The grayness of nursing...

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Does the gray area that exists in nursing bug any of you all? I tend to be a black and white person, so nursing can be difficult for me sometimes. People will say "use your nursing judgment" but I am more of a policies and procedures type of person. I am not sure if its my personality or from time spent in the military. I am currently working urgent care and wonder sometimes if something a little more black and white would suit me better? I was told today I would do well in an OR/PACU area or case management. Are there any more nurses out there that are like me? where do you work? Thanks!

Like I stated earlier it is not the critical thinking I am talking about. I am fine making decisions based on a patients conditions or assessment. What I am talking about is there seems to be 100 different ways to do the same thing, and for someone with a black and white personality this is can be difficult. Coming from a rigid military background we followed SOP for almost everything.

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Specializes in Pediatrics, Emergency, Trauma.

Coming from a military family, having a black and white personality is not always a bad thing; you can combine that with you nursing practice; having a routine when you check pts before you even get report; or adhering to your own nursing judgement in times where it may be challenge can be a positive thing.

There are some absolutes I use due to my upbringing but I have learned to be objective and to think out of the box in turn because of my upbringing that certainly didn't happen overnight; and you have to give it time to reconcile that we are independent thinkers; that's the beauty of nursing. :)

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Specializes in Emergency/Cath Lab.

To me it is refreshing. I am a very black and white person in my life outside the hospital. I like it that way. But man when I am at work, the world is open to new things.

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Thanks Ladyfree. I just wish I could chill out but I am guessing that comes with time and experience.

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Specializes in Pediatrics, Emergency, Trauma.
Thanks Ladyfree. I just wish I could chill out but I am guessing that comes with time and experience.

It does; think of those 100 options as a part of protocol in an abstract way, and that's half the battle. :yes:

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Thatguy, I never thought of it that way! Thanks for your perspective!

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Specializes in Critical Care, Education.

That's the most wonderful thing about nursing - there is a place for all types of folks. Many of us are just not comfortable with ambiguity... it has nothing to do with intelligence or skill ... just the way our brains are wired. Me? I discovered a few decades ago (yep, I'm old) that I am most content in very unpredictable situations. My goal is to have an entirely random life - LOL.

BTW, I tend to be fairly stress-free.... but I have been told that I am a carrier.

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Specializes in Quality Management.

The need to evaluate varying "shades of gray" speaks directly to the heart of the "vocation versus profession" debate in nursing that has carried on for over a century. I think of it as a continuum with vocation at one end and profession at the other and each of us falls some where in the middle depending on how comfortable we are exercising independent judgement. Not everyone is nor should they be.

As I have stated on multiple occasions regarding the great education debate, nursing is a big tent and one size need not fit all. There are specialties where a nurse can stick closely to policy & procedure, calling on others when things "don't feel right." Then there are specialties where the patient dynamic is constantly changing and the care team must constantly re-evaluate the patient's condition just to keep up. Those subtleties just can't be dictated in a P&P codex.

Bottom line: As in all things, you just have to find your level and work with it or else you will have stress.

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Paganoid...ambiguity is a better way of describing my issue than grey areas. I am very structured and like to know what I'm walking into so my current job increases my stress levels. Are there any jobs that are the same everyday?

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Hi all this is my first post from Tasmania Australia. I have been reading your comments with interest and some amusement too. I have worked in many different nursing roles but my current job is probably the most removed from nursing pursae thus far. I work as the manual handling coordinator for our area health service. I provide skill based training for nurses, doctors, allied health staff and support workers as well consult with nurses about the best options for handling complex needs patients particularly the morbidly obese. It has been an credible learning curve for me but I feel very happy in this position as I can be both autonomous but remain in contact with my nursing colleagues and provide patient care at the same time. The job can be quite black and white which I think would appeal to you but occasionally there is a call for thinking outside of the box when nothing else works a bit like the grayness you describe that we have all been exposed to at some point in our nursing careers. I guess there is no easy answer but if you really want black and white I would consider a move into management or adminsatration type roles. The down side is that you become much more removed from patient care which is the most rewarding part. Have you thought about working ina military hospital? All the best from Tasmania.

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OP, as a military nurse in a military hospital working with SOPs that make NO sense and are essentially impossible to change no matter how much evidence you throw at them... enjoy your freedom. Enjoy the ability to choose the best way based on evidence. Enjoy being able to exericse your judgment and autonomy as a nurse. SOPs and procedures are only as valuable as the evidence they're based on. It's quite possible to have SOPs that cover all the bases and still do most everything wrong!

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Thanks Ladyfree. I just wish I could chill out but I am guessing that comes with time and experience.

I have a notebook that I keep at work with tons of different things (including our hospital's standard policies and procedures) that I use as reference. For the things that seem to have a hundred different ways to do them right, I will type up my own policy or procedure that works best for me. I get a lot of use out of it, because as a fairly new nurse, a lot of these things aren't second nature to me yet, and I'm prone to forget certain steps or where to document certain things. It also appeals to the black and white side of me, because even though it wasn't issued out by the hospital, it's a set of guidelines that I know are correct and can follow step by step if needed.

Maybe trying out something like that can hold you over until you find your niche!

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