ALRIGHT. ONE OF THE WAYS THAT WE'VE GIVEN OURSELVES
A SYSTEM OF CRITICAL THINKING
IS BY DEVELOPING WHAT WE CALL THE NURSING PROCESS.
WE ARE GOING TO USE IT FROM NOW ON.
AND THE THING I REALLY LOVE ABOUT YOUR BOOK
IS THAT IT IS ACTUALLY OUTLINED IN THE NURSING PROCESS.
AND SO IT LOOKS AT ASSESSMENT, IT LOOKS AT INTERVENTIONS,
PLANNING, OUTCOMES, IT GIVES YOU DIAGNOSIS.
SOME OF IT IT DOESN'T APPLY RIGHT NOW.
IN OTHER WORDS, SO MUCH SO FAST.
IT WILL GET TO ALL OF IT EVENTUALLY.
BUT WE WILL ALWAYS USE THE NURSING PROCESS
AND YOU JUST NEED TO SEE IT NOW AND APPRECIATE THAT THIS IS GOING TO BE COMING.
WE ALWAYS ASSESS, I TOLD YOU THAT.
NURSES ASSESS. WE GATHER DATA, THAT'S OUT GOAL.
SO ASSESS.
WE THEN ASSIGN A NURSING DIAGNOSIS. NOT A MEDICAL DIAGNOSIS.
WE DON'T SAY THAT YOU HAVE APPENDICITIS.
I DON'T EVER SAY THAT YOU HAVE PHENOMENA. THAT'S THE DOCTOR.
BUT THERE ARE THINGS THAT I DO SAY BASED UPON MY NURSING SCOPE OF PRACTICE.
AND I MAY SAY THAT YOU HAVE AN ACTIVITY INTOLERANCE.
AND I HAVE NURSING INTERVENTIONS
THAT I CAN...ACTUALLY INSTITUTE
BASED ON MY PROFESSIONAL SCOPE OF NURSING
AND WE ARE GOING TO SORT THAT OUT AT ABOUT WEEK FIVE.
BUT NURSING DIAGNOSIS.
THEN WE DEVELOP A PLAN OF CARE FOR OUR CLIENTS.
WE DECIDE WHAT WOULD BEST HELP THEM.
SO WHEN I SAY TO YOU IN THE HIGH-FIVE
YOUR GOING TO CHECK THE DOCTORS ORDERS AND THE NURSING CARE PLAN,
WE ARE PUTTING MEDICAL WITH NURSING TOGETHER TO MEET THE HOLISTIC NEED OF THAT CLIENT.
AND THERE ARE TWO DIFFERENT SCOPES OF PRACTICE.
WE ARE GOING TO THEN DO THINGS FOR OUR PATIENT.
THERE ARE THINGS THAT I CAN DO THAT A DOCTOR MAY NOT IMPLEMENT.
FOR EXAMPLE, THE DOCTOR MAY NOT SAY ELEVATE THE HEAD OF THE BED.
BUT I KNOW THAT THAT NEEDS TO BE DONE FOR SOMEONE THAT'S HAVING DIFFICULTY BREATHING.
I CAN APPLY ICE TO SOMEONE THAT'S GOT SOME SWELLING BECAUSE IT'S NOT INVASIVE.
AND SO THERE'S THINGS THAT I CAN DO WITHOUT A DOCTORS ORDER.
AND WE NEED TO KNOW WHO CAN DO WHAT
AND WHAT I CAN DO INDEPENDENTLY AND WHAT I CANNOT.
AND THAT'S IN OUR INTERVENTIONS AND WE'LL LEARN THOSE IN THE NEXT TWO YEARS.
AND THEN, NURSES ALWAYS EVALUATE THE CARE THAT THEY GIVE.
DID WHAT WE DO WORKED?
DID THEY BREATH EASIER? DID THE SWELLING GO DOWN?
WHAT HAPPENED BASED UPON THE PLAN THAT WE CREATED?
AND DID IT HAPPEN WITHIN A TIMEFRAME THAT WAS EXPECTABLE
OR THAT WE WANTED FOR THAT CLIENT.
SO, YOU VERY OFTEN HEAR THIS REFERRED TO AS ADPIE,
AN ACRONYM FOR ASSESSMENT, DIAGNOSIS,
PLAN, INTERVENTION, EVALUATION.
I USE JUST CALL IT APIE.
THEY USED TO NOT ALWAYS PUT THE DIAGNOSIS INTO IT.
SO, IT'S THE NURSING CARE PLAN AND MEMORIZE IT.
IT'S VERY IMPORTANT TO WHAT WE DO.
