Producing a New Generation of Nurses

Colin T. Son

Disclosures

May 05, 2009

I watched the senior student fumble with the syringe and antibiotic vial, desperately trying to "sit on my hands" and let her work it out for herself. The clock was ticking and we still had a lot to get through that morning.

As she flicked haplessly at the barrel of the syringe in a vain attempt to dislodge every last bubble, I thought back to my student days. I was pretty sure I had been that bad, before I'd discovered about creating a vacuum in the vial, using a large bubble to "soak up" smaller ones, and other tricks of the trade.

The attribution for that quote is an anonymous nurse, using the pseudonym NurseAusmed, on the blog Nursing Handover. The quote's description of what, in part, goes into educating a nurse is all too important. Parts of the world are facing physician shortages, but it seems that the entire world is facing a shortage of nurses. In terms of healthcare labor, finding more nurses may be the single most imperative thing that any healthcare system can do to improve the care that it provides.
 

Nursing Handover hosts Grand Rounds
May 5, 2009


As important as every member of a modern healthcare team is, there's a reality about the nurse-patient relationship in that it is the most fundamental in the inpatient setting. Here's how NurseAusmed put it:

There's no way the medical staff can keep track of all the nuances of my patients. They see them for a few minutes a day; I see them all day, and I have to be able to recognise the important changes and feed them back in a meaningful way.

If I were a patient in a hospital, all other aspects of my care being adequate, I'm not sure that there's anything I would trade for a dedicated, smart, caring, well-trained, and observant nurse. Educating the next generation of nurses and keeping the current generation up-to-date and on their toes undoubtedly is important. Nursing Handover covers a broad range of topics important to nurses, but nursing education is one of its primary focuses.

One of the blog's most prominent recurring features is the series "Questions of the Week." Practical, clinically oriented questions are presented to get nurses thinking about their practice environment. In a recent edition, after discussing the problem of multidrug-resistant bacteria, these questions were posed:

1. Does your area implement MRO screening on admission from the community? How about from other hospitals or facilities?

2. How long can MRSA survive on inorganic surfaces? Klebsiella? C-diff? Just for variation, how about rotavirus? The answers may surprise you.

3. Best guess, how many patients did you work with in the last week that you know had an MRO?

Other education is focused more on the metaphysical. Several recent postings have discussed the nurse's role in helping patients and families deal with bad news. One post explored how nurses in training deal with the loss of their first patient and included this experience shared by a student nurse:

She looked dead. Was she breathing? I shook her shoulders, got no response.

It was at this point that my brain emptied itself of all useful information and skills! Instead of using the emergency call bell, or at least checking and clearing the airway, I ran out of the room and down the hall looking for an RN, any RN. I found an agency nurse but she seemed just as confused as I was.

Finally I located one of the staff nurses and things began to look more organised. The room filled with staff intubating, giving CPR, administering drugs. I stood in the corner feeling wretched and trying not to get in the way.

My clinical instructor was actually pretty understanding although naturally she had some pointed words to say about proper use of the emergency call bell and the ABC's. I never forgot that patient though, and I became a lot less "polite" in making sure my patients were alright--even if it meant waking a few sleeping beauties unnecessarily!

It's anecdotal and sad -- and a little bit charming. The advice, however, that Nursing Handover gives on dealing with death or with grieving and questioning families is poignant and a great educational resource.

The shortage in healthcare professionals will continue to generate discussion that is economically and politically infused. However, I hope that people like NurseAusmed over at the blog Nursing Handover continue to write about how to make nursing education more effective, to prompt nurses to continue to learn even once they're out of school and to just generally inspire.

There may be some inspiration demonstrated this week over at Nursing Handover as it hosts Grand Rounds. Grand Rounds is a collection of the best online writing from nurses, physicians, students, health policy wonks, pharmacists, patients and anyone with an interest in healthcare. Each week it is hosted by a different site. I encourage everyone, nurse or not, to go check out Nursing Handover and the best online medical blogging from the past week.

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