I really enjoyed week one's posts. Your insights are amazing.
Review at least 5 of the philosophy surveys on the WIKI. How did the philosophies of the nurses you worked with today differ from those you reviewed? Do you think nurses philosophies change over time? If so, why do they change? What must the new nurse do to keep thee most ideal philosophy for the remainder of their practice?
About Me
- Mrs. A
- Married 28 years to my college sweetheart - Tom; 2 sons: David, a broadcast communication major and Jonathan, an education major who is going to seminary later
24 comments:
It is difficult to maintain an ideal standard of care in anything we do if we do it everyday. It becomes routine. Although I trust that IP nurses still believe in the ideals they acquired as students (i.e. being a pt's advocate, providing emotional support, etc.), it may be difficult to maintain that standard indefinitely. I did not see any evidence of any IP nurses being apathetic this week. It seemed like these nurses still hold themselves to the highest standards wrt pt care. One possible explanation for this may be that it simply takes extraordinary people to want to work in this field.
I believe that the nurses that I have worked with the past couple of weeks still hold themselves at the same standards that us nursing students do. All the nurses that I have had a chance to work with really love their job and do a great job at it. They all spend a lot of quality time with their patients teaching and building a strong nurse-patient relationship. Each week I am more and more amazed at how the nurses are, I have had several nurses that I have worked with during previous clinicals that lose their love and compassion for their job. I believe it takes a special person to be an IP nurse and they really want to make it the most special day in a families life.
The nurse I worked with today exuded professionalism, but in a hurried manner which is understandable given her patient load. She is older and has worked in this field for many years so has had occasion to experience negative situations in addition to the constant wonderful experience of cherishing newborn babies and sharing the joys of new motherhood. Even if she still feels the positive emotions as freshly as she did as a student nurse, no doubt they are pushed away somewhat by guarding against the possibility of negative emotions, such as outrage at some mothers, anguish at some babies’ conditions, etc. I would think that negative experiences over time would change the idealistic philosophies with which a good nurse begins practice and lead to defensive detachment. To keep an ideal philosophy for the duration of my practice I would apply what I have learned in other aspects of my life, which is: Agony and ecstasy are simply two sides of the same coin. You can’t have one without the other in life or love or nursing practice. If I guard myself against feeling the pain of a neglected or abused infant I also lose the ability to feel the joy of newborn innocence and vulnerability.
For the most part I had a hard time seeing very many differences. Most of my classmates really focused on the aspect of caring for the mother AND baby. They also realized that providing support is essential to a good philosophy. If I had to find a difference I would say that my nurse also brought out the fact that nursing is best done as a team. Each nurse needs to be able to function on her own but for the patient to receive the absolute best care a team approach is needed. That way if a young nurse needs information of how to perform a task the best way possible she has a huge resource pool at her fingertips in her coworkers. I do think that philosophies change over time, and I believe this necessary and good for nurse and patient. A nurses philosophy can change for many reasons but I believe that experience is probably at the top of the list. If one is observant, how can they help but to pick up on what works best or start to question how to make things better? In order to keep those parts of a philosophy that are ideal and nurse should probably avoid burn out, keep up to date on research, and question the norms. By that I mean we should remain curious and always desire the best for our patients.
The RN that I worked with yesterday on Mother-Baby was a recent graduate of Wallace State. She was 20 years old and had worked on the unit for 2 months. She was quick to tell me that she would rather be downstairs in Labor and Delivery where she had precepted. Although she was quite efficient and organized with her patient care and assessments, I could tell that her heart was not in her work. As far as her philosophy, I believe that her answers would be very similar to the ones that my classmates gave. She seemed to work well with other team members, was safe when giving meds, and gave adequate patient education. It is a shame that she is so early on in her career, and she is not excited about working on a mother-baby unit. I know many of my classmates (including myself) would love to be in her shoes. I hope that she will maintain her professionalism and continue to give the best care to her patients. Maybe the unit will grow on her. If not, I hope she is able to transfer to another area where she will truly love her job.