ALRIGHT. SO FINALLY, WHAT ARE ATTITUDES ON AN EFFECTIVE CRITICAL THINKER?
YOU KNOW, IT'S AN ATTITUDE.
MOST EVERYTHING HAS AN EMOTION
OR SOMETHING PSYCHOLOGICAL ATTACHED TO IT.
SO IF YOU'RE GOING TO BE A CRITICAL THINKER, WHAT WOULD BE YOUR ATTITUDE?
ONE IS THAT YOU'RE GOING TO HAVE CONFIDENCE.
YOU WILL HAVE RESEARCHED, YOU WILL HAVE THOUGHT THROUGH
AND YOU KNOW THAT THIS IS IN THE BEST INTEREST OF YOUR CLIENT.
IT DOESN'T MEAN THAT YOU WON'T ENTERTAIN
SOMEONE ELSE'S IDEAS OR THOUGHTS OR INFORMATION,
BUT YOU'RE CONFIDENT ABOUT WHAT YOU KNOW AND WHAT YOU'VE LEARNED.
YOU'RE AN INDEPENDENT THINKER.
YOU DON'T JUST DO WHAT SOMEONE ELSE SAYS
BECAUSE SOMEONE ELSE SAYS IT.
THAT'S SCARY. YOU VERIFY.
YOU TRUST IN VERIFYING AND YOU THINK ON YOUR OWN
BECAUSE YOU'RE RESPONSIBLE FOR YOURSELF.
YOU'RE FAIR. YOU KNOW, IN OUR PRACTICE,
WE HAVE TO BE JUST, WE HAVE TO RECOGNIZE OUR OWN BIASES AND PREJUDICES
AND WE HAVE TO NOT ALLOW THEM TO AFFECT WHAT WE DO FOR EVERYONE ELSE.
WE ARE WHO WE ARE AND PEOPLE ARE WHO THEY ARE
AND WE HAVE TO BE FAIR ABOUT HOW WE TREAT EVERYONE.
WE'RE RESPONSIBLE AND ACCOUNTABLE
AND WE HAVE TO TAKE OUR RESPONSIBILITY SERIOUSLY.
WHAT I DO I AM RESPONSIBLE FOR, YOU ARE NOT.
YOU'RE RESPONSIBLE FOR YOU.
SO THE BLAME-GAME THING THAT GOES ON IN THIS WORLD IN WHICH WE LIVE, STOP ALREADY.
TAKE RESPONSIBILITY FOR YOUR OWN ACTIONS,
YOUR OWN BEHAVIOR AND YOUR OWN LEARNING
BECAUSE THAT'S WHAT A NURSE IS, WHO IS A CRITICAL THINKER.
AND BE ACCOUNTABLE, WORK WITHIN THE STANDARDS OF THE PRACTICE.
BE A RISK TAKER.
THERE'S SOME THINGS WE GOT TO DO
THAT'S NOT BEING DONE IN YOUR FACILITIES WHEN YOU SEE
AND YOU TAKE A RISK BECAUSE YOU READ THE RESEARCH.
HERE'S A RISK YOU MIGHT WANT TO TAKE.
WE'RE GOING TO TEACH YOU LATER ABOUT CHECKING FOR NG TUBE PLACEMENTS.
THAT'S A TUBE THAT GOES NG, NASOGASTRIC.
A TUBE FROM YOUR NOSE INTO YOUR STOMACH.
AND AS NURSES, WE HAVE TO VERIFY PLACEMENTS OF THOSE TUBES.
AND IN THE LITERATURE, YOU'RE GOING TO READ
THAT THE BEST WAY OTHER THAN X-RAY --
THAT'S THE FIRST THING WE DO, RIGHT AFTER A TUBE'S PUT IN.
THE BEST WAY TO CHECK FOR PLACEMENT IS TO CHECK THE PH OF THE TUBE.
YOU CAN'T FIND ANYWHERE IN THE LITERATURE,
WHERE THAT'S NOT A GOOD WAY TO CHECK THE TUBE.
BUT YOU FIND ME A HOSPITAL IN THE CENTRAL VALLEY THAT'S DOING IT.
I'VE BEEN TRYING FOR EIGHT YEARS.
I'VE WRITTEN LETTERS TO ADMINISTRATORS, I'VE SENT ARTICLES.
I'M TAKING RISKS. I CALL WHEN I HAVE STUDENTS,
I CALL TO SEE IF THERE'S PH PAPER.
I ASK IF WE CAN SEND THE SOLUTIONS --
WE GOT TO TAKE SOME RISKS AND DO SOME DIFFERENT THINGS
WHEN WE'RE KNOWING BECAUSE OF OUR EDUCATION
THAT THINGS AREN'T BEST PRACTICE.
