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Nurses, perception difference and education

Nurses   (6,606 Views | 58 Replies)

pedicurn is a LPN, RN and specializes in CVICU, Obs/Gyn, Derm, NICU.

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You are reading page 2 of Nurses, perception difference and education. If you want to start from the beginning Go to First Page.

roser13 has 17 years experience as a ASN, RN and specializes in Med/Surg, Ortho, ASC.

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I'm still struggling to understand your point. The example that you gave simply illustrates (to me, at least) the differences in nursing styles, nursing personalities and nursing beliefs.

All of which will continue to exist across the educational spectrum. Even if you have all masters'-prepared RN's on a floor, you are going to have those that believe as you believe and those that believe in any number of alternative approaches to the situation that you cited. I'm having trouble believing that you sincerely think that if all nurses were equally educated (advanced education), they would all approach any given patient issue in the exact same way. Again, in the example that you gave, I understand that you believe your approach to the issue to be the preferred solution. If I were your co-worker, I might differ with your solution and would hope that you would appreciate that I might have a different, yet perfectly acceptable, approach.

"I would assert that it's inappropriate for these differences to remain if nursing is to be a real profession. "

Nonsense. Advanced/equivalent education does not make for robotic nurses who all believe, think, and act the same. Nor should it. There will never be any one perfect solution to patient issues. Thank goodness for our variability and our willingness to use nursing judgment to deliver patient care.

Edited by roser13

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dudette10 has 9 years experience as a MSN, RN and specializes in Med/Surg, Academics.

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Here's an example that crops up quite a lot in my unit.

A p't arrives intoxicated with a supply of vodka in their belongings. Many of my coworkers automatically throw the alcohol out because the 'p't has come in here drunk' and alcohol abuse is one of their problems.

However I keep the alcohol and the rest of their belongings in a secure place and return on discharge.

My rationale is based on a few points:

- The p't will just go buy more alcohol on discharge and that will likely mean they wont have enough money to fill their prescriptions on discharge and eat properly. Thus we will have them back in soon enough. It may also mean they could be so skint at that particular time - will be evicted as can't pay the rent -therefore now homeless and with all the problems that entails

- Will need to keep drinking in the short term to avoid withdrawl

- Alcohol is legal

-The alcohol is p't property

- It can be kept away from the p't and others whilst admitted so no risk keeping it in the hospital.

This difference in perception exists amongst our staff nurses and also amongst our group of charge nurses

Ok, I am BSN-educated. It really doesn't mean a hill of beans in this scenario, I think.

The ONLY reason I would keep it in storage is due to the fact that it's the patient's property, while my mind is screaming, "THROW IT AWAY!"

Saying that giving it back to him will help him in some way (which seems to be part of your point) is a bit far-fetched. It's a matter of the patient's priorities whether he buys vodka or buys scripts on discharge; it's not due to whether or not he already has a bottle of vodka in hand. :confused:

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dudette10 has 9 years experience as a MSN, RN and specializes in Med/Surg, Academics.

1 Article; 3,530 Posts; 26,112 Profile Views

I'm having trouble believing that you sincerely think that if all nurses were equally educated (advanced education), they would all approach any given patient issue in the exact same way. Again, in the example that you gave, I understand that you believe your approach to the issue to be the preferred solution. If I were your co-worker, I might differ with your solution and would hope that you would appreciate that I might have a different, yet perfectly acceptable, approach.

Perfectly stated.

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noahsmama specializes in pediatrics, public health.

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One could just as easily argue that if the drunk has his vodka on discharge, he won't stay sober long enough to make it to the pharmacy to buy his meds.

Also, if a drunk is going to prioritize their spending to buy alcohol before medications, they'll likely buy another bottle of alcohol instead of medication even if you give them that first bottle back. Heck, if they have health insurance and can get their meds for free, they might choose to pick up the meds and try to sell them to get even more alcohol. If that's how they prioritize their purchases, I don't see that there's anything you can do to change it, and I don't believe that having that one extra bottle of alcohol is likely to make any difference at all in what choices they make once they leave the hospital.

And does the drunk have a car? Aren't they more likely to be driving home from the hospital drunk if you hand them a bottle of alcohol as they head out the door?

I'm a BSN educated RN with a PhD in another field, and my inclination would still be to throw out the bottle of alcohol. Seems to me there's at least as many valid arguments for throwing it out as for keeping it. And I agree with others that one's level of education is likely to have pretty much nothing to do with how one views this particular issue.

Just my :twocents:

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What degree are you pursuing, that you are postulting this?

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pedicurn is a LPN, RN and specializes in CVICU, Obs/Gyn, Derm, NICU.

696 Posts; 8,809 Profile Views

Ok, I am BSN-educated. It really doesn't mean a hill of beans in this scenario, I think.

