06/26/2019
This summer, student nurses from academic institutions throughout the U.S. are working at Yale New Haven Hospital to improve their understanding of the professional nurse’s role. Interns are working for 10 weeks in various service lines ..., learning clinical skills by providing patient care under the see Yale's Website:
As President of the CT Nurses' Association I would like to commend these nursing students who want to learn how to understand and differentiate the different aspects of a Registered Professional Nurses' role. It is not only the majority of people who do not understand what it is that nurses do in the course of a day; many nurses themselves cannot articulate it to others. The image of nurses as handmaidens (or hand grooms) to physicians still prevails yet nurses are colleagues to physicians with many at very high levels of education up to and including Doctoral degrees in different aspects of nursing specialization; and yes, many of these highly educated nurses work at the bedside; they are in independent practice, in research, in education, in businesses and in their own businesses and practices. Nurses do not report to doctors and are not supervised by them. If a nurse makes a practice or judgement error he or she cannot turn around and say, "The doctor ordered it". Nurses are responsible for what do and do not do; they are legally, morally and ethically responsible for their actions. Many think of a nurse by what they do at point of contact between a nurse and a patient and completely overlook the essentials of nurses’ extensive bodies of knowledge underlying their thought processes, critical thinking skills, scientific knowledge, and nursing process that underpins the independent judgements a nurse has to make as they care for patients. This is not unexpected; I doubt the public or even many of our health colleagues are aware of the rigorous course of study that comprises nursing education.
A nurse does not just provide pills, injections or treatments to patients. They need to call many things into consciousness before they do any of that. Their professional understanding of how those actions interact with a patient's diagnoses, other prescribed and over-the-counter medications, lab values, nutritional status, cognitive and emotional status and potential dietary interactions. Nurses monitor how patients respond to medications and treatments, which means understanding their intended outcomes as well as the potential side effects and adverse reactions of anything we do to a patient. This is where the heavy emphasis in nursing education on chemistry, biology, nutrition, anatomy and physiology, psychology and sociology come into practice at the bedside.
Nursing process is at the heart of nursing and involves assessment, planning a course of action to address gaps between what is and what should be, AND what the patient wants; it involves constantly re-evaluating the patient and the plan of care and making modifications as needed. In my 50 years of nursing I have used nursing process in all my life decisions and strategies. We do not operate in a vacuum. nursing like the rest of health care practice is a "team sport". A nurses communication skills and leadership skills are essential attributes of a good nurse and leadership takes place at the bedside as well as in supervisory and administrative roles.
Nursing is the only profession that in the course of basic nursing education needs to learn aspects of what every other health professional does. It is what makes nurses the ideal care coordinators, care planners, care managers and discharge planners. We are the strongest patient advocates because of the intimate knowledge we acquire of patients and their support systems, all of which we bring into play in the care of our patients. Nurses are at the patients side when they are born, when they die, and at some of the most existential crises of their lives. We practice with individuals, communities, population and cultures. Environmental health is another area of practice. This is a profession where you know that every day that you go to work you will be making a significant difference in people's lives. It is part of why nurses are rated as the most ethical, trusted professionals for decades by people across the nation in the National Gallup Polls. (Google National Gallup Polls: Nursing). Nurses are way above every other profession, and by a wide margin. This is not by chance.
Nurses need an "elevator speech". Perhaps one or more of these nursing students can develop one and share it with us! Good luck to all of you. Welcome to Connecticut and welcome to nursing; the greatest profession in the world!!
Reach out if I can be of any assistance to you while you are in our Great State of Connecticut.
Dr. Stephanie R. Paulmeno, DNP, MS, RN, NHA, CCM, CPH, CDP
President: CT Nurses Association-President of the CT Chapter of International Forensic Nurses Association
spaulmeno47@yahoo.com 203-326-0400