HERE'S WHAT'S KIND OF TRICKY.
YOU'RE GOING TO LEARN BEST PRACTICE. WE'VE GOT THESE BRAND NEW TEXTBOOKS,
AND WE'RE GOING TO DO NEW ARTICLES THAT WE READ JUST LAST WEEK.
AND SO YOU'RE GOING TO KNOW BEST PRACTICE IDEAS AND IVORY TOWER NURSING.
AND YOU'RE GOING TO GO TO THE HOSPITALS
AND YOU'RE GOING TO SEE SOME THINGS THAT,
"THAT'S NOT WHAT THE BOOK SAYS." AND YOU'RE NOT GOING TO LIKE IT
BECAUSE YOU'RE KIND OF BLACK AND WHITE STILL RIGHT NOW.
AND WE'VE GOT TO WORK THROUGH SOME OF THAT.
IS WHAT THEY'RE DOING OKAY? COULD IT BE BETTER?
DO THEY JUST NOT KNOW YET?
BECAUSE OUR JOB IS TO STAY ON TOP OF IT.
SO TAKE SOME RISKS OUT THERE TO IMPROVE THE QUALITY OF CARE.
ALRIGHT. YOU'RE GOING TO HAVE TO BE DISCIPLINED ABOUT THAT.
YOU'RE GOING TO HAVE TO BE DISCIPLINED ABOUT YOUR CRITICAL THINKING.
ABOUT THINKING ABOUT WHAT YOU'RE THINKING
AND THINKING ABOUT IT TO MAKE SURE IT'S BETTER.
YOU'RE GOING TO HAVE TO PERSEVERE.
YOU'RE GOING TO HAVE TO KEEP ON GOING WITH IT.
YOU KNOW? KEEP CHUGGING ON. PERSEVERE.
BE DETERMINED. YOU'RE GOING TO HAVE TO BE CREATIVE.
SOMETIMES WE JUST HAVE TO USE OUR IMAGINATION.
WHEN I FIRST STARTED NURSING,
AS A STUDENT, I'LL NEVER FORGET MY VERY FIRST ANYTHING.
AND MY VERY FIRST PATIENT WEIGHED ALL OF 80LB.
I DON'T REMEMBER HER NAME, BUT I REMEMBER HER.
I CAN REMEMBER THAT BED, I REMEMBER THE HALLWAY AND I REMEMBER THE SMELL.
AND I WALKED INTO THAT ROOM AND SHE WAS ALL IN THE FETAL POSITION.
AND MY ASSIGNMENT WAS TO FEED HER BREAKFAST.
THAT'S ALL I HAD TO DO THAT DAY WAS TO FEED HER BREAKFAST. AND I WAS SO SCARED.
I HAVE NO NURSING BACKGROUND, I LIKED BIOLOGY,
I LIKED DISSECTING FROGS AND I THOUGHT I SHOULD BE A NURSE.
BECAUSE I DIDN'T WANT TO BE A HAIRDRESSER AND I DIDN'T WANT TO BE A TEACHER,
AND SO I THOUGHT, "I GUESS I SHOULD BE A NURSE."
SO I WALKED IN THAT ROOM AND I WENT,
"OH, MY GOSH! SHE'S GOING TO DIE.
SHE'S GOING TO DIE RIGHT NOW WHILE I'M HERE IN THIS ROOM. OH, MY GOSH!"
AND I RAN OUT OF THE ROOM. I JUST RAN OUT.
I WAS ALL OF 19. DOESN'T MATTER, I WAS SCARED TO DEATH.
I PROBABLY -- I DON'T KNOW, I WAS SCARED TO DEATH.
SO I WENT UP TO MY INSTRUCTOR AND I WENT,
"I THINK MY PATIENT'S GOING TO DIE."
AND SHE GOES...
"WELL, LET'S GO LOOK."
SO SHE WALKS IN THE ROOM AND THE LITTLE LADY DID LOOK VERY FRAGILE.
AND SO SHE GOES, "WELL, SHE'S BREATHING. I THINK SHE'S OKAY."
"OH, MY GOD. OH, MY GOD!" I WAS SO SCARED.
SO WE TURNED HER AND I THOUGHT --
SHE WAS JUST A LITTLE BAG OF BONES, HONEST TO GOODNESS
AND SHE WAS ALL IN A FETAL POSITION.
AND WE TURNED HER AND HER LITTLE KNEES WERE UP TO HER CHEST,
AND WE GOT HER ALL STRAIGHT AND WE PUT THE HEAD OF THE BED UP,
AND I FED HER BREAKFAST.
