RNs and up - Do you really use all of the "gen-ed" course material on the job?

[RomaniGypsy]

I just finished taking another A&P 1 exam, and I just have to ask - do y'all really use all of this stuff on the job? Do you really need to know the difference between a tuberosity and a tubercle, or the names of all of the cranial nerves, or what muscles get innervated by what spinal nerves, or the names and locations of the individual bones in the wrist, etc, etc, etc?

Or, for that matter, do you really need to know about all of the philosophers they teach you about in Ethics, or how to do a 2-way ANOVA (Statistics), or what Lev Vygotsky did with his life (Psychology)? Do y'all use _any_ of this stuff "on the job"?

It strikes me that these classes are a lot like throwing a large amount of mud at a wall and hoping some will stick. I'll remember a few things from each, but I can't promise to remember which indentations are called "fossae" and which bear the name "ala".

I intend no disrespect to LPNs/LVNs when I say "RNs and up", but an LPN I know said that what LPNs and RNs really need to know on account of what they do on the job is distinctly varied. Another student in my A&P 1 class said, today after the exam, that her mom is an LPN and she doesn't even know the nine abdominal regions that we learned about in the first week of class. (My takeaway is that she, and at least the other LPNs with whom she works in that facility, don't need to know even this basic A&P information in order to do their jobs successfully.) With this information in mind, I want to see if what I hear from RNs, NPs, and other "specialty nurses" is substantially different.

I've worn a couple of different career hats in my life and I know that in both cases, I didn't use a lot of what I learned on the road toward being fully qualified to "do" that career. I'm still at a solid "A" in A&P 1 with only one exam to go, but part of me is disenchanted with the whole process because I feel like I'm rote-memorizing a whole bunch of stuff I will never again use after regurgitating it for the exams... and that would be naught but a waste of my time.

[RNperdiem, RN]

My foreign language skills have served me well.

[WestCoastSunRN, MSN, CNS]

No offense to the OP -- I know you are just asking an honest question, but ....

oh goodness, the answer is YES, YES, YES! You won't remember everything. You will have to review things as they become pertinent to your specialty and everyday practice. But you absolutely need the exposure to all that stuff and MUCH of it you will use directly.

Also, it's just a fraction of what you're gonna have to know. If you aren't into being a lifelong learner and making complex connections between didactic learning and practical application -- this is not the career for you.

Consider the responsibility and scope of practice nurses have. We should be some of the brightest, most well-educated of professionals.

[JBudd, MSN]

There are some really subtle things in pathophysiology, that without a good understanding of normal A&P just won't make sense.

When I taught head-to-toe assessments, I had students saying they had never seen many of things being done. I reminded them that not every patient needs indepth assessing of every system every time, but they had to know how to do each system as needed. Many questions about what was significant about a particular abnormal finding, and understanding the physiology behind it was based in all the general stuff ahead of time. Clubbed fingers: anyone can see the abnormality, but can your nurse identify and explain to you what and why this happens?

So, you get a broad base of knowledge in a lot of areas, never knowing when you will need any particular batch of it. Do I use all the knowledge every day on my job?. No. But it is like having money in the bank, there to draw on if you need it.

Philosophy and ethics... there are some hard questions that get asked about dealing with some situations, and having learned different theories and points of view helps find the answers. So why study all the details of an area? If all you ever got exposed to was a few sentences, you wouldn't have learned enough to remember or apply it, "outside the box".

[TriciaJ, RN]

Nursing isn't about memorizing and regurgitating. Nurses need to have a comprehensive fund of knowledge to draw on when managing an infinite number of potential situations and problems.

If you just want the bare-bones knowledge needed to perform specific tasks, then you're better off as a CNA. A nurse is not just a CNA who can do more things. A nurse is responsible for all aspects of a patient's care and needs to be versed on many subjects. Just because you can't see an immediate application does not mean your education will be wasted.

