Nurses, perception difference and education

Yes you are quite correct ... agree

Intellect is a big part of it.

Perception relates to intellect

The nurses with the broader perception I am advocating for have good intellect.

Without intellect and related broader perception we cannot be real professionals

In relation to your example, I don't think nursing education clearly addresses the proper nursing treatment for alcoholism, and I've been through both BSN and MSN. Even physicians don't properly address it based on their own personal bias and related to a lack of specific education in school.

In your example, according to AA, neither nurse is acting properly. According to AA, one should not manipulate the alcoholic in order to stop drinking. Therefore, you neither prohibit their drinking by throwing it away or do you "save" their alcohol for them by enabling them to drink. The nurse should remain neutral, this is a non factor for her except to provide education and treatment options once and then more often if the patient is open to it, or if a different opportunity for discussion exists. The patient should be allowed to "suffer" the negative consequences of their drinking, this includes health and financial consequences as they will only seek true treatment when they hit bottom.

I hope you will see the true issue here. Neither side that you presented is truly correct in the only medically effective method of treating addiciton.

Well, I would think as an "educated" nurse, you would realize the negative effects of alcoholism, which are cocommittent with heart disease, liver disease, bleeding disorders and diabetes.

As an educated nurse, throwing out the alchol or not does not matter. Educating the patient about the effects of alcoholism and finding recovery resources are more important than that issue.

Alcoholism is just as bad as not affording your metformin, and is actually the cause of not being able to obtain the metformin in your example and that is the issue that needs to be addressed.

The point is, if the pt is truly an alcoholic and will buy alcohol over medications, by saving his alcohol, you are really only buying him a few days of time. The nature of the disease will eliminate all health care priorites as the need for alcohol increases.[/quote

I think 'educated' nurses understand perfectly

When someone is not likely to ever stop drinking permanently - we understand that the next best thing is keeping them safe, functioning as best as can be and out of hospital.

Otherwise they are in and out of hospital way too frequently. I would rather help them maintain their delicate balance at home.

This approach is much more cost effective and better for the p't

In relation to your example, I don't think nursing education clearly addresses the proper nursing treatment for alcoholism, and I've been through both BSN and MSN. Even physicians don't properly address it based on their own personal bias and related to a lack of specific education in school.

In your example, according to AA, neither nurse is acting properly. According to AA, one should not manipulate the alcoholic in order to stop drinking. Therefore, you neither prohibit their drinking by throwing it away or do you "save" their alcohol for them by enabling them to drink. The nurse should remain neutral, this is a non factor for her except to provide education and treatment options once and then more often if the patient is open to it, or if a different opportunity for discussion exists. The patient should be allowed to "suffer" the negative consequences of their drinking, this includes health and financial consequences as they will only seek true treatment when they hit bottom.

I hope you will see the true issue here. Neither side that you presented is truly correct in the only medically effective method of treating addiciton.

All well and good. And yes they often do finally start to take action when they are at their lowest point.

However I would add - many of them don't have much to live for at this stage with health, family, money, job, friends all gone.

If they have been to rehab upteen times I'm more interested in keeping them out of hospital by sorting their infection or whatever.'

It is way less expensive having the community nurse or psych nurse visit these people at home and keep 'plugging up the holes' rather than having them coming into hospital

You know we have an issue when we receive a variety of response from new nurses regarding the difficulty of their state boards.

Hearing 'it was way too easy it was pathetic, I can't believe I went to university for this' is as bad as hearing 'oh my goodness, it was the most difficult thing I have ever done' ... both make me cringe.

Yeah, I'm sure that never happens in any other licensed profession.

Differences in perception exist in every profession and even among the most educated people. In fact, the perception of our physical world has been the topic of much intense debate among physicists. Many worlds versus Copenhagen and so on. I would expect nothing less from any other profession.

The comment about exams being very easy or extremely tough made me chuckle. When we sat for our boards, 34 years ago, it was a 2-day event. Some of us were relaxed, went to dinner, socialized. Some stayed in our rooms and fell asleep with open books in our laps.

