Back in my student days, whenever we go on a duty at a hospital or community health center, our routine of activities is focused mainly on one thing: taking vital signs. Even though there are times when we were given opportunities to perform procedures and give medications to clients, our instructors oftentimes only ask us to take our client’s vital signs. For a time, I thought that nursing assessment was only focused on taking vital signs, and so during that time, whenever the doctor, staff nurse or my own instructor asks me what I know about my client, oftentimes I tell first the vital signs. In some cases, the client’s vital signs are the only data that I know about my client.
Of course, as I began working as a staff nurse, I verified that the nursing routine was more than that. The things that contributed to this were the times I was observing students having their related nursing experience in the units where I was working. When I ask them about information about the clients they were assigned to, they oftentimes limit their answers to vital signs. In fact, some students have vital signs as the only info they have about their clients.
If all nurses in the Philippines are like this, it certainly spells doom. The sad thing about it is that it is true in most clinical scenarios. Most Filipino nursing students just spend their whole duty hours taking vital signs, and nothing more. And so for most students, nursing to them becomes routine… and boring. Sad to say, some even get the impression that nursing is easy.
Maybe this is one of the reasons why most nursing students also fail the Nurse Licensure Exam (NLE). Nursing students graduate without sufficient training to standards of practice. Nursing students are misinformed about the totality of the practice. And for some, their limited perception of nursing practice becomes the major obstacle for positive change.
Who is at fault? Perhaps the teachers are to blame primarily. In my own experience, it is rare to see a clinical instructor deeply immersing students to performing total client care. They just spend their time sitting in a unit’s conference room chatting with their students, and the only time they go out with their students to the station and the clients’ rooms is when they need to get vital signs.
I personally had difficulties teaching students about nursing assessment. In most cases, students who have been used to the “vital signs routine” complain that I ask too much of them. The feedback that I often get when I task them to perform a comprehensive assessment are these:
· “Isn’t that the doctor’s job?”
· “Our other instructors only ask us to take vital signs.”
· “We are only allowed to take vital signs.”
How do we expect nursing education to improve if this is the mindset of our nursing students? I firmly believe that the primary responsibility rests with the teachers. They have the power to enrich, motivate and mold their students to achieve the necessary competencies so that it wouldn’t be a burden to them to unlearn poor ways and re-learn the right way. Assessment, as we should know, is very crucial in formulating an effective care plan, and everything boils down to good assessment. The client’s information is vital for the nurse to identify the client’s needs, and will determine what interventions would suit his/her needs. We should know that in every patient, the nurse must obtain data about (1) the client’s perception of his/her health, and (2) the signs that indicate the way an illness affects the client’s health.
A student nurse with good foundations from a good mentor will result to a competent professional nurse, locally and globally, if the teacher continually motivates himself/herself to integrate excellence and innovation in guiding students to the expected standards of nursing practice. In this way, people ultimately can be assured of better health through quality nursing care.
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