We've had so much contradictory teaching so far. We've been drilled with the RACE acronym, then today we had a test where the correct answer out of the four options within RACE was to pull the alarm. What?? Last time we were tested on this the correct answer was to rescue. Why isn't there any consistency?
Then we had another question on DKA, which we've never covered by the way, on our acid-base exam. Well out of the choices given, two of them were incorrect for sure (i.e., dextrose IV), so it came down to O2 or sodium bicarb. The question focused on their breathing and what collaborative care we would provide. Well, I knew from past reading on my own that HCO3 was a last resort and deemed fairly unsafe in most cases unless the pH was less than 7.00 and special circumstances existed. Cerebral edema, over correction, cardiac issues, and so forth puts bicarb at the bottom of the list of treatment measures. Since we weren't given any ABG values in the question or anything to suggest the patient was in a poor state, I went with O2. Is O2 that helpful? I have no idea. However, the Med-Surg book puts O2 high on the list of initial interventions, then fluid replacement, insulin, and potassium. Well, the instructor wasn't swayed by our reason for picking O2 over bicarb.
This kind of thing happens all the time. Another question we had dealt with Foley placement. We were told in lab not to inflate the balloon prior to insertion, as research had shown that it can cause irritation going in the urethra. On our exam we answered the question dealing with a Foley so as not to inflate the balloon. Well we were marked wrong. Surprisingly, someone found in the book that is does say not to inflate the balloon to test it. Didn't matter, we weren't given the point.
Every week we take a test we argue with the teacher and wonder what the point of all of this is. They keep going on about "critical thinking", but it is way more a game of craps since the majority of our tests have more than one right answer and if you choose a "wrong" one but show the teacher another nursing book (NCLEX review) or the one we've been given that backs up our answer, you're shot down. They will actually say "The book is wrong". Okay, so my Saunders NCLEX review book is wrong??
I missed another one today regarding the defintion of palliative care. They had home care, hospice, and a couple choices that were more acute. I chose home care simply because palliative care is not limited to the dying patient and hospice. That is not the core definition of palliative care, which is often used in treatment of chronic conditions. Well, the teacher seems to think palliative is synonymous with hospice, and that palliative care does not pertain to the maintenance of long-term chronic disorders.
I think nursing school has so many problems in how they "teach", jumping out of sequence regarding topics (e.g., covering ethics and law after physical assessment), preventing the use of medical books to better understand diseases or write papers, giving to little time to skills lab, ect....
