If you are expecting an elaborate article, you won't get it here.
1. cost too much to transfer license from another state. About 220 bucks just for me to transfer my RN license since I am moving to another state. Lame. it's not like ive performed any crimes in the past few months.
2. Phd in nursing- LOL? Who would get a phd in nursing? it is not like it is as an elaborate field as chemistry, biology, or psychology. WHAT A JOKE. This is pretty much just a bullbeat way to try to OVERLEGITIMIZE the nursing profession. What are you performing double blind controlled studies on.... HOW TO GIVE A BEDBATH OR BREAK THE SEAL ON THE ASPIRIN TABLET???? Keep it simple folks.
3. Overcomplication- nurses are probably the worst at over complicating things. I remember back in undergraduate, we were taught those elaborate care plans. Do you know what care plans are? GARBAGE. You never use them and nobody cares about them. Unless you are one of those old hags with a Phd IN NURSING..... You know what else is dumb. NURSING DIAGNOSES. you know what those are? cheap copies of medical diagnoses, aka nurses trying to legitimize themselves with medicine. I remember having to come up with these stupid things. IMPAIRED NUTRITION SECONDARY TO DIFFICULTY SWALLOWING. ARE YOU KIDDING ME, NO CRAP, IF YOU CANT SWALLOW YOU CANT EAT. NO CRAP ROFL. I also remember the nursing skills manual. 10 pages on HOW TO FOLD A FREAKING WASHCLOTH AND MAKE A BED. Go home overcomplicators, go home.
I also remember having to learn indepth about diagnoses such as cardiac tamponade. WHENS THE LAST TIME YOU PAGED THE DOCTOR AT 3 AM "Hey I think this patient is in cardiac tamponade, you know when they stick the tampon in lemonaide???" ARE YOU KIDDING ME... NEVER.
I could go on and on about point 3.
Overcomplication is a simple way to try to self-legitimize. Something the PHD level nurses are professionals at. Good professionals simplify as much as they can, not do this garbage.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I also remember having to learn indepth about diagnoses such as cardiac tamponade. WHENS THE LAST TIME YOU PAGED THE DOCTOR AT 3 AM "Hey I think this patient is in cardiac tamponade,
I also remember having to learn indepth about diagnoses such as cardiac tamponade. WHENS THE LAST TIME YOU PAGED THE DOCTOR AT 3 AM "Hey I think this patient is in cardiac tamponade, you know when they stick the tampon in lemonaide???" ARE YOU KIDDING ME... NEVER.
[1] You're the triage nurse at an urban trauma center. You're overloaded with patients and ambulances and having to triage patient traffic to the waiting room or the hallway. A rig comes in, you examine the patient and find them tachycardic with distended neck veins... what do you do? Send them to the trauma bay - bumping the present resident to the hallway - place the patient, and perhaps grab the attending, with whom you have a solid and long-term relationship and say, "This dude's in a bad way... tachy, JVD, muffled heart tones... you want us to set up for a pericardiocentesis?"
[2] Same hospital but patient was stable on arrival... went through the prelim trauma eval... and waiting for disposition or perhaps further study... it might be that CT is backed up and you're holding patients... and then the patient starts to crump... JVD, tachy, muffled heart tones... you page trauma and say, what? In my case, most likely the person answering the page is a doc I know and you bet your butt that I'm going to say, "hey man, this guy's showing signs of a tamponade..." and you bet your butt that I'm going to have a bunch of docs at the bedside in no time flat... and that I will have already set up the bedside US and had the trays sitting out (but still unopened).
"Hey I think this patient is in cardiac tamponade, you know when they stick the tampon in lemonaide???"
What? I'm not following the second clause... I mean, I guess if the nurse is an idiot and speaks that way to the docs then I'd guess that they wouldn't be taken seriously.
I've had several docs say things like, "good catch... thanks for watching them so closely... thanks for letting us know... you saved him..."
Actually I like my job. Doesn't require nursing diagnoses. Medical diagnoses are more fun. Oh look his creatinine high he's got an AKI. Time to find out why.
Not....
Hmm diarrhea. Increased chance of skin breakdown. How can I over complicate this. IMPAIRED SKIN INTEGRITY RELATED TO INCREASED STOOL and nutritional deficit related to the diarrhea also.
I'm so use some protective cream and change his brief more. Oh wait the prior is a medical int unless you just use baby powder.
I'll take the AK I plz.
What is your point? kidneys are prioritized over bowels, nutrition, or skin integrity? Or...kidneys are medical while stool and wounds are relegated to a nursing domain?
When I was in LPN school, we had to hand write elaborate nursing diagnoses for each and every patient we had in clinicals. It became apparent that "everyone" could have both a discharge care plan, as well as an alteration in health care maitenence plan. Then the instructor got onto us, so I then started using the seemingly off the wall ones--spiritual distress if my patient so much as uttered "why is God doing this to me". just to mix up the mundane a bit....
Real world is that in my state, LPN's do not create care plans. And they were in paper charting days printed off the internet, stuck in a patient chart, and gathered cobwebs, never to be looked at again.
