Nursing Nurses only please?

Question

I am in nursing school 2nd semester med surg and i am having problems prioritizing on the tests. I think pain of 7/10 should come before a dressing change with moderate serosanguinous drainage but this was wrong on the test. I picked pain also over risk for infection because the pain is real and the infection is just a risk. Does anyone have a good resource or way to prioritize nursing care? Thanks all.

Answer 1

I would agree with everything PJH had to write.
Bottom line...... ( I don't mean to transmit any negative vibes towards your instructors, they are full of experience & knowledge ) but I'd venture to say, that in any field, nursing, business, hell garbage collection even, ...the ones teaching you have their way of doing things & prioritizing things & that is the way they are going to teach you & want you to do it. Sure they have 'guidelines' 'objectives' from the institution but this doesn't really mean squat. Take what you need from them ( instructors ) when you are out in the cruel reality of nursing & leave what you don't need. With this said, ...during school & their class & their tests, ... humor them & choose the answer that they want you to choose, not necessarily what you would do in 'your' practice.
I've found that way of thinking helped me in nursing school.
It also helped me with the nursing exam, as it will be consistent with the way your instructors exams & priorities are. So remember that!!! After you acheive your RN, then you're on your own to do what you feel is right first.
Example, the pain against dressing change. In real life, you'd reinforce the dressing, go for the pain med, give it bit to work as a dressing change can be painful so you want them to be pre-medicated, then do the dressing change & be assessing it during. Essentially, you'd do both at the same time.
As for pain and risk for infection, well pain is subjective so basically that would be priority for the patient, but you as the nurse and his/her caregiver, would know that an infection can kill. So you'd have to take the risk of your patient screaming at you for putting his pain med on hold while you asses the risk for infection & call the dr. Hope this helps :)

Answer 2

It's been a long time since I was in school for this, but, if I had an answer wrong on something when I was in school, I felt that I paid for the explanation of why it was wrong from the instructor.

OK, lets look at this. 7/10 pain to dressing change with serosang. I would have gone for the pain on that one. It would take about 5-10 min. to dose someone, 20 minutes at least to get the stuff, do the strerile dressing, assess, chart....then get the pain meds after 25 min. wait. You would risk needing more medication for the pain person created by delay. Not good.

BUT, if there was evidence of a wound going bad, even if the drainage was moderate, wound first. Some wounds I would expect drainage, other wounds..not good. But pain over dressing change in real life sounds right, on the test...its not my test.

Pain over risk of infection, how high of pain and what risk of infection.. I would probably go for risk of infection on this one. A dressing change is a task. It is fit in to all the tasks you are doing, unless something looks wrong. Then it is no longer a dressing change, it is a search for something wrong, which bounces up to the top of the list.

Risk for infection is also a top of the list item because a risk of infection is not going to kill your patient, but by the time it becomes an infection it will kill them really, really dead. Both of these issues may have come upon the first real time rule of nurse priority and that is safety is the first consideration. If they have a bad wound, they are not safe and if they are risking infection they are not safe and the less safe they are, the higher they are in priority.

Now, I am not saying this will get you through any test, but in real life you have to just stop and ask "who isn't safe?" and start there. Sorry about the spelling, I have once again bogged down the spellcheck.