AND I HAVE TO TELL YOU, SHE ATE TWO EGGS, A BOWL OF OATMEAL,
ONE PIECE OF TOAST, AND A PIECE OF BACON.
AND I'LL NEVER FORGET ALL, EVERY PIECE.
BECAUSE I PUT IT IN HER MOUTH. AND THEN SHE JUST ATE IT UP.
SHE JUST ATE IT UP.
AND I REMEMBER SAYING THIS TO HER AND I SAID,
"WELL, YOU MUST HAVE BEEN RAISED ON A FARM. YOU EAT LIKE A FARM GIRL."
AND I'M THINKING, "WHY DID I SAY THAT? I DON'T KNOW WHY."
YOU KNOW, YOU THINK YOU GOT TO TALK BECAUSE SHE DIDN'T TALK OR ANYTHING, SHE WAS OUT OF IT.
AND I REMEMBER THAT.
OKAY, WELL, THAT'S ALL I COULD DO THAT DAY,
COS I WAS SO SCARED AND I WAS JUST --
I WAS OUT OF MY ELEMENT AND I KEPT THINKING,
"WHAT AM I DOING? I DON'T REALLY WANT TO BE A NURSE.
WHAT AM I DOING? OH, MY GOSH."
OKAY. WE STAYED AT THAT NURSING HOME FOR THE WHOLE OF OUR STUDENT HOOD.
AT THE END, THIS OTHER NURSE TOOK --
NURSING STUDENT, TOOK CARE OF THE LITTLE LADY WHO ATE THAT.
HOW CAN SHE BE 80LB AND EAT LIKE THAT, I JUST WANT TO KNOW.
BECAUSE SHE PUT AWAY THAT BREAKFAST EVERY MORNING.
AT THE END, THE NURSE -- THE LITTLE STUDENT THAT TOOK CARE OF HER,
YOU KNOW WHAT SHE DECIDED TO DO?
SHE DECIDED TO BE CREATIVE.
SHE FELT THAT LADY NEEDED STIMULATION.
SHE REALIZED THERE WERE NO VISITORS IN THAT ROOM.
SO SHE GOT A RADIO FOR THAT LADY.
SHE GOT SOME PRETTY BLANKETS TO PUT IN THAT ROOM.
SHE WAS CREATIVE. SHE COULD LOOK BEYOND HERSELF.
SHE COULD THINK ABOUT HER THINKING.
SHE COULD THINK ABOUT WHAT WAS BEST FOR THAT CLIENT
AND SHE WAS A CRITICAL THINKER.
I WAS PATHETIC. SHE WAS REAL.
YOU HAVE TO BE BETTER THAN ME.
DO YOU SEE WHERE I'M GOING HERE WITH THIS?
SOME OF YOU WILL BE PATHETIC. IT'S OKAY.
YOU CAN COME FROM PATHETIC TO SOMETHING.
THAT'S WHY I LOVE BEING AN INSTRUCTOR.
I UNDERSTAND WHERE YOU'RE AT.
BUT THE POINT IS, TO BE A CRITICAL THINKER, BE CREATIVE.
I REMEMBER AT THE END OF THAT ROTATION GOING,
"I WISH I WOULD HAVE THOUGHT OF THAT."
I'M NOT SO DUMB. YOU KNOW WHAT I MEAN?
BUT IT'S NOT ABOUT JUST DOING THE JOB,
IT'S ABOUT DOING MORE THAN THE JOB,
IT'S ABOUT CARING FOR PEOPLE.
AND YOU GUYS KNOW HOW TO CARE FOR PEOPLE.
AND YOU WOULD KNOW WHAT YOU WANTED YOUR FAMILY MEMBER TO HAVE IN THAT ROOM.
YOU KNOW WHAT YOU'D WANT IN THAT ROOM.
THINK BEYOND WHAT THE CIRCUMSTANCE IS TO MAKE IT BETTER.
BE CREATIVE, THAT'S A CRITICAL THINKER.
BE CURIOUS. WHY IS IT LIKE THAT?
WHAT DOES SHE MEAN? WHY DID SHE SAY THAT?
BE CURIOUS ABOUT STUFF.
IF YOU'RE CURIOUS ABOUT YOUR LEARNING,
IF YOU'RE CURIOUS ABOUT YOUR PROFESSION, YOU WILL LEARN MORE.
THE QUESTIONS THAT YOU ANSWER FOR YOURSELF,
BECOME YOUR OWN.
IT'S YOUR OWN LEARNING.
IF YOU JUST TRY TO MEMORIZE WHAT I PUT TOGETHER TODAY
WITH A LOVELY, YOU KNOW, PRESENTATION, EXCEPT FOR THAT BLEEPING.
