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.

- 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.