Now with computer charting, there's a drop box of choices--and again, never to be looked at again. Although many computer charting systems have a merging tool that drives one's interventions/daily plan of care with the original care plan choices. But again, not sure how many RN's are planning their day according to the care plan.
As long as we have highly educated but never been at the bedside powers that be driving some strange academia portion of bedside nursing (and I am not sure there is an academia portion of that kind of nursing) or facilities that are holding masters degrees over experience, one can create all sorts of care plans--but unless one knows HOW to implement interventions instead of just talking about them, it is laughable.
Alas.....Fees make the world go around. Look at an airplane ticket. Look at paying for that silly blanket or pillow. Look at your cell phone bill or cable....what are those fees for?
I about laughed myself silly when my daughter was applying to colleges...Other fees??? That cost more than the actual education. What in the world?
But...it is what it is...my earlier reference to I'M AS MAD and I'm not going to take it anymore is a nod to a 1976 movie NETWORK. Stands true still today. Check it out on Youtube
OH,OH,OH I have that answer for you Esme!! It is because in the state of MA, if one does well on the MCAS test in high school, they are allowed to go to any Massachusetts state college tuition free. AND as you can see, the tuition amount is not even $1000.00 so they have to get their money somehow....and that would be the "other fees"....awesome way to get around actually making the "success" of the standardized testing (and one has to get 2 subjects "advanced") mean a nice chunk of college expenses be paid for.....
"Often these folks lack practical experience in actual nursing. Instead they live in a world filled with research papers, statistical analysis, and academic fluff. This leads to them imposing their nonsense on bedside nurses through regulatory requirements, thus clogging the workplace and and actually impeding patient care."
OMG ooh yes! The "book knowledge" nurses. The patient will likely die before they run through all of the protocols and algorhythyms. Example, i was pulled from ICU to "stay" with a brand new BSN on the post op floor that had only 2 patients. Both patients fresh out of surgery. Since i spent some years floating in the units (I'm an LPN) I was the first one pulled. This BSN was real nice, had ooodles of book smarts, and zero (first job as a healthcare ANYTHING) experience. When I say it was her first....I mean it was her first time on the floor being licensed. I was ok with that. Our patient's was a 40ish woman, post op cholecystectomy. The other, a girl of 21 that broke her femur in a skying accident. About 2 hours into our shift (3-11) and after assessing etc. The 21 year old's call light went on. The BSN answered and I followed her in prepared to just grab some ice water or such... When I walked in, I immediately grabbed the 02 because this girl was gasping, pale and was turning blue. I told my partner to push the code button. She started to argue with me that we need to assess and maybe call the doctor. I threw the 02 on the girl..... pushed the code button myself and pushed the BSN into the hallway.....told her to grab the code cart. She was still arguing about calling the doctor. i told her.... we don't have time. I told her to think very hard about what she knew about fat emboli, broken femurs and PE's. I didn't mean to be so rough...but really. Stop and think how much your procedural guidelines go out the window in situations like this.
Wow, it astounds me that you were even "allowed" to be in ICU!! In my parts, the BSN would have another new grad BSN to "help" each other.
Oh, but first it would have to be you to show the BSN's how to critically think, do all sorts of clinical skills.....THEN you would be told that unless YOU got your BSN, you no longer know how to be a nurse.......
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
OH,OH,OH I have that answer for you Esme!! It is because in the state of MA, if one does well on the MCAS test in high school, they are allowed to go to any Massachusetts state college tuition free. AND as you can see, the tuition amount is not even $1000.00 so they have to get their money somehow....and that would be the "other fees"....awesome way to get around actually making the "success" of the standardized testing (and one has to get 2 subjects "advanced") mean a nice chunk of college expenses be paid for.....
Do NOT even start me about MCAS and that "free" tuition....I will derail the thread and get in trouble for what I have to say should NOT be voiced in polite society.... Grrrrrrrrrrrrr!
Specializes in Cardiology, Cardiothoracic Surgical.
Maybe I posted this story another thread....maybe I didn't. Can't remember.
I had a 3rd-semester nursing student with me taking the patient to get an ultrasound for potential DVTs done. Had A fib/other cardiac hx. I figured I would use this opportunity to help her on her care plan/concept map/ whatever papers
she had to do for clinical that day. I started asking questions about his plan of care and why he was getting an ultrasound.
She shrugged her shoulders and proceeded to play on her smartphone. I didn't expect a perfect explanation, but at the very least
I wanted to hear some basic background and what she was doing to further his recovery, especially from someone who would be graduating in another semester. At the very least I'd expect her to have some medical dx, critical lab values, meds, and some nursing diagnoses/plans if she was on the floor taking care of this patient.
I was so appalled about her lack of participation and information I informed both her nursing instructor and the patient's care nurse about it. No wonder schools are losing clinical placements in hospitals.
. Grrrrrrrrrrrrr!
BusyBee91
229 Posts
1. This makes me giggle.
2. I see where both sides are coming from.
3. As crucial as practical skills are, I'm gonna have to go with there being some value in the correct spelling of algorithm