IT'S JUST MINE. I'M THE ONE THAT THOUGHT ABOUT IT.
NOW YOU NEED TO GO HOME AND THINK ABOUT IT.
AND THINK, WHAT'S YOUR FAVORITE DEFINITION ABOUT CRITICAL THINKING?
HOW WOULD YOU DESCRIBE IT? HOW WOULD YOU TEACH IT?
ARE YOU CURIOUS ABOUT THOSE NURSING PROFESSIONS?
YOU KNOW, REALLY, THOSE NURSING ORGANIZATIONS ARE THERE TO SOCIALIZE US.
ARE YOU CURIOUS ABOUT THAT ONE? WHAT DO I MEAN BY SOCIALIZE?
I THINK THEY'RE THERE TO HELP US UNDERSTAND NURSING AS A WHOLE,
BETTER THAN JUST NURSING ON MY FLOOR.
THAT'S WHAT THEY'RE THERE ABOUT.
I'M A MEMBER OF A NURSING ORGANIZATION, AS A MATTER OF FACT.
I'VE STAYED ACTIVE IN NURSING ORGANIZATIONS ALL MY LIFE.
THEY COST MONEY. I MEANT TO TELL YOU THAT WHEN WE TALKED ABOUT NURSING ORGANIZATIONS.
THEY ARE NOT FREE. AND I USED TO THINK AS A STUDENT SITTING THERE AT MY DESK,
"WELL, I'M NOT DOING THAT. I JUST WANT TO GET A PAY CHECK AND GO HOME."
SOME OF YOU WANT THE SAME, I SEE.
BUT YOU KNOW WHAT HAPPENED WHEN I JOINED THE NURSING ORGANIZATIONS,
I BEGAN TO NETWORK, I BECAME SMARTER
BECAUSE THEY WERE SMARTER THAN I WAS.
AND I TOOK ON THEIR BEST QUALITIES.
AND NOW I BEGAN TO KNOW THERE'S A PRACTICE BIGGER THAN MINE
AND I BECAME BETTER BECAUSE OF THEM.
YOU'VE GOT TO GET SOCIALIZED INTO THE PROFESSION.
BE CURIOUS ABOUT WHAT YOU'VE DECIDED YOU'RE GOING TO BE.
FIND OUT ALL ABOUT IT.
YOU'VE GOT TO HAVE INTEGRITY.
INTEGRITY. THIS IS JUST ONE OF MY FAVORITES.
AND I'VE LOST MY -- HERE WE GO.
SOUND MORAL AND ETHICAL POSITION,
PERSONAL INTEGRITY BUILDS TRUST FROM PEERS AND SUBORDINATES.
WE ARE PEOPLE OF INTEGRITY.
THAT'S WHY WHEN I SEE THIS CHEATING THING THAT I'VE GOT TO PUT IN THE SYLLABUS
AND I WENT TO THAT CLASS AND I'M JUST SHAKING MY HEAD,
I'M GOING, "NO. NURSES DON'T CHEAT.
NURSES ARE PEOPLE OF INTEGRITY."
AND I WANT TO TELL YOU WHY THAT IS SO IMPORTANT TO ME
AND WHY I WOULD BE SO INCENSED ABOUT FINDING CHEATING
AND IT WOULD BE THIS.
THE GALLUP PEOPLE THAT DO THE SURVEYS, DID A POLL.
AND ON THE POLL, THEY ALWAYS ASK
WHO OF ALL THE PROFESSIONS HAS THE MOST INTEGRITY?
AND YOU KNOW WHO THEY PICKED NUMBER ONE FOR THE LAST FIVE YEARS, EXCEPT FOR ONE?
NURSES. 80% EVERY YEAR HAS BEEN NURSES.
ARE PEOPLE OF INTEGRITY AND THEY TRUST US NUMBER ONE.
OF EVERYBODY.
AND HERE IS WHO ELSE. DRUGGISTS AND PHARMACISTS
ARE NUMBER TWO, MILITARY OFFICERS.
WERE YOU CURIOUS ABOUT THE YEAR WE WEREN'T NUMBER ONE?
WHO WASN'T CURIOUS?
OH, YOU NEED TO BE CURIOUS. WHO WAS IT AND WHEN WAS IT?
WHO BEAT US OUT?
FIRE-FIGHTERS OF 2001.
DOES THAT NOT MAKE SENSE?
AND YOU KNOW WHAT? I'LL SHARE SECOND PLACE. WE WERE SECOND.
BUT I'LL SHARE IT WITH THEM.
OH, I LOVE BEING IN THAT KIND OF COMPANY.
