Wednesday, October 3, 2007

Are You Experienced?

Last week we took our exam on the topic of high risk OB. For a lot of people, including me, it is our worst subject. When I took the mid-curricular HESI last spring, I missed every single question on the OB portion of the exam. A lot of guys don't do well because almost every male nursing student I know hates OB.

For the women a different dynamic come into play. I would say the majority of female nursing students are mothers or have been through labor. For some of us it was as long as 20 or 30 years ago. This is a problem because what happened to us then is different then what happens to patients now. Our experience in labor and delivery is probably very different from what we need to know for the test.

This is true of nursing in general. What happens in nursing school is very different from what happens on the job. I don't have very much experience in actual patient care. The small amount of experience I do have has proven to me that there often is no direct application of what we learned in school to actual hands-on patient care.

I had written in a previous post about the pros and cons of going to nursing school at middle age. One of the problems we encounter is what we learned a long time ago may have changed. The medical field is constantly changing. New research is being done all the time. What used to be the gold standard for a certain kind of care, is later found to be either ineffective, dangerous or it doesn't matter one way or the other.

For example, pre-eclampsia. Years ago this used to be called toxemia. The treatment is still the same but the name has changed. What has changed is the treatment for preterm labor. In the past a woman who was having contractions before she was due was ordered strict bedrest. Studies have shown that there is no conclusive evidence that bedrest makes it any better or worse. In fact studies point to evidence that bedrest is actually slightly more harmful, not so much to the unborn baby, but to the mother and her quality of life. If a mother is ordered to bedrest and has other children, she needs to find someone to help her care for the other children. Nowadays most women work outside the home. If a Mom is placed on bedrest, she has to quit working which creates financial difficulty for the family. Then there is evidence that putting Mom on bedrest can cause her muscles to weaken and lose their function. This can be a problem during labor when Mom needs those muscles to help push the baby into the world.

So in weighing out the pros and the cons, the experts have figured out that the slight benefit, if any, of bedrest does not outweight the downside of being in bed. What I love about this is that more and more often medical care is focused on not just the physical aspect of a medical condition, but all the parts of a person's life that can affect their condition; their quality of life.

The problem is if you are a middle-aged woman who experienced preterm labor decades ago, you may apply your experience to the test question and not what was in the book or the lecture. The challenge is paying attention to what the information is today. When I'm taking a test I have to ask myself "okay, is what I'm thinking what I just learned, or is this something I remember from way back when?"

For the guys I have no idea how this information affects you. I cannot think of anything in urology that has come along in the past decade or so that can affect what you learned 30 years ago.

Oh wait. I just thought of something.

Think about what I talked about before. Your health problems and your choice of treatment don't just affect you, but other people in your life.

And remember, get help if your erection lasts longer than 4 hours. Not only will it be a test question, but it'll seriously cut into your action if you don't apply it to real life.

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