When a nurse gives a medication, why does he or she do it? Well, there are orders to do it. Yes, but we can hold something, or give something. The former is called parameters or judgement and the latter is called prns. Its a little odd, because nursing judgment isn’t the same across the board, and what one nurse will hold, another nurse will give. So how are you supposed to develop your own judgement? By what you see? Nurses don’t always see the same thing. Patients don’t always exhibit the same behavior to each person. Communication is everything in nursing (a fact that no one tells you in school), but when different nurses don’t see the same thing, what can you do? How do we decide to move on something (give a prn and find the doctor) and how do we decide that something can go? If a resident has pain in the hospital, we find out what is going on with that pain. In long term care, it is entirely possible that someone is bored.
Are the rules different in long term care vs. acute care? What is nursing judgment, how do you develop it, and how do you determine whose judgement is good? I think it is based on senority, to a degree. A nurse who has a lot of experience has seen, and knows more than a nurse who is fresh out of school.
I’m still trying develop my own judgement, but I lean towards not giving anything if at all possible. This may not be the right answer all the time, but I still feel that the body should be allowed to try to reach equilibrium by itself, if we can afford to wait.
Sometimes we can’t wait. Sometimes it would be dangerous to try. Where is the line? I don’t know. As I go, perhaps I will learn where the line is.