The ONLY reason I would keep it in storage is due to the fact that it's the patient's property, while my mind is screaming, "THROW IT AWAY!"

Saying that giving it back to him will help him in some way (which seems to be part of your point) is a bit far-fetched. It's a matter of the patient's priorities whether he buys vodka or buys scripts on discharge; it's not due to whether or not he already has a bottle of vodka in hand. :confused:

It is a matter of priority for the p't.

Because he already has his immediate vodka he will have the money to fill the prescription and eat. Therefore he might take his Metformin and also he might start his antibiotics for his cellulitis.

If he doesn't have much money he will prioritise and buy vodka to the detriment of the other.

It isn't at all far fetched - we see it all the time

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pedicurn is a LPN, RN and specializes in CVICU, Obs/Gyn, Derm, NICU.

696 Posts; 8,809 Profile Views

Even if you have all masters'-prepared RN's on a floor, you are going to have those that believe as you believe and those that believe in any number of alternative approaches to the situation that you cited. I'm having trouble believing that you sincerely think that if all nurses were equally educated (advanced education), they would all approach any given patient issue in the exact same way. .

'Exact same way' will not happen ....agree. We wouldn't want that.

But what will happen is that nurses will move onto the same page and a more common perspective will be the order of the day. Similar to what we see with professionals who have more education eg doctors.

Example

I do not see much 'hearts on sleeve' behaviour from doctors. Even if it is a close and personal subject for them - I would not expect a doctor to say 'throw out the alcohol' without utilising a broader perception.

Someone mentioned earlier that a nurse with experience of alcoholism in her family might be more inclined to automatically throw it out. I would assert this is not about personal nursing style .... it's about a lack of a professional perspective regarding how she is handling information

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merlee has 36 years experience.

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1. There needs to be a policy on what to do with the EtOH. Most places do NOT have appropriate places to secure bottles like this.

2. Is there no one to give this stuff to? No family/friend/companion?

3. What would be YOUR liability if the patient drank the remaining contents then got in his car and drove away?

4. Involve your supervisor and/or administrator and make this THEIR decision, not yours. Whereas I agree that the bottle is the property of the pt, I don't think we should be part and parcel of enabling them by giving it back at discharge.

5. I see your point about the patient's financial priorities, but the bottom line is - they will spend their money any way they see fit.

I do not believe that ANY of this has to do with the level of education of the staff.

Good point for discussion. Thank you for this interesting topic.

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pedicurn is a LPN, RN and specializes in CVICU, Obs/Gyn, Derm, NICU.

696 Posts; 8,809 Profile Views

I'm still struggling to understand your point. The example that you gave simply illustrates (to me, at least) the differences in nursing styles, nursing personalities and nursing beliefs.

.

Sounds quite wishy washy for a profession. It's almost in the fluffy bunny / unicorn/ rainbow realm ( that I was forced to endure during some of nursing school lectures)

The argument further cements my creeping dissatisfaction with the premise that nursing is a profession.

Making a general statement here ...

When we state the degree of analytical endeavor we pay to any particular nursing problem is dependent on our nursing styles, personalities and beliefs .... then I believe we have lost the plot as a profession

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3 Articles; 2,107 Posts; 35,394 Profile Views

I have NO idea what y'all are talking about. Can you broaden my perception, please?

Or dumb it down for me?

What exactly is the question again?

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pedicurn is a LPN, RN and specializes in CVICU, Obs/Gyn, Derm, NICU.

696 Posts; 8,809 Profile Views

1. There needs to be a policy on what to do with the EtOH. Most places do NOT have appropriate places to secure bottles like this.

2. Is there no one to give this stuff to? No family/friend/companion?

3. What would be YOUR liability if the patient drank the remaining contents then got in his car and drove away?

4. Involve your supervisor and/or administrator and make this THEIR decision, not yours. Whereas I agree that the bottle is the property of the pt, I don't think we should be part and parcel of enabling them by giving it back at discharge.

5. I see your point about the patient's financial priorities, but the bottom line is - they will spend their money any way they see fit.

I do not believe that ANY of this has to do with the level of education of the staff.

Good point for discussion. Thank you for this interesting topic.

Perhaps I should have chosen a better example.

My point seems to be lost along the way

I was asserting that perception difference is broad in nursing and this causes us difficulty. Life as a nurse would be easier if we were on the same page and unifying education might be a good way of attaining this.

So much nursing time and energy is wasted, one way or another - dealing with this

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Miller86 specializes in Medicine.

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I agree with you on not throwing away personal belongings but if the individual in question is an alcoholic, he/she will drink the entire bottle within a day or two and use the money to purchase more of it. I think they would be consumed by the addiction and ignore their need for the medications you described.

I doubt giving the bottle back (it's their belonging anyway!) will result in them being compliant with their medications. And if they are compliant initially, how long does it last before they end at the hospital's revolving door?

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