Nursing Diagnosis?

[Critical Care-Bear]

Hello,

I got into an argument with my physical assessment lab instructor and I want some feedback. Okay, we did the "ear, nose, throat" lab last week and my partners tonsils were swollen, she said her throat was sore and complained she wasn't feeling good. So in the write up we have to fill-out these sheets and on the back is a SOAP format, which means we have to list the subjective, objective, assessment, and I think the "P" is for plan of care or something, this is were we give the "diagnosis." So in the last part, I said I would collect throat cultures and send them to the lab to be examined to determine if the infection is bacterial or viral. Then I said that once I get the results I would suggest an antibiotic, such as azithromycin, if the infection is bacterial. If the infection was viral, I would recommend an anti-inflammatory agent or pain killer, such as aspirin, and remind the patient to drink plenty of fluids and get bedrest.

Anyway, next lab when I walk into class the instructor was going off about how we, as nurses, don't order medications. I knew she was talking about my paper. So before I sat down I said "well can't we suggest a course of therapy

or medication to the doctor?" She then said that we couldn't because the patient could be allergic to a particular medicine. I then told her that one of the first pieces of information we collect in an assessment is the patient's allergies. The teacher then kinda yelled at me and said, quite frankly, "YOU'RE

NOT A DOCTOR."

This is rediculous, Med-students only take 1 pharmacology course too. I've talked to med-students and they say that alot of the knowledge involved in prescribing a certain medication has to be learned on their own. Some nurses have 20 or more years of experience, I'm sure they can offer insight by suggesting medications to a Doctor. Am I wrong?

The teacher told me that what she was looking for was "nursing diagnosis's."

She suggested things like "adjusting the patients pillows." I'm not paying $500 a credit to learn how to fluff pillows! I want to be an active member in the healthcare process, not some ******* orderly. Does anybody feel me, or am I just going nuts? I think I'll get a prescription for xanax. This really gives me aggita. :angryfire

[1Tulip]

I'm a little concerned about the notion that we have to think/act like nurses up until we get our MSN/APN and then we can think and act like doctors.

This promotes the notion (that we've worked for eons to negate) that a nurse is a doctor-minus something, a lesser doctor, a doctor's helper. Maybe I'm a fossile, but I always believed that nurses and doctors have different frame-works on which to hang their professional practices even though the "things" we do have broad areas of overlap.

Doctors approach patients focusing on the symptoms and the underlying disease and then they fix it where possible. Nurses approach patients from the standpoint of health (broadly defined) and identify processes that impair the patient's highest possible level of function.

I know that sounds mushy and philosophical. But I can see a huge difference between the way PA's function and the way NP's address their patients and approach their work.

Anyway, for what it's worth, there is a difference between nurses and doctors and it's a lot more than just scope of practice. It's actually how we think.

Disagree? Agree?

[MIA-RN1, RN]

Coopergrrl, you have the same name as me, my last name is cooper. I'm not a "she" though. . .

heehee....Cooper's not my last name tho! Just a big Alice Cooper fan! :)

[MIA-RN1, RN]

Anyway, for what it's worth, there is a difference between nurses and doctors and it's a lot more than just scope of practice. It's actually how we think.

Disagree? Agree?

I see where you are coming from. As nurses, we are treating the human response to health and illness, where doctors treat the actual illness. WHich is not to say that doctors don't treat/respond to the human response but as nurses that is our scope of practice.

A nursing diagnosis is the response to the illness and then the nurse's assesment and plan for helping the client with that response.

[MMARN, BSN, RN]

I agree that, although we may have the same amount of knowledge (if not more:specs: ) as a MD, we have to realize that our scope of practice doesn't go beyond assessing the patient and seeing those small subtleties that make us nurses . I'm sure in the real world we will be able to help or suggest the MDs with different prescriptions because we've seen the patient firsthand, but as many posters have said, in NS we have to have an NCLEX mind, if you know what I mean.