School vs. The field

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Question from a nursing student to nurses currently working in the field. I am in my first semester now of a part-time program, won't even have clinical till next semester. So, as I don't currently work in health care, my experience is basically nill. 

My question was regarding electrolyte and drug levels/values, does one just try to memorize them for school? I have seen plenty of people say it better to "understand" the subject matter, which I feel I do (mostly). But, when you're in the field do you really remember all the levels or the signs and symptoms of imbalances, etc. off the top of your head?

I'm just terrified that I'll end up hurting a Pt by forgetting this type of stuff.

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Sorry. My original question was a rambling mess. To put it more clearly, how much of the nursing school content did you memorize long-term and how much did you have to relearn (or learn for the first time even) in the field?

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Specializes in being a Credible Source.

Since you've gotten no replies, I'll chip in...

1) Your title, "School vs The field" reflects a misunderstanding of terminology... the field is everything that happens outside of the hospital environs... ambulances bring patient in from the field... when those patients have IV lines, we refer to them as "field starts" and regard them differently than hospital starts.

2) "...regarding electrolyte and drug levels/values, does one just try to memorize them for school?"

Well, not precisely... while there are hundreds of lab values, there are only a few that are clinically significant on a routine basis and even there, the precise values aren't terribly important for a couple of reasons... the first is that the range of normal values varies by the specifics of the lab equipment and process used in its determination... secondly, all lab reports include the range of normal values for each parameter... thirdly, critical values will be reported directly from the lab...

Rather than focus on memorizing the numbers, focus on what they mean for the patient... If I were going to pick the 5 most important/common, I'd go with sodium, potassium, blood sugar, leukocyte count, and hemoglobin... the next 5 would probably include lactic acid, PO2/PCO2, CRP, INR, and % neutrophils... (or maybe D-dimer)...

Regarding signs & symptoms, yeah... pretty much... at least the big hitters for each of them... though it gets to be much, much easier when you actually see a patient suffering from the disturbance and manifesting the symptoms...

3) "I'm just terrified that I'll end up hurting a Pt by forgetting this type of stuff." Highly unlikely... generally speaking, if you follow the physician's orders, you'll be fine... unless, that is... those orders were grossly inappropriate (which typically means the doc inadvertently placed them on the wrong patient or perhaps hadn't seen a brand new lab result)...

Be crystal clear about what the range of normal looks like (I'm referring to a physical exam here) so that you can quickly recognize - and report - abnormal.

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Specializes in being a Credible Source.

Since you've gotten no replies, I'll chip in...

1) Your title, "School vs The field" reflects a misunderstanding of terminology... the field is everything that happens outside of the hospital environs... ambulances bring patient in from the field... when those patients have IV lines, we refer to them as "field starts" and regard them differently than hospital starts.

2) "...regarding electrolyte and drug levels/values, does one just try to memorize them for school?"

Well, not precisely... while there are hundreds of lab values, there are only a few that are clinically significant on a routine basis and even there, the precise values aren't terribly important for a couple of reasons... the first is that the range of normal values varies by the specifics of the lab equipment and process used in its determination... secondly, all lab reports include the range of normal values for each parameter... thirdly, critical values will be reported directly from the lab...

Rather than focus on memorizing the numbers, focus on what they mean for the patient... If I were going to pick the 5 most important/common, I'd go with sodium, potassium, blood sugar, leukocyte count, and hemoglobin... the next 5 would probably include lactic acid, PO2/PCO2, CRP, INR, and % neutrophils... (or maybe D-dimer)... If I were going to pick only one... potassium... it's the one with a very tight range of normal, deviation from which can cause all kinds of badness all kinds of quickly...

Regarding signs & symptoms, yeah... pretty much... at least the big hitters for each of them... though it gets to be much, much easier when you actually see a patient suffering from the disturbance and manifesting the symptoms...

3) "I'm just terrified that I'll end up hurting a Pt by forgetting this type of stuff." Highly unlikely... generally speaking, if you follow the physician's orders, you'll be fine... unless, that is... those orders were grossly inappropriate (which typically means the doc inadvertently placed them on the wrong patient or perhaps hadn't seen a brand new lab result)...

Be crystal clear about what the range of normal looks like (I'm referring to a physical exam here) so that you can quickly recognize - and report - abnormal.

Oh, and this: "does one just try to memorize them for school?"

Care plans are "just for school," the clinical stuff... that's to take care of patients.

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My 2 cents is that you WILL memorize normal levels of labs/drug levels that you encounter regularly on the unit in which you work.  And the lab reports have the normal range listed on the lab report for the ones that you don't have memorized.  As for s/s of imbalances, I think it's too early for you to worry about that now.  An instructor told me "A good nurse doesn't know everything.  A good nurse knows her (his) resources."

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