The RN I got to work with seemed to like her job, but at the same time reminded me of a "refrigerator" nurse. She only had one laboring mom-to-be and didn't spend alot of time with her. Most of her time was spent talking to the staff about clothes and talking on the phone. Although, she was efficient at her job, knowledgeable, and got everything done accurately, I still feel that more patient time is a must! I really hope that none of us forget that more patient interaction increases the quality of patient care. :)
I think that having a personal philosophy is important in the kind of work that nurses do. At it's heart most of us in this profession share the same ideal of caring for our patients (no matter who they are) above all else. Most of the nurses that I have worked with have delivered care with this in mind. There have been a few exceptions where I got the feeling that they were fed up with thier job. I heard a couple say that if they had to do it over again that they would never go into nursing. In the grand scheme of things I beleive that our philosophies will develop over time and change, but as long as at the core we still truely care about what happens to our patients(no matter who they are)that we will be good nurses.
The nurse that I worked with today seemed to have many of the same philosophies that us as nursing students have. I got to observe my nurse in a unique situation where she had to stand up and be a patient advocate. I would hope that nurses' philosophies do not change over time because I feel that it is the foundation that brought them into this profession and I hope that they always continue the same standards they have set for themselves in the beginning. I do understand that as you become a more experienced nurse that you will learn to handle certain situations differently but I think that your personal philosophy will stay the same. I think the new nurse must always look back at what their philosophy was from the beginning and never forget that we must always be a patient advocate and provide the proper emotional support for our patients.
I listen to nurses tell us about bad experiences on the fifth floor. Because Decatur hospital OB/GYN doctors no longer work there, the indigent population has increased at Huntsville. I heard some hurses commenting they really prefer not to work with that population of people. In my opinion, some nurses have forgotten why thy chose this noble profession. Their philsophies have changed, because maybe they are losing their passion for this area of nursing. If that's the case, there are so many other areas they can choose to work as another kind of nurse.
The nurses that I had the opportunity to work with were very attenative to their patients provicing excellent care. I believe the quality of care provided by them is a direct result of their philosophies and attitudes that they have toward nursing. They made an effort to build a positive relationship with each patient by building trust and displaying an attitude that put the patient first. The nurses were also attenative to pain, provided support to patient and family, provided explanations for procedures and participated in patient teaching.
The nurse that I was assigned to this week is a recent graduate. It was evident that she enjoyed what she did and provided the best care possible to her patients. I believe that not necessarily do our pholosophies changed over time, usually we want the original philosophy to be there at all times, but times and circumstances change who we are. As a nurse in any field that we may choose, we always need to keep in mind why we chose this field and continually look back at the way we felt about nursing when we started out and strive to always provide the best and most competent care we can. At the first signs of burnout, we need to find somewhere else to work, because our patients are not benefiting from our care if we aren't providing the care that is due to them.
I think that although most people who want to be a nurse have a philosophy of always being the patient's advocate, always conforting the patient, and always doing what is right for the patient. However, it is easy to deviate from these ideals and nurses do it all the time. Sometimes, if you are doing a procedure (like putting in an IV, changing a dressing, etc.), you forget to assess the patient's level of comfort because you are so focused on doing the procedure right, keeping thigs sterile, etc. I think for many nurses, the ideals they started out with, didn't stick with them throughout the entirity of their career because it becomes 'just a job' to some people. But, I think if we should always think back to our initial philosophy of nursing so that we don't just do not become apethetic.
The nurse that I was assigned to today was a pretty recent new graduate. She talked about how much she wanted a job on the L&D unit and that it was the reason she went into nursing. She provided adequate care for her patient, but I would've never guessed that IP nursing was her passion if she hadn't of said something. She was very good at what she was doing, but didn't seem very enthusiastic about it. Now, I did have a chance to see a delivery with another nurse who was absolutely amazing and seemed more excited about the birth than the mother did. I'm sure she has witnessed many births in her career but she displayed such passion and enthusiasm as if it were her first time. It was very inspiring and I can only ask...how could anyone ever get tired of aiding in a child coming into this world?
I feel that patient care should be a nurses number one priority. The problem is that every nurse views "good" patient care differently. I feel that as an L&D nurse who is assigned to only one patient the nurse should spend most of her time in the room building a trusting relationship with her patient and easing her anxieties. My observation this week can only be compared to a group of high school girls sitting in a circle gossiping for hours on end. Yes they all had monitors that they could watch the FHR and Contractions but that is not the same as being in the room with your patient. I feel it is the nurse managers responsibility to cease all the talk at the nurses station and remind these nurses what good patient care consists of. I can only speak for myself when I say that if I am a L&D nurse after graduation most of my time will be building a relationship with my patient and if I ever find myself sitting at the counter constantly gossiping it must be time for me to change areas of nursing because I am not putting my patient first.
