Textbook nursing vs. real world nursing.

[dudette10]

I've seen that phrase a lot, and I really don't understand it. I'm not being snarky here...I sincerely don't get what that means.

For example, working with difficult people and noncompliant patients is not something taught in nursing schools, so it's NOT a textbook thing...not taught in lecture, but it certainly comes up in clinicals. It's mainly the real world of nursing, but we might have seen it on the floors during our education. Therefore, there is no "vs." about it.

Is it because in "textbook" nursing, the assumption is that every patient is compliant, every role does their job without question, and when you get on the floor, those assumptions no longer apply?

That's really the only thing I can come up with.

I guess my question comes from nursing friends who said to me after I did an FB post that I got a job, "Forget everything you learned in school. You're in the real world now." I use what I learned in school every single day: pharmacology, assessment, pathophys. When I have questions about nursing judgement, my basis for those questions is what I learned in school, although school didn't teach me everything, of course, which is the reason I'm asking the questions in the first place.

How do you define that phrase? What do you really mean when you say it?

[royhanosn]

text book is exact that, its the basics. The once you get into the field, you learn real world, and watch others, and ASK questions. Thats how you learn and learn to cope. Remember your a rookie!

[SusanRN82]

When you are in school and in a lab setting, you learn how to do things the "right way", according to established standards and protocols. You are also taught to think critically, which should help prepare you with how to deal with the messiness of the real world. Yes, we all have to adjust procedures depending on the circumstances, but you can never lose sight of the right way to do things. And don't let others influence you to cut corners as you provide care.

Worst case scenario - 30 years ago I was working with a new grad who had an order to hang heparin, which she did, but she couldn't get the pump to work right and it was time for her dinner break. So she left the IV to hang by gravity, figuring what could possibly go wrong in just 1/2 hour. Wrong thinking lead to wrong decision-making, which lead to wrongdoing...

[royhanosn]

its been awhile since been in school, so yes textbook and lab...the right way.

when you get into real world, as long as the shortcuts produced desired results, you are good to go.

[Eaglelady]

text book is exact that, its the basics. The once you get into the field, you learn real world, and watch others, and ASK questions. Thats how you learn and learn to cope. Remember your a rookie!

I totally agree textbook are the basics and the nursing program helps to teach Critical thinking but hands on to me is what we called "Reality Check" as a nurse you move from the basic to the advanced mode--my critical thinking actually was put to the real test with my 1st patients when I realized the patient was under my care and that I was responsible for my patients and when I made my first call on a patient and realized I did great it felt awesome to realize I had done what I had been trained for and from there my knowledge only expanded and every day I continue to learn so I guess you could say as a nurse we go from a school of basic learning or foundation of nursing to a school of higher learning which is referred to as the real world.