But that was a reflection of how studying went on in school, as well. I am lucky/blessed with an excellent memory, and rarely studied very hard. Others burned the midnight oil.

But we received the same education. Does that mean that we should all always come to the same conclusions, all the time? Much of the time, yes. But all of the time???

Get real. And ask your supervisor about the bottle of rot-gut.

You know we have an issue when we receive a variety of response from new nurses regarding the difficulty of their state boards.

Hearing 'it was way too easy it was pathetic, I can't believe I went to university for this' is as bad as hearing 'oh my goodness, it was the most difficult thing I have ever done' ... both make me cringe.

I think this is a poor example to use, in attempting to make your point. Unless you have a nationwide poll/statistics of how many BSN educated nurses felt the NCLEX was "easy," versus how many ASN or diploma nurses felt it was "the most difficult thing," there is no basis to this comment.

People have different IQ levels, some have learning disabilities, others put more effort into studying, and you also have those who are simply poor test takers. So you will naturally hear both comments from both degrees.

Furthermore, a higher education does not necessarily mean one is smarter or possesses common sense. And it certainly doesn't mean all nurses who have a BSN or higher, will perceive things the same way. Don't get me wrong, I'm not knocking you for feeling there should be the same level of education for nurses. That isn't a new argument. But to truly believe that we would all agree more, based on a similar level of education, is a bit ignorant. Examples disproving that are everywhere, even right here in this thread, from nurses with varying degrees.

even if that means we have him back in tomorrow? and then two days later ?

Because that will happen when he makes a choice between buying more alcohol and filling his meds. Eg He doesn't fill his Metformin, his cellulitis worsens

He will come back sooner than later. Throw the stuff out. I would like not to enable him.

I think this is a poor example to use, in attempting to make your point. Unless you have a nationwide poll/statistics of how many BSN educated nurses felt the NCLEX was "easy," versus how many ASN or diploma nurses felt it was "the most difficult thing," there is no basis to this comment.

People have different IQ levels, some have learning disabilities, others put more effort into studying, and you also have those who are simply poor test takers. So you will naturally hear both comments from both degrees.

Furthermore, a higher education does not necessarily mean one is smarter or possesses common sense. And it certainly doesn't mean all nurses who have a BSN or higher, will perceive things the same way. Don't get me wrong, I'm not knocking you for feeling there should be the same level of education for nurses. That isn't a new argument. But to truly believe that we would all agree more, based on a similar level of education, is a bit ignorant. Examples disproving that are everywhere, even right here in this thread, from nurses with varying degrees.

I agree with this. Math and science come easily to me, whereas my colleagues are very afraid. I learn things easily, and remember things easily, whereas many of my colleagues (master's and up, mind you)...need a constant reminder.

It's the ability to learn that's a big caveat here.

even if that means we have him back in tomorrow? and then two days later ?

Because that will happen when he makes a choice between buying more alcohol and filling his meds. Eg He doesn't fill his Metformin, his cellulitis worsens

Do you honestly think someone with an ETOH abuse problem that severe is going to be responsible enough to worry about having sufficient funds for his Metformin or whatever drugs he needs? Interesting. I haven't come across too many substance abusers who were so responsible.

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

You're assuming the pt. will do those responsible things.

This feels like either someone working on a paper or showing off a bit.

Different people think differently on many topics, AEB the different opinions on the patient with vodka! Different thinking isn't necessarily incorrect thinking; it's just different. There are lots of things that have no clear right or wrong answer. I think the situation of the patient who has a bottle of vodka with him is a big example of that.

Consider that taking away the vodka could be seen as a codependent personality trait....

Consider what you'd think:

if the patient was obese and brought food,

if the patient was a cocaine addict and brought a crack pipe,

if the patient was extremely thin and brought laxatives,

if the patient was a teenager who never left his home ,because he was always playing video games, brought his PS2...

Would you consider throwing those things away too? Why the difference?