So...do you really use this stuff in the hospital?

[cherubhipster]

Hello friends!

I just started school to get my RN. Now that I have started school I feel like:

Before- I didn't know what being a nurse entails but I thought I did.

Now- I have scratched the surface and....whoa.

There are a million and one theories and things that are supposed to be going on in your head when you actually work with pts in the hospital. My question is- how much of what you learn in school do you actually use? Do you sit there and break down the nursing process in your brain and think about self care requisites and deficits as you converse with a pt...or do you concentrate on the straight skills at hand? How does one ever balance this balancing act?

I'm just feeling a little overwhelmed (like everyone that just started school apparently) and looking to hear some thoughts.

Thanks!:redpinkhe

[Creamsoda, ASN, RN]

I can honestly say that I do not use all the fluff that was taught in school. I work in ICU, and theres alot of different skills involved, managing many drips, ventilatiors, ect, usually the pt is sedated. My list of priorities are...not necessicarily in order...often all at the same time.

Safety...are all my lines, tubes safe...is the patient gonna pull them out?

Airway, oxygenation?

Hemodynamicly stable?

GI/GU issues

Skin condition.

Any other problems at hand.

Talking with the pt and family and updating the situation.

As im taking care of the patient, im not thinking about florence nightengales theroy on nursing care, or Orem, Neuman or Erickson. Im sure some elements come into play during my assesment, but I dont actively use any model. I systematically assess my patients, and prioritize using ABC's, and go from there.

They fill your head with alot of fluff in school. Learn it, for what you need it for, but when your in the real world you dont even think about those things.

[RNsRWe, ASN, RN]

Well, I guess I think that I do use the huge majority of what I learned, but I don't break each patient encounter down that way. While in school, there were seemingly endless bits of information to learn and know and use. A head to toe assessment could take a half hour when following all the steps we were expected to do. Now, however, a head to toe assessment takes me about five minutes, and I haven't missed anything I did while in my school days.

I don't use every little thing I was ever taught, or in the manner it was taught. But I'm glad to have gone through the process.

It's not that you're learning useless stuff, it's that eventually, it all gels together so well that you don't even realize what you're utilizing :)

[jncRN]

hi,

congrats on going to nursing school. nursing is the most wonderful occupation in the world! :)

to answer your question: you practice all that stuff in nursing school, and then when you get out there and get experience, you will be automatically doing that stuff in your head. when you get your pt. assignment each day, you will be scanning their health hx., thinking about potential nursing diagnoses and interventions, and then carrying them out, readjusting your approach as need be based on the pts' progress.

i was one of the biggest complainers to my friends about having to do nursing care plans during my nursing program -- but now i see that doing all that theory prepared me to think critically once i got out there.

enjoy nursing school...it is a journey, and you will be so proud when you have accomplished your goals!

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

nursescarlett

er nurse

[Blove86]

I had kind of wondered the same thing. Because I know that working in a face paced environment such as ER, we REALLY wont have the time to do a full head to toe assessment. But like you guys said, just enjoy the knowledge for what it is and then us it when you can!

[AnneP726]

I think when you start you concentrate on the straight skills at hand. Once you get comfortable with that the stuff what you learned in school comes back you... it makes sense

You learn to balance through prioritizing and organizing. It really can be fun when you get the hang of it.

School can be pretty rough sometimes, but, for me at least, worth every bit of it.

[Tweety, BSN, RN]

Nursing school attempts to put into words what we really do.

When you first come out you are going to be concentrating on tasks....meds, assessemtns, treatments. There will come a day when you might realize that you've developed your critical thinking skills and are actually using a process smilar to the nursing process, only you're not going through them one by one in your head.

An example would be you take a pulse ox on a patient and it's 88% and you put on 2L of Oxygen. That's not all you do because in you're head you're thinking "why is this patient's sat 88%"....you then listen to his lungs, look at the big picture - medical diagnosis (is a low 02 sat expected - for example are they admitted with pneumonia, post-op). You hear a lot of fluid in the lungs, notice their BUN and Cr. are normal, notice they have IV fluids at 150 cc/hr and decide they might be fluid overloaded and you then call the doc and collaborate on a treatment plan. You then give lasix 40 mg, slow the IV fluids, monitor the patient's urine output and pulmonary status, and evaluate if the treatment plan worked. Two hours later the patient is able to be weaned from the oxygen and their lungs are clear.

It's what we do on a daily basis with each and every patient. So yes, we do actually use this stuff. We adapt it to ourselves and our own practice, but nursing school laid the groundwork.

Good luck.

[nerdtonurse?, BSN, RN]

I'm an LPN now in RN school, studying nursing theory...

Today we have to do our "personal nursing theory statement" -- mine is "Logical pathophysiology/psychology/social work done with caring and compassion." Excuse me while a gack up a hairball...

In reality, it's "figure out what's wrong, figure out how to fix it, figure out how to get the Doc to write the order, figure out how to keep them alive until 7:45."

[RazorbackRN, BSN, RN]

hi,

congrats on going to nursing school. nursing is the most wonderful occupation in the world! :)

to answer your question: you practice all that stuff in nursing school, and then when you get out there and get experience, you will be automatically doing that stuff in your head. when you get your pt. assignment each day, you will be scanning their health hx., thinking about potential nursing diagnoses and interventions, and then carrying them out, readjusting your approach as need be based on the pts' progress.

i was one of the biggest complainers to my friends about having to do nursing care plans during my nursing program -- but now i see that doing all that theory prepared me to think critically once i got out there.

enjoy nursing school...it is a journey, and you will be so proud when you have accomplished your goals!

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

nursescarlett

er nurse

i also thought careplans were the biggest joke, but once i graduated and started working, i realized how well those careplans had help me prepare to think critically.

a few years later, i still remember the pain of the work, but i also still reap the benefits. ( i can't believe i just said this)

[meandragonbrett]

You will be amazed how nursing school changes your thought processes. You might not think you will ever use the nursing process but we actually USE it daily although we don't always consciously perform the steps.

[mama_d, BSN, RN]

I think the most valuable skill from all that nursing education is how to think critically and evaluate a constantly changing set of circumstances while always staying a step ahead of the game...kinda like learning how to play eighteen games of chess at the same time in your head. If you stop to think about it, the fact that all of it becomes second nature so quickly, and that you're able to assimilate so much knowledge and experience and constantly learn from it is amazing.

Nursing school gives you the technical skill set and background general knowlege, with the critical thinking skills....on the job training and practice gives you a more specific knowledge that expands on all that you learned while constantly refining those thinking skills.

[Roy Fokker, BSN, RN]

When you're playing catch - you don't see it in terms of conics, trigonometry and calculus, even though you are using them in intimate detail to catch the ball.

As a child learning to walk, you had to literally train yourself to "left foot forward. Pause. Right foot forward. Pause". As you grow up, because of all the practice and experience you get, it becomes second nature. You no longer "think" in terms of "left foot forward. Pause. Right foot forward. Pause" - even though that's exactly what you're doing since the method itself hasn't changed one bit since you were a child :)

It's a similar concept, IMHO.

Sure, care plans and procedures take hours to do in school. But when you do hundreds of them in a week, after a certain point it becomes second nature. When you've done hundreds of them for months on end, you become proficient that you start to formulate them in your head.

Now, do I use everything that was taught to me in school? Of course not.

School is for establishing good, sound, fundamental base. To get the 'basics' down - hard and cold. So that tomorrow when you're out there working and when faced with an unfamiliar situation, you fall back to the basics - and work from there on up.

cheers,