THAT'S THE KIND OF COMPANY THAT YOU'RE GOING TO KEEP.
THAT'S THE KIND OF PEOPLE THAT YOU SHOULD BE ABOUT, PEOPLE OF INTEGRITY.
WELL, I COULD GO ON, BUT YOU CAN FIND IT YOURSELF AT THE GALLUPPOLL.COM.
ALRIGHT. YOU WANT TO KNOW WHO WAS LAST? ARE YOU CURIOUS?
- I'M CURIOUS TO KNOW WHERE FIRE-FIGHTERS CAME LAST YEAR?
- RIGHT NOW FIRE-FIGHTERS AREN'T EVEN ON THE LIST,
WHICH IS DISTURBING TO ME.
MILITARY OFFICERS ARE NUMBER THREE, POLICE OFFICERS ARE FOUR,
CLERGY ARE FIVE AND LAST BUT NOT LEAST...
CAR SALESMAN.
[LAUGHTER]
[ALL TALKING AT ONCE]
ADVERTISEMENT WAS SECOND TO LAST.
THEY ONLY GOT 10% OF THE VOTE.
TV REPORTERS ARE VERY LOW. LAWYERS ARE ALSO VERY LOW.
AND CONGRESSMAN. THOSE ARE THE FIVE LOWEST.
AND DOES THAT KIND OF MAKE SENSE IN THE SOCIETY IN WHICH WE LIVE?
SO, IF THAT HELPS. AND THEN FINALLY CRITICAL THINKERS...
I'VE ONLY GOT A FEW MINUTES AND I WANT TO DO TWO QUESTIONS.
ARE HUMBLE AND THAT'S THE WHOLE THING ABOUT BEING A CRITICAL THINKER.
WE DON'T KNOW IT ALL. AND AS SOON AS WE DETERMINE WE'VE GOT SO MUCH TO LEARN,
THE BETTER OFF WE ARE, BECAUSE THERE'S JUST SO MUCH TO LEARN.
ALRIGHT. SO IT'S A LIFELONG PROCESS.
WE ARE A PROFESSION, WE ARE CRITICAL THINKERS,
BUT WE WORK WITHIN A BODY
THAT SUPPORTS US AND HELPS US BE WHO WE ARE.
WE DO NOT WORK UNTO OURSELVES.
YOU DON'T GET TO JUST GET YOUR LICENSE AND THEN GO...
CRAZY. WE HAVE TO WORK WITHIN THE PRACTICE.
AND WE'LL TALK MORE -- THROUGHOUT OF WEEKS TO COME.
ALRIGHT. WHAT I LIKE TO DO AT THE END OF MY CLASS,
IS I WANT TO GO OVER STYLES OF QUESTIONS.
SO I'VE GIVEN YOU SOME MATERIAL TO COVER.
AND LET'S JUST SEE IF YOU CAN ANSWER SOME QUESTIONS.
BUT I DO WANT TO EXPLAIN THAT THERE ARE SOME LEVELS OF QUESTIONS.
I SUPPOSE EASY QUESTIONS ARE THE ONES YOU KNOW THE ANSWERS TO.
WOULD THAT NOT BE TRUE? - YES.
- BUT THERE'S REALLY AN EASIER STYLE OF QUESTION
THAN JUST A QUESTION YOU KNOW THE ANSWER TO.
THERE ARE SOME LEVELS OF QUESTIONS
WHICH THE INCLEX BOARD WORKS AT AND THAT IS THIS.
THERE IS THE KNOWLEDGE LEVEL OF QUESTION.
A KNOWLEDGE LEVEL QUESTION IS A QUESTION
THAT IS EXACTLY QUOTED FROM THE TEXTBOOK.
IN OTHER WORDS, I SAY THE 'ANA' ORGANIZATION IS --
AND I LIST.
A REGULATING BODY. A SOCIALIZING BODY.
A STUDENT PRE-PROFESSIONAL GROUP.
OR THE ONLY ORGANIZATION THAT LETS IN...
NON-PROFESSIONALS.
SO WHICH ONE IS IT? - A.
- B, THE SOCIALIZING GROUP. THE 'ANA' IS NOT REGULATING.
AND THAT'S JUST KNOWLEDGE. IT'S JUST, I TOLD YOU, THAT'S IT,
YOU EITHER KNOW OR YOU DON'T KNOW IT. KNOWLEDGE.
THERE'S A SECOND LEVEL AND THAT'S CALLED COMPREHENSION.
I DON'T THINK I MADE A SLIDE OF THIS. OH, THAT'S THE QUESTIONS.
WELL, DON'T LOOK AT THE QUESTIONS.
