By Richard Freedberg, RN, MSN, MPA
My family is already asking me for advice! What should I do? Hmmm, only part of the way through nursing school and you are already being hit up for free healthcare advice. Anyone else out there running into this type of situation? Absolutely! This is a common circumstance.
Think about your own experiences. There is a certain nice guy with construction experience in my family who saved me from disaster when I was doing a home project. Another nephew with stellar tiling skills helped with a bathroom. You know the drill: We all seek help from people who we know, who we trust, and we try to help when we can. The only way we can all safely and successfully make it through life is together. But what about nursing care? Isn’t that different?
On one level, it isn’t. Isn’t nursing nothing more than a defined knowledge base, a set of skills, and some basic critical thinking used to implement those skills? Sure sounds similar to tiling the bathroom to me. However, tiling the bathroom without the requisite know-how and skills is not something you want to try on a whim. (You need to trust me there, but that is a whole other conversation!) In the same way, you don’t want to enter into a nursing relationship with someone unless you one, know everything you need to know and two, plan to do it right. Why don’t we consider each of those conditions for just a minute?
First, let’s examine the question of knowledge. Obviously (or hopefully!), you will have more nursing knowledge as you progress through your curriculum. Let’s insert an example here: A family member comes up to you and says, "My heart feels fast, could you listen to it?" If you are in the first semester, you might hear the lub-dub of each beat and determine the rate to be 130 beats/min. In a later semester, you might discern tachycardia but with an S3. After some graduate study, the nurse practitioner might also detect a dangerous diastolic murmur that warrants immediate assessment and intervention. The point is we all need to have some sense of the boundaries to our knowledge.
Secondly, how do we "do" nursing right? Remember, we need to follow the nursing process: assess and gather data, make some sort of clinical diagnosis, plan and implement an intervention, and evaluate the response. Here’s a true story: What would you do if someone asked you how to treat a pulled muscle? A client came to the family practice clinic where I was collecting clinical hours and asked me to prescribe something for a pulled muscle. I didn’t cut corners, did the full history and assessment, and found out what she was calling a pulled muscle was actually a mass above her left breast. It turned out to be a benign tumor, but see what I’m saying here? You always need to follow the process to reduce the risk of an error.
Let’s pull it all together. This is the process you should go through when someone wants your nursing help. First, for example, if it is an emergency, it is okay to start CPR if the person needs it! Second, is the problem within your actual practice scope and knowledge? If not, help guide the person to the right provider. Third, are you and your prospective patient prepared to do it right, to follow the full nursing process? This last item is important because of the nature of family and friend connections. It is supremely hard, if not impossible, to initiate therapeutic relationships with these people. Aside from any legal considerations, we aren’t able to maintain the professional detachment and focus required to be the care provider for people we love or care about.
So, the bottom line is if a family member or friend seeks some advice, feel complimented by their trust. If you can provide some general information having to do with diet or how to take medications for example, sure, that might be okay. If someone needs and wants you to help advocate for them with their care providers, help them. However, if family or friends approach you for anything more complex, tell them you care enough about them to want them to receive the best care. Then, be willing to help them find it!
Editor’s note: Freedberg is a professor of mental health nursing at Lansing (MI) Community College and the author of Stressed Out About Pharmacology. Email your questions or comments to him at editor@stressedoutnurses.com.
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