Thanks to everyone who commented on the last post. Like I said, I wasn't looking for a "right" answer. I was just curious what others thought. As for those who asked about my opinion, I would sign the form. I think looking out for a patient's health comes first. If I don't think the system is working very well, I could work to change that also, but in the mean time, it's not my job to decide how best to manage the patient's finances. I could expand more, but I think I'll just stop there since you guys really hashed this issue out, and I think all had some great points.
As for the comment that nursing schools are wasting time discussing issues like these, I respectfully but enthusiastically disagree. I am not a nurse. I am not chalk full of experience. I can only speak to what I've seen. But I have been on hospital floors all over the place, and I have seen many nurses that are the result of that kind of education where all you talk about is lab values, assessment, etc. I think the result is an extremely task oriented nurse. Patients become lab values and assessment findings. I feel that this kind of attitude and nursing approach lead to burnout, sloppy assessments, and poorer patient outcomes in the end. I have found that nurses who have been taught to think about the patient as a person and to think about the ethical issues that will inevitably arise in the healthcare setting (the situation I presented in that last post was an actual situation, presented to me by a nurse who encountered it) keep their eyes on the ball a little better. They can analyze lab values and perform assessments and administer medications safely, but they think about what they are doing in terms of the impact it will have on a real, living, breathing person. I agree that most of our time at nursing school should focus on the learning of those very important technical skills but I don't think it's a waste of time if someone actually presents us with real life ethical situations and asks us to think about them.
Of course, I would like to just throw in that I don't mean to generalize. Some nurses who talk about ethical issues in school will still turn out to be crappy nurses while some who never talked about that are still patient-oriented and make great nurses. I have just found a more general trend in the opposite direction. That's just my experience.
Tuesday, November 18, 2008
My opinion
Posted by ShaNae at 11:55 AM
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8 comments:
Oh ShaNae, you've got my goat....
"I have seen many nurses that are the result of that kind of education where all you talk about is lab values, assessment, etc. I think the result is an extremely task oriented nurse. Patients become lab values and assessment findings."
I studied nursing at BYU, it was extremely competitive and I worked hard to get there, really hard. To have you say, "that kind of education," really gets my dander up so forgive the insolent tone, I'll try to control myself. I never, never looked at my patients as lab values and assessment findings....not once! I knew their names and I spent my time sitting with them in their rooms talking to them and their families. I cleaned up their rooms to help them feel better in their hospital environment. I went out of my way to get them the things that would make them happy and comfortable. All that work to have someone years later tell me that an emphasis on lab values and assessment findings makes me a task oriented nurse? Boy, why do you think I learned them so well? It's my job to not let them die, that's why. I could talk until I'm blue in the face about affording energy, but it isn't going to help my patient a lick when they've just converted to rapid afib after a valve surgery. So you choose what you want to focus on and incorporate it into your nursing practice, just please don't insult the other nurses around you who have made it a point of their practice to know what is going on with their patients body.
BTW, I never said the issue you brought up in your post was outside the scope of nursing practice.
p.s. The highest compliment I ever received as a nurse was when our charge nurse who had worked in our unit for over 13 years told me she would want me to be her nurse. Does that follow your line that nurses who focus on assessment, labs, and meds and their significance with the patient are just task oriented?
"I don't think it's a waste of time if someone actually presents us with real life ethical situations and asks us to think about them."
If you are referring to my comment here, I never said it was a waste of time to think about ethical situations. Indeed, ethics are very much a part of nursing practice. In the case you presented, it doesn't sit well with me to grant someone assistance while they simultaneously gamble away their money. That strikes me as irresponsible on both counts (patient, nurse). That is why I said the patient should be redirected, or counseled if you will.
Uh, let's try this instead (delete the previous)
It has been my experience that nurses who attend to a patients physiology with a keen understanding of the same are the best nurses, marked not only by their knowledge but also by an express interest in the patients overall well-being. In fact, their focus on assessment, labs, and pharmocology, is only an expression of a deeper concern of truly caring for another. This concern is what gives birth to their incomparable code of ethics and practice of holistic nursing.
Thanks ShaNae
Wow, did ShaNae talk directly to you or what? Man, here I was thinking that she was being kinda vague in the details, but she was talking about you? Oh, wait... no I still don't see that. Oh well, ShaNae I think you are wonderful nurse! You've taken my blood pressure, and I can officially say that I have a nurse to help me. :)
I do have to speak up against the rantings of the Waddells a little though. (I don't know which one posted it) But it's ok to tell someone that you disagree how certain programs work. I personally think anyone who graduates from ITT Tech and is happy with the education they got, is pretty stupid. And I don't care who gets offended. Your way of putting it was much nicer.
So don't let someone's rantings get you down. I'm glad there is a little more than stats and numbers behind your education.
Ha, ha Robert! Ya, I did rant a bit didn't I... what's my problem? No, ShaNae wasn't talking ABOUT me, I don't even know if she could pick me out in a crowd of people, but it felt like she was talking TO me since her post referred specifically to my comment. I just felt like I had to defend myself against the accusation that nurses who try to master the physiology of nursing reduce their patients to stats/values/numbers and give no heed to the ethical issues inherent in nursing. That has not been my practice or experience.
I like you though Robert. You seem merry and you spread cheer wherever you go (or write).
Annalee
p.s. I better clear my good husband's name and claim responsibility for the "chris and annalee waddell" comments. I'm the (cold-hearted) nurse, he's the (nice beyond belief) sculptor/artist :)
This subject certainly got some heatlhy conversation going, regardless of which side each one comes down on.
Way to go ShaNae!
Love you.
Wow, I'm late coming to this party. Sorry I've missed the boat!
My two cents: talking about ethical issues all day long does not make good nurses. Talking about lab values and assessment does not make good nurses. I believe people come to nursing school either with compassion (or the ability to learn it) or without. I'm only 10 weeks young in this education, and I can already separate my classmates into "those that care," and "those that don't." It doesn't have to do with politics,it doesn't have to do with the hours-long discussions we have in our ethics class (that persuade only the already-persuaded), it has to do with those who are willing to take a patient's hand and look in their eyes and ask them what you can do for them instead of text messaging in the lounge. It has to do with getting into a patient's room immediately after they're incontinent to respect the fact that no one would want to sit in that for hours, instead of asking your teacher if you can have post conference early. When I think of a great nurse, I don't think of signing forms and giving electricity to people. I think of the people I'd want in my room after an operation or a scary diagnosis. I see a lot of people who answer the ethical questions "right" whose presence I wouldn't feel comforted by.
For me it all comes down to compassion. Face to face, soft spoken comfort, compassion.
There seems to be a fundamental misunderstanding of "ethics" here. Ethics is not a list of rules. It is a sophisticated philosophical discipline which deals with complex questions relating to the decisions we make and the implications they can have. Ethics is not a set of answers; it is a set of questions. The discipline of ethics is not concerned with persuasion or even morality. It is concerned with making people think about their actions and coming to philosophically sound and consistent conclusions.
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