[Lemon Bars]

Unfortunately you will only use a small fraction of what you learn in each class, both prerequisites and nursing school classes. Your analogy of throwing mud at a wall and hoping that some will stick is accurate. You will not need to know the difference between a tuberosity and a tubercle unless you specialize in orthopedics or something similar. However, if you study hard, you might learn enough about each topic to make a decision about what specialty area of nursing interests you most, and that may motivate you to independently learn more about that specialty area. You might also pick up enough information that, if you find yourself in an unfamiliar situation, you might remember enough to point yourself in the right direction when researching answers to questions that come up.

I went through the prerequisites and a BSN program over the last five years. It seems clear to me that most teachers and administrators simply don't have the skill or the will to design classes that are more closely aligned with real working environments. Some teachers are too proud to spend time teaching practical skills and will only teach advanced concepts and philosophies. Consider yourself fortunate if you are taught by a professor who has the time, the energy, and the inspiration to seek out ways to help students connect class material to real life situations.

P.S. I recommend considering LVN or ADN programs then bridging to the RN or BSN. The ADN students in my area get a lot more clinical time and learn more practical skills compared to students in my BSN program. We wrote more papers, though, if that's your thing...

[PeeWeeQ, ADN, RN, EMT-B]

I'm almost 3/4 of the way done with my ADN and I can tell you from the clinicals I just finished on the cardiology floor that YES---you need to know and UNDERSTAND your A&P.

In the program I am in, we have progressive courses that build on A&P more and more (it goes deeper and deeper--Health Promotions, Health Alterations, and Complex Health Alterations, 1 and 2) each semester.

In your first semester, it's not such a big deal when you're just learning to take vitals and a head-to-toe and history, but, as you move on and you are passing meds like lasix, warfarin, metoprolol, and diltiazem---all on one progressive care patient, you'll be glad you had all of those "gen-ed" classes, especially when your trying to explain endocarditis and heart failure to family members and why they need to be taking so many meds AND when it's up to you to follow a weaning protocol for those meds and you have to apply some critical thinking.

As for the other stuff, it rounds you out a bit and also aids in your ability to think critically, think outside the box, and to look at patients (and family memebers) from all different sides.

I'm just a 3rd semester ADN student and I have A LOT of learning left to do, and, I am certain that the learning will never stop. But, you really do need that gen-ed base if you want to be a good and well-rounded RN....In our program, those are pre-program courses. That is, you don't even get accepted into the core at all until you are a CNA and have completed A&P, Advanced A&P, and Developmental Psych......

[Cowboyardee]

Gen ed college curriculum classes will serve you well in life. Even if they don't apply directly.

Science fundamentals classes like A&P and statistics are crucial and are absolutely helpful if you want to go on to learn any of the nursing subject matter beyond a very basic level.

Classes on nursing theory and professional nursing are junk and indoctrination with no substantial evidence base and no real standard for research. They are an embarrassment to our profession, and nurses would be better served by taking those credits in a foreign language, mandatory chemistry or organic chem, formal logic, or any clinical course material.

[Ruby Vee, BSN]

On 4/18/2019 at 10:08 PM, RomaniGypsy said:

I just finished taking another A&P 1 exam, and I just have to ask - do y'all really use all of this stuff on the job? Do you really need to know the difference between a tuberosity and a tubercle, or the names of all of the cranial nerves, or what muscles get innervated by what spinal nerves, or the names and locations of the individual bones in the wrist, etc, etc, etc?

Or, for that matter, do you really need to know about all of the philosophers they teach you about in Ethics, or how to do a 2-way ANOVA (Statistics), or what Lev Vygotsky did with his life (Psychology)? Do y'all use _any_ of this stuff "on the job"?

