balance are incredibly important concepts to master, imo. They are key in understanding so many disease processes and how to intervene.

Nutrition is a weak spot for me and it seems like it is for a lot of nurses as well. Pharmaconutrition sounds interesting actually!

Both my LVN and RN program were simply springboards to do more learning as a practicing nurse. Neither equipped me 100% for the "real world." I still look through my books and recall experiences in clinical rotations. Looking back at myself as a student, I was in *NO* position to judge what was worthwhile to learn and what was not. I think I would have done myself a disservice by putting that mental block on myself. Knowledge builds upon prior knowledge. Have the widest possible foundation. :)

snowyowl, BSN · Oct 12, 2011

Although it may feel as though you are learning things too in depth, the reality is you need those skills for future practice. As you advance in your practice, you will be able to complete a through assessment in a shorter period of time and be able to combine assessments with other necessary tasks. You also shouldn't compare how a physician completes an assessment versus how you were taught, since you have a much different scope of practice. Learn as much as you can and I am sure you will be successful!

HouTx, BSN, MSN, EdD · Oct 12, 2011

The use of that 'deeper knowledge' is not noticeable in practice... When a nurse is doing a task, the only thing that is noticeable is his physical activity. You don't know all the 'stuff' going on in his head and how that 'stuff' guides his practice and decisions. Trust me, you will be using that knowledge also. It's the basis for critical thinking as well as the factor that differentiates RNs from other practitioners.

A thorough physical assessment is intended for use when a patient is being worked up to determine overall health status. My physician (an FP) does a very thorough physical each year for my annual - just like the one I learned in nursing school - she doesn't skip anything. Hospitalized patients have already had their major problems pretty well documented so it may not be appropriate. In my clinical setting (ICU), a head-to-toe is still the usual standard for each shift but we don't use each and every technique that is learned in nursing school.

nicubee · Oct 12, 2011

Your replies have really helped me, and I'm sure others will benefit too.

I am also a pediatric OT and HouTx, you're right. When I work with an infant or toddler using balls and toys, I know that it just looks like I'm playing with them when really every action is carefully aimed at facilitating specific muscle activation or sensorimotor response. I failed to realize the same thing occurs with nursing.

Cuddleswithpuddles and Snowyowl, You helped me focus in my fog of little sleep and test stress. You have reminded me that there were many classes in OT school where I felt we were losing the big picture by getting too far down into the nitty-gritty. Now I'm glad for those classes and that knowledge-- even if I don't use it in every pt encounter.

Thanks! I will press on!! :)