Saturday, December 21, 2013

Exactly what does a nurse do anyway???

There we were, a bunch of people that I love, sitting around the table discussing our week, and the subject turned to jobs...then somehow it turned to college and why education was or was not important.  The subject then turned to nursing education and just how much was truly needed in order to "become a nurse." 
One of those people that I love (and of course still do) gave the opinion that "nursing education has turned into something so ridiculous and hard...mostly you just need to know how to follow doctor truly would only take half the time to educate someone to be a nurse"...and on and on it went. I will spare you all the "in depth" conversation that followed~~ BUT what this conversation did do for me was cause me to reflect on a lay person's idea of what the job of nursing entails...

Educating people to become a nurse entails so much more than teaching the technical skills required to be a nurse. 
Yes we teach them how to wash their hands properly (to not spread infection) take vitals signs (Blood pressure, pulse, temperature, count respirations, oxygen saturation and assess pain), insert foley cathetors, IV lines, nasogastric tubes, and trachs, give a bed bath and change linens, safely move people in bed and safely ambulate someone or move them to a wheelchair etc, to "wipe butts" and empty bedpans, hang IV drips and give medications in many forms...and on and on and on.
AND YES we could teach just about anyone to do these things.

BUT we also teach them anatomy, physiology, pathophysiology, biology, microbiology, immunology, algebra, chemistry, English grammar, sociology, psychology, developmental psychology, abnormal psychology, pharmacology, health and wellness/assessment across the life span, science of nursing, alterations in health/ illness, nutrition, nursing theory, research, informatics, clinical decision making, transcultural diversity and relations, ethics, professional behaviors, spirituality, death and dying processes, nursing management, leadership, community health, interpretation of lab values....and on and on. 

We also teach all of the above through concepts of human caring, basic human needs and teach the nursing process. 
We teach them all of these things in order to prepare the nursing student for the art and science of nursing. We educate them properly so once they are in the work setting and "following doctors orders" while performing their technical skills, that they will do so safely. The subjects that are taught give the nurse the ability to use the technical skills as a compass to asses the true health status of the patient. Without the knowledge base~~the technical skills would have no meaning.  

So~~ while the nurse is talking to their patient they are studying them and assessing their neurological status and assessing their oxygenation. During the communication with their client they are also assessing the patient for knowledge level, home safety, patient advocacy, illness insite, inside information to shed light on present situations and to develop a relationship of caring so that healing can occur. 
While the nurse is checking the patient's vital signs they are learning about their cardiovascular, respiratory and thermo-regulatory states.  
When the nurse is giving their patient a bed bath they are assessing their skin integrity, their ability to assist (their strength), fluid balance, nutritional state and infection/ skin breakdown risk. 
While assisting someone to a wheelchair the nurse is providing safety while assessing their patient's strength, cognitive ability, safety risk and spatial awareness. 
When inquiring about their patient's med list the nurse is assessing the patient's knowledge around their disease processes as well as their safety regarding how, when and why they take the medications. 
During the process of changing a patient's dressing the nurse is assessing the wound healing stage, the surrounding tissue state, as well as checking for odor/infection...they are also assessing whether that type of dressing that was "ordered by the doctor" is actually working.  
While "wiping butts" the nurse is assessing skin integrity, assessing the color, odor and consistency of the stool to detect disease states or healing. 
When a nurse is "following a doctors order" and medicating their patient, that nurse does 6 checks in order to ensure the patient is receiving that medication correctly~~ but more importantly the nurse has to know why that med was ordered, and they need to know if it is the right dose for that patient, and they need to know what side effects to watch for...and on and on and on.  

I could go on!!  The bottom line is that the nurse is with the patient far more than the doctor is. The nurse is the front line (bringing their thoughts, assessments, interpretations and communications to the doctor in order for the proper care to be given to the patient) and safety net for their patient (ensuring that the doctor's orders are indeed safe for the patient and not given if they are not!). If the nurse isn't educated but merely taught technical skills, then that nurse would not be able to do the above I just mentioned and the health of the patient would be in jeopardy. 

How educated do you want your nurse to be????