THERE'S A SECOND LEVEL OF QUESTION AND THAT'S CALLED COMPREHENSION.
IT'S STILL THE EASIEST LEVEL OF QUESTION.
AND THAT IS THAT YOU RE-WORD THE KNOWLEDGE.
YOU DON'T PUT IT ANY OTHER CONTEXT
EXCEPT TO RE-WORD THE INFORMATION FROM THE TEXT.
IT'S STRAIGHTFORWARD OR FROM SOMETHING I PRESENTED.
SO A CRITICAL THINKER IS -- AND MAYBE YOU LIST SOME KINDS OF THINGS
THAT ARE JUST DIFFERENT THAN THE EXACT INFORMATION.
I NEED TO TELL YOU THAT'S THE LEVEL OF QUESTION
YOU'RE USED TO TESTING ON IN MOST OF YOUR CLASSES.
IT'S JUST REGURGITATION OF KNOWLEDGE AND COMPREHENSION.
THE INCLEX STATE BOARD EXAM HAS NONE OF THAT KIND OF QUESTION.
THERE IS NO "YOU JUST REGURGITATE FROM THE BOOK."
THERE'S THE THIRD LEVEL OF QUESTION WHICH IS CALLED APPLICATION.
CAN YOU APPLY THE KNOWLEDGE THAT YOU HAVE GLEANED
TO A CERTAIN SITUATION.
AND THEN FINALLY, THERE'S AN ANALYSIS LEVEL QUESTION.
WHICH IS, THEY KIND OF EXPLAIN A LOT OF SIGNS AND SYMPTOMS
AND SEE IF YOU CAN RECOGNIZE WHAT IT IS.
AND IF YOU RECOGNIZE WHAT IT IS, WILL YOU DO THESE THINGS
THAT THEY DON'T JUST GIVE YOU THE WORD FOR.
THEY DESCRIBE IT AND YOU AND HAVE TO FIGURE IT ALL OUT.
INCLEX IS ALMOST ALMOST ALL ANALYSIS LEVEL QUESTIONS.
AND SOME APPLICATION, NONE COMPREHENSION.
ALRIGHT. YOU'RE IN THE NURSING PROGRAM AND YOU HAVEN'T LEARNED THIS LEVEL,
AND YOU WOULD FAIL IF I GAVE ALL ANALYSIS LEVEL QUESTIONS, DAY ONE.
IN FACT, IT'S HAPPENED AT THE UPPER LEVEL DIVISIONS
BECAUSE THEY TRIED TO GROOM YOU GUYS TO A HIGHER LEVEL.
AND SO AT THE LAST SEMESTER, THEY TRIED
AN ANALYSIS LEVEL QUESTION THE FIRST WEEK AND EVERYONE FAILED.
THIS IS UNACCEPTABLE.
SO THIS IS HOW IT WILL WORK FOR ME.
I WILL DO 50% TO 60% OF MY TEST QUESTIONS ABOUT KNOWLEDGE COMPREHENSION.
I HAVE TO AT THIS LEVEL BECAUSE I NEED TO MAKE SURE
THAT YOU'RE FOUNDATIONALLY STRAIGHT AND KNOW YOUR INFORMATION.
BUT I WILL ALSO DO, SOMEWHERE IN THE BEGINNING,
AROUND 30% APPLICATION LEVEL QUESTIONS.
AND I WILL NEVER DO LESS THAN 10%, BUT 10% TO 20% ANALYSIS LEVEL QUESTIONS.
BECAUSE YOU NEED TO START SEEING THEM
SO THAT YOU CAN PICK THE RIGHT ANSWERS
OR YOU WILL NOT PASS YOUR STATE BOARDS.
AND THAT'S IMPORTANT. SO LET'S LOOK AT A QUESTION.
THIS IS A KNOWLEDGE LEVEL QUESTION.
A NURSE WHO FUNCTIONS IN THE ROLE OF A CLIENT ADVOCATE.
ONE, MAKES DECISIONS FOR THE CLIENT.
TWO, COUNSELS THE CLIENT ABOUT THE APPROPRIATE DECISIONS.
THREE, SUPPORTS THE CLIENT'S DECISIONS.
D, SHARES HIS OR HER OWN PREFERENCES WITH THE CLIENT.
- B. - C.
- WE HAVE B, C AND NON-COMMITTAL.
OKAY. THE ANSWER IS C. I SAID EXACTLY
AND I MADE SURE I ANSWERED THIS QUESTION IN THE LECTURE,
THAT YOU'RE GOING TO LISTEN TO THE CLIENT'S NEEDS
AND YOU'RE GOING TO ADVOCATE FOR THEM
SO THAT THEY --
I CAN'T REMEMBER EXACTLY WHAT I SAID TO ANSWER THAT.
