[I put Claire Temple there because she is the only nurse on TV that I’ve seen that actually acts like a nurse. Like, she breaks scope of practice all the freaking time, and there was that little incident where she abandoned her patients without telling anyone, but in Daredevil S1E2, I was thoroughly convinced of Rosario Dawson’s nurse status. And that’s saying something, cause you all know I’m picky.]
Nursing publicity actually sucks (see chapter 21 of this textbook), so here are some fun facts to get you thinking in the right direction when you’re writing, reading, or otherwise applying your knowledge of the nursing profession in a creative way:
1. Nurses treat reaction to disease. Literally
our job is to assess and treat the reaction a person has to a disease process,
or what impact a disease has on a person physically (are they in pain? having
trouble breathing? can’t walk?), mentally (does a disease process alter how
they think, their quality of life?), emotionally (are they devastated by a
prognosis? depressed by their inability to act as they used to?) and spiritually (what is their relationship
with their belief system? has it changed in response to disease? how do they
feel about that?). In contrast, a
physician treats the disease itself.
2. Nurses have a system of diagnosis and care
planning that is unique from that of a physician. Medical
diagnosis of course is taken into consideration when treating a patient and
planning care, but remember that we are treating a reaction to a disease process, and so our diagnoses are those reactions. Some examples include:
Sleep deprivation
Impaired gas exchange (difficulty breathing)
Decreased cardiac output (less (or too little) blood getting out of the heart)
These are usually written as part of a larger
“Diagnosis Statement” which goes something like this: “Impaired gas exchange
related to bronchospasm as evidenced by expiratory wheezing, abnormal blood
gases, patient statement of ‘I can’t breathe’ and medical diagnosis of acute
asthma exacerbation.” Nurses then plan and carry out interventions to improve
the patient’s condition. Often, this goal coincides with the physician’s plan
of care, and a nurse can ask a physician for orders if they feel the patient
needs something that requires such an order.
3. There are different “levels” of nursing.
These are:
Nurse Aide (NA or UAP): 2 weeks-3 months of training. Nurse Aides carry out patient care activities such as bathing and dressing, they can measure patient intake and output, take vital signs (depending on facility), take blood sugars (depending on facility), remove IVs and Foley Catheters and do other duties as assigned by the Registered Nurse or Licensed Practical Nurse they work under. Must have passed either
State Licensure or a facility-based training program.
Licensed Practical Nurse (LPN): 1-1.5 years of training. These are starting to go out of style and mainly found either “grandfathered in” in hospital settings or working as supervisors in nursing homes. In addition to all things listed above, they can do a full assessment and basic nursing interventions, including placement of IVs an Foleys, pass (most) medication, collect samples for testing, take health histories, supervise Nurse Aides, and other duties as assigned by a Registered Nurse. LPNs must have taken and passed national licensure (NCLEX-PN in the USA).
Registered Nurse (RN): 2-4 years of training, usually with an accompanying associates’ or bachelors’ degree. Registered Nurses can do all of the above, as well as administer all medications, do full range of IV therapy, write and make plan of care for nursing diagnoses, follow ACLS protocol (without deviation), do nursing research and supervise LPNs and NAs. Training for RNs focuses a lot more on critical thinking and research skills. RNs must have taken and passed national
licensure (the NCLEX-RN in the USA). This is generally what people think of when they think of a nurse.
Clinical Nurse Specialist (CNS): 6-8 years of
training. CNSs are masters’ or doctoral prepared nurses who specialize in
one area or population, usually in the inpatient hospital setting (though some specialties practice in community or mental health settings). They
provide higher-level care in their specialty and are able to perform
procedures outside an RN’s scope of practice. CNSs also teach, supervise
and conduct nursing and medical research within their specialty. CNSs have either extremely limited or no prescriptive privilege (they can’t prescribe medication).
Nurse Practitioner (NP): 6-8 years of training (minimum Doctor of Nursing Practice (DNP) degree by 2030). NPs can often practice independently in a primary care capacity (varies by location),
and have a broader scope of practice than a CNS. In a primary care
capacity, they can prescribe medication, do office-level medical
procedures and refer to specialists. NPs also do research, teach and
supervise nurses in hospital and long-term acute care facilities.
4. Nurses are expected to question
orders and advocate for their patients. We are the end-point of all orders and
the last line of defense before an order hits a patient in a hospital setting. In
the USA, a nurse is legally responsible for questioning orders and may choose
to hold an ordered medication or intervention if they think it will harm the
patient (we do have to immediately call the physician and ask for another
order, but we can do it).
5. Nursing is applicable in
extremely diverse fields that have nothing to do with clinical nursing care. For example, there are:
Forensic Nurses, who collect
evidence from victims of crime
Nurse Advocates, who are
practicing lawyers who also hold degrees in nursing
Nursing Informatics Specialists,
who design computer systems and technology applicable to nurses and healthcare
Insurance Nurses, who work as
liaisons between the insurance industries and patients
Nurse Administrators, who work
the business end of healthcare
I recommend to all my younger family members that they take a look at nursing, because it’s such a huge career field and is nothing like what you see on TV!!
When we honestly ask ourselves which person in our lives means the most to us, we often find it is those who instead of giving advice, solutions, or cures have chosen rather to share our pain and touch our wounds with a warm and tender hand.
You can’t just give up on someone because the situation’s not ideal. Great relationships aren’t great because they have no problems. They’re great because both people care enough about the other person to find a way to make it work.
I reclined in my chair, enjoying the hot sun on my face. The waves before me crashed with rhythmic purpose and I felt myself growing sleepy. Seagulls cawed overhead. The air smelled of salt and sun tan lotion. Things were good.
Women in my mother’s family have an unusual relationship with death. We believe in signs and listening when the universe, or whatever you want to call it, starts trying to tell you something. The night before my great grandmother passed, she was telling anyone in her nursing home who would listen that she was going home; that Daniel, her husband of forty-seven years who had pre-deceased her by five, was coming to get her. The next morning, the staff found her tucked neatly in her bed, her hair and makeup done up as best she could, with a smile on her face.
If you’re not doing anything with your life right now that doesn’t mean you never will. Maybe this phase in your life is necessary for reasons you’ll eventually find out.
“I am a 16-year-old Australian self-taught special effects makeup artist. I make myself into all sorts of crazy things for fun and post them on my Instagram account in the hope of inspiring more people to give this crazy art form a go!
I was inspired to start after falling in love with the extraordinary characters in movies such as Pirates of the Caribbean and X-Men. Then when I discovered the reality TV show FaceOff where they compete with SFX makeup and heard that many of them taught themselves, I decided it was time for me to give it a go! I used mainly Youtube to learn the basics from channels such as Madeyewlook and Glam and Gore. I started on my 14th birthday and have now been teaching myself for over a year.
Each time I create a look I get a bit better and slowly they are becoming bigger and bigger. I can now body paint, create horns and teeth, and even make custom prosthetics! I make prosthetics by sculpting what I want on my face cast, I then make a mould of it and fill it with homemade SFX gelatine and then all that’s left to do is stick it on my face and paint it! I hope to one day have a hand in creating a character for a movie or video clip for the world to see and enjoy. For now I am grateful for any experience and exposure I can get.”