The nurse that I was assigned to this week just recently graduated last May. My nurse was excited about her position and gave the best care for each individual patient. I believe that we change everyday based on EBP and newer techniques and technology. However, we still reflect on the original philosophies of nursing. As nurses we need to consider burn out and remember the symptoms that accompany to this. Also we need to strive to give the best care possible. The last and most important thing to consider is to love the job that we do everyday and reflect on the reasons we chose this profession and speciality as our destination.
I think that the nurses I have worked with so far have maintained a bright outlook on their jobs. Their philosophies seem to be much like ours in that they still contain a passion and respect for their job and the people whom they are caring for. I believe that we as young nurses have to avoid burn out at all costs... we have to find our niche in the system that we have that same love and passion for and remind ourselves that we may one day be in our patients' shoes.
The nurse that I worked with and all the others I witnessed seemed to have the same philosophies that we as nursing students have. They seemed to care about what was going on with their patients and wanted to provide the best possible care. The nurse that I worked with said L&D was her passion, and she was very encouraging to the patient. However, I felt that she, as well as some of the other nurses, could have spent more time with their patients and not at the desk, being that most of them only had one patient.
I believe...whether or not someone actually intends to reflect their personal beliefs on their patient...it happens, and it's happened with just about every nurse I've followed. I think that the media, family, demographics and other influences shape our values and morals and over time, yes, they do change. Whatever happens to be the case, it influences our care and definitely has positive and negative impacts on our patients. What is the most 'ideal' philosophy? I can't say I know. I believe that saying something is 'ideal' is totally whatever that person makes it, their opinion. I can say that I will take what I believe to be the most non-biased opinion on what I believe is 'ideal'...and pass it down to new nurses...student nurses that I come across in my career. I can't say that the nurses I've come across have had philosophies as 'ideal' as I think most people would agree on.
This past rotation I saw how some of the PP nurses can be slow to do their job and be distracted by their surroundings. There wasn't much going on, but it seemed the slower it was the slower the nurses were at delivering care. The nurses I was around seemed to be very good nurses, but they also seemed to adjust to the slower pace of the floor and not use their extra time to be at the bedside with these new moms. It takes a special person to be a IP nurse and off days are expected with every job. I am still impressed with how my nurse I was with and others on the floor attend to both the nuclear family and the extended families. The philosophies that I read were all pointed toward what I would call a textbook IP nurse. I think everyone goes into their field with some sense of how a job should be done, but those views usually change when one is actually working in the field. Everyones views change with time and experiences.
I really enjoyed week two. I got to care for three hispanic clients and view cultural differences that the exhibit. One major thing that I noticed is that they do not show pain. When asked about their pain they would respond that they were hurting but there were no facial signs or body movements that would lead the nurse to believe this without asking the client. I also watched a circumcision, which was VERY intresting. The baby was given sugar water in a nipple to take his mind off the pain of the procedure. There was very minimal bleeding and I was suprised at the babies response to this. He hardly cried and was sleeping within minutes of this procedure. I really enjoyed this experience and am looking forward to next week.
I was on the L&D floor. It was alot different than the medsurg floors i have been on. One thing is there is smaller patient to nurse ratio. therefore the nurse was able to spend more time with each patient. I also liked that the patient could be monitored at the nursing station because sometimes it was hectic in the room with all the family. Being able to monitor the baby and mother at the desk is comforting.
I was with a nurse that has recently graduated from UAH, so her ideas and actions were similar to that of nursing students. I believe some nurses philosophies may change over time but they should still revolve around the best care of the patient and child. To keep the ideal philosphy the nurse must remember to put their own personal feelings aside and give their patient the best care possible.
Today was an interresting day. It was totally opposite of the first week that I had at HH. My nurse was distant and didn't communicate at all. Her response to her patient and myself was that we were an inconvienience. I believe that peoples philophies change with their life experiences. I guess I could say they evolve. I believe that it is important to be open and to evolve as health care changes but to remember to always give the best patient care. It is our responsibility as professionals to join a professional organization in the nursing field htat we have decided to work in to maintain the education and changes that are taking place. This is our responsibility as nursing advocates!
Laura
I believe the nurses on the L&D floor still have the same philosiphies as us students. They help us to learn and are willing to teach us things each week. The nurse I worked with was deffinatly a patient advocate and was there not only for the patients emotional support but also there for the patients husband and mother. I believe that as nurses being there for emotional support should be held as one of the highest standards along with the physcial nursing skills. Again I really enjoyed this weeks clinical and enjoyed the L&D floor as well as the nurses.
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