Feeling like such a fraud

[chayan]

I'm 4 weeks away from graduation and still feeling like such a fraud...

For the past couple days my husband has been complaining of pain when swallowing. All I could tell him was to make an appointment for a throat culture. I coulda done the same thing without nursing school.

And a friend was complaining of hand pain after she lifted something heavy. I asked her if she had the hand x-rayed. That was dumb--a pulled muscle wouldn't show up on an x-ray. I didn't have any advice for her other than to use ice packs.

People seem to think that as a nursing student I should possess great health insights. Personally I feel that despite being an almost-RN, when it comes to actual health situations I'm no better than any layperson, or any better than I was before school.

[malkieh]

A. your not a doctor.
B. we are not supposed to be diagnosing people..

We all have questions like that...my husband hands me the phone and says "such and such has a question." and it's usually something medical..

blah

[medic09]

Chaya,

Malkieh is right. You really aren't supposed to know it all. Even AFTER graduation.

The truth is, that school only prepares you to do the real learning, which occurs when you start work. And it takes most people a few years before they start to develop good clinical judgement and correlation between the book learning and the real world.

Even doctors are limited in these things, depending on their field. I was in the Golan Heights a few weeks ago, with my medical ethics seminar for Shabbat. The lecturer for Shabbat is an accomplished radiologist. Just as Shabbat ended, a madricha from another group came and asked if he would come see a young woman with chest pain. Without hesitation, he pointed to me and said, "take him. He actually deals with these things. I wouldn't know what I'm looking at."

So you see, all of us have real significant limitation based on our education, experience, and area of practice. Don't sweat it. Just keep learning, and daven everyday that Hashem should guide you to treat your patients kindly and correctly.

[achot]

Everything you did sounds like good nursing practice to me...
As coordinator of health care, you are expected to refer patients (including dear hubby) to the proper professionals to take care of them. You are not expected to be a nutritionist, psychiatrist, physical therapist, internist, radiologist, etc all rolled in one.
Just as a home decorator might refer a client to a roofer or a plumber etc.

People will turn to you and ask you questions, some of those will fall within nursing practice and some require referrals. It is not a sign of failure but of wisdom and knowing your limits.
Pirkei Avot teaches us that a wise man admits when he doesnt know something.
Referring doesnt make you incompetent, besides you can help by looking things up on the internet, while people can do this themselves, it is possible you will be able to interpret the information for them in a way that they can better understand it and apply it properly.

[chayan]

We're not supposed to diagnose but we are supposed to assess. I feel that my assessment skills are no better than the layman's. I tried palpating my husband's neck when he was complaining of pain on swallowing, but really didn't know what I was feeling and whether it was normal or not. As much as I scour my assessment textbook over and over, I still don't have a real sense of what's an "expected" versus "abnormal" finding.

[Rivka P]

I agree with most of what is posted above. I just wanted to add that I was taught that as a nurse, we are supposed to be told a diagnosis and know which symptoms to expect. Whereas a doctor looks at symptoms and suggests a diagnosis. I think that ice is a reasonable treatment for hand pain. That and rest, compression and elevation. (RICE)

Different areas of nursing require different skills. Much of what people are asking you about isn't really in the scope of a hospital nurse. Don't feel like a fraud. Take this opportunity to educate your friends and family members about what being a nurse is all about.