Tuesday, October 21, 2014

Things I wish I knew when I was in nursing school

It's hard to believe I finished nursing school 18 years ago. (But I'm not old!) I became a nurse practitioner 5 years later. As I look back on my years, I think about things I wish I knew when I was in school.

Here's my list.

1. Most of the stuff you learn in school will be outdated in 5 years. 

Medicine is currently changing and it's important to keep up. Read journals, go to conferences, most of all just keep your eyes and ears open.

2. Nursing diagnoses and care plans are obsolete.

Alteration in respiration due to impaired gas exchange as manifested by dyspnea and tachypnea. Hmm.. maybe shortness of breath? I think the point of nursing diagnoses is to teach nurses to think for themselves but let's be realistic. What nurse in their right mind diagnoses their patient with alteration in comfort due to surgical incision as manifested by patient's complain of pain? If nurses want to be treated as equals on the health care team they should probably use the same language as the rest of the health care team.

3. Learn to think for yourself!!

I see this all the time. Nurse has taken care of many patients with the same diagnosis and is really good at how to take care of them. She listens to their lungs, she changes their dressings, she gives them pain medication. But then one patient has something unusual happen to them. Nurse can't possibly figure out what to do because she's used to "what she was taught" and defers to the doctor's orders. Nurses need to be able to look at the situation at hand and make a decision based on the data available, not just thinking generically that patients with the same diagnosis are all the same. It's easy to get into a rut. Think for yourself.

4. Learn from your patients.

I can't tell you how many patients stick out in my mind over the years because they taught me something. Listen to their stories, get to know them. You might see a patient with a particular problem and then 5 years later see another one. You will be more likely to recognize it because you have seen it before. File it in the back of your brain for next time.

5. Work together with your coworkers.

No one takes care of patients alone. Everyone has an important job- from the PCT who takes the blood pressure to the doctor who orders the meds to the nurse who gives the meds to the secretary who makes the chart to the person who cleans the floor. People in health care depend on each other. Treat everyone with respect. You are no more important than anyone else.

6. You don't know everything.

Nobody knows everything. Learn from the people around you. Ask questions.


What are some things you wish you knew?


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