I have long-forgotten the names of all of the cranial nerves and what muscles go with which spinal nerves. I couldn't tell you the names of the individual bones in the wrist, either, but the folks in the hand clinic sure could, and my friend Rosemary who works in Neuro ICU can not only tell me the names of all the cranial nerves, but what they do and how to test them and what the potential issues are if they don't do what they're supposed to do. I've done CCU and Cardiac Surgery since the mid 80s, and I can tell you about the coronary arteries, and which ECG leads indicated an RV infarct and what particular issues to watch for. So will you use all of this stuff? Not every day, and not unless you work with those patients. But the stroke patient who had an MI may end up in your CCU, and the MI patient who then stroked may show up in the Neuro ICU. I've had OB patients with pregnancy-induced heart failure in my CCU for monitoring, and I once had to deliver a baby on the oncology floor. (Because the intern covering the floor had a seizure -- his first -- and didn't wake up quite right. I had to deal with that, too.) It's good if you remember at least some of the A & P.

Knowing the physiology is important to understanding how things work. Knowing how things work helps you do understand pharmacology, microbiology, pathophysiology. You don't have to remember the names of all of the cranial nerves unless your working in that ICU, but you'd better be able to recognize a problem, describe it to the doctor on call when you wake him up in the middle of the night, and have some idea of what to do about it so that when he says, "Give lasix and call me in the morning," you'll know that won't help anything.

You probably won't ever use the names of the philosopher, but you need to know how to construct an argument and have the confidence to make your argument when it counts. Know when to call the ethics panel, for example. It also helps not to look uneducated when trying to extract orders from a physician who looks down on nurses.

[Oldmahubbard]

Let me just say, studying The Death of Ivan Ilyich in my English 101 class has informed and shaped my thinking on that topic for the last 30 years.

That being said, there is a great deal in any program you will never use, or even ever hear of again.

And you will find the content of certain courses important but superficial, requiring extensive digging and study on your own.

[VioletKaliLPN, LPN]

LPN here. . my program required chemistry as a pre req. I took the same pharmacology class that my BSN program teaches, so I tested out of it.

I took Med Surg, 1 and 2. I took mother and baby, peds, even did an OR clinical..

YES, you will use them. The teachers are not going to spoonfeed you. If they lecture about a drug and state "This works on the ascending loop of henle", you should already know what that is. If not, they are not going to teach you and you are SOL.

[Workitinurfava, BSN, RN]

Honestly, we should recieve education like doctors. Go over the general stuff and when you pick your specialty, you learn in the classroom and also get hands on experience for a year(when you get the job). 6 or 12 weeks of training is not enough time to really put it all together.

[buttercup9, ASN, BSN, MSN]

You have gotten some good advise here so far and I will add this:

Working in healthcare is accepting lifelong learning. Research is ongoing and practice will be in a constant state of flux.

Evidence based practice is based on just that- research and evidence.

This is where your knowledge of statistics and yes, ANOVA comes in. In order for you to understand research, and how to determine for yourself if the study is good or bad, you need to have a basic understanding of statistics. This comes into play when determining if you/your unit/ department is looking to see if changing the way you do something will be useful or not.

Having said that, in no way did I enjoy taking statistics. I had it a million years ago in undergrad so that I did not have to take it to get an ASN. Sadly, now that I am in an NP program, I had to re take it b/c it was too old.

Though it was miserable (I did fine, I just took it in 6 weeks while working full time) I can say not only was it needed to do the work required for my MS, but it has helped me in my greater knowledge of the world around me.

As dorky as it sounds, it has made me a better citizen and consumer of information from science to pop-science and "fake news". Even the other courses like history and philosophy are useful. Nurses are required to think critically. Trying to understand philosophy is a great way get into a critical thinking mindset.

However, if you want to do the least amount of work possible have no interest in wanting to excel, then the "when will I ever use this" attitude will serve you well.

Someone else said it already but think about the caliber of people you would want taking care of you or your loved one.

You said yourself that you are doing well in your courses. I know it is exhausting and frustrating but there is a purpose behind it even if you can't see it.