YOU'RE GOING TO STAND IN THE GAP FOR THEM
SO THAT THEIR NEEDS ARE MET AND THEIR EXPECTATIONS ARE ME.
AND SO YOU'RE DOING FOR THE CLIENT AS AN ADVOCATE.
NOTICE THE COMMON DENOMINATOR IN ALL OF THESE QUESTIONS.
YOU MAKE THE DECISION FOR THE CLIENT.
YOU COUNSEL THE CLIENT.
AND YOU SHARE YOUR OPINION WITH THE CLIENT.
AND THE ONLY THING DIFFERENT ABOUT THREE IS THAT, ONE,
YOU'RE NOT DOING ANYTHING BUT SUPPORTING THE CLIENT.
AND SO THAT DELINEATES IT. IT'S DIFFERENT,
BECAUSE ALL THE DECISIONS AND THE OTHER THREE ANSWERS
ARE ABOUT YOUR OPINION.
AND MAY I JUST SAY IN THE WORLD OF NURSING AND IN ANSWERING THIS,
MOST OF THE TIME NO ONE CARES ABOUT YOUR OPINION.
AS A PROFESSIONAL, YOU'RE ADVOCATING FOR THE CLIENT.
IT'S NOT ABOUT YOU.
ALRIGHT. SO, ANSWER IS C. - I HAVE A QUESTION.
- SUPPORTS THE CLIENT'S DECISIONS.
- SO WHAT WE DO IF THEY HAD NO FAMILY AND THEY COULDN'T SPEAK?
- THEN YOU'RE GOING TO BE LOOKING OUT FOR THE BEST INTEREST OF THEM
TO MAKE SURE THAT THEY'RE IN A GOOD NURSING HOME, FOR EXAMPLE.
TO SEE ABOUT CARE THAT'S ADMINISTERED TO THEM.
THAT THEY'RE NEGLECTED BECAUSE THERE'S NO ONE WATCHING OUT FOR THEM.
SO, IN ESSENCE, YOU'RE STANDING IN THE GAP,
HOPING YOU'RE MAKING A RIGHT DECISION FOR THEM.
SO THEN IT MIGHT BE SORT OF YOUR OPINION,
BUT IT'S STILL BASED ON WHAT'S BEST FOR THEM, NOT WHAT'S BEST FOR YOU.
DOES IT MATTER TO YOU IF THEY HAVE SOMEONE COME SIT WITH THEM ALL EVENING?
NO, THAT DOESN'T HELP YOU ONE LICK.
YOU'RE GOING TO GO HOME AND HAVE A NICE DINNER.
BUT YOU'RE LOOKING OUT FOR BEST INTERESTS OF THAT CLIENT
AND THAT'S ADVOCATING FOR THEM WHEN SOMEONE ELSE CAN'T.
AND THAT'S A HUGE POINT.
ALRIGHT. THIS IS A COMPREHENSION LEVEL QUESTION.
AND THIS IS TAKING INFORMATION
THAT YOU RECEIVED IN THE LECTURE HERE TODAY
AND IT'S BEEN REPHRASED.
BUT THERE'S NO APPLICATION, IT'S JUST REPHRASING.
SO WHICH OF THE FOLLOWING IS CONSIDERED
TO BE AN EXPANDED NURSING ROLE?
OKAY. SO WHICH OF THE FOLLOWING IS EXPANDED?
A STAFF NURSE, A NURSE AIDE,
A CLINICAL NURSE SPECIALIST OR A HOME HEALTH NURSE?
- C.
C IS YOUR EXPANDED NURSE ROLE.
THAT'S GOING TO NEED ADDITIONAL EDUCATION.
SO STRAIGHTFORWARD QUESTIONS, KNOWLEDGE COMPREHENSION.
THAT'S ALL I'M GOING TO INTRODUCE TODAY.
ON FRIDAY, WE'LL ADVANCE OURSELVES TO APPLICATION AND ANALYSIS
AS WE LOOK AT INFORMATION THAT GOT PRESENTED.
SO.
THAT'S IT. I HAVE NO TIME.
IT'S 12 -- IS THAT WHAT WE GO TO -- 2:15?
WELL, THEN, IT'S BEEN A PLEASURE.
I LOOK FORWARD TO HAVING A FUN, FUN SEMESTER.
READ YOUR MATERIAL, IT WILL REALLY HELP.
HEAVY CONTENT ON INFECTIONS CONTROL.
AND WE'LL DO SOME FUN THINGS WITH MOBILITY.