The Why’s of Nursing

As a nursing instructor, I always find myself asking my students ‘why’? And I always have a problem with the answer. Because someone told me to do it that way. This is the heart of nursing and also the downfall of many nursing schools. If you can answer the question of why in any situation, chances are you are a good nurse.

Let me further explain this concept. Why do we put a larger gauge needle in the AC when we are giving Vancomycin? Why do we give our second NS flush at the same rate as our IVP med? Why do we aspirate before giving the IM injection? Why don’t we crush certain medications? In nursing school we were always taught to perform a task a certain way, but did anyone ever teach us the reason and rationale as to why we are doing it that particular way. Most instructors are great at telling us how, but very frequently leave out the why. I think we fail our students by leaving out the rationale behind the lesson. This is what will make the difference between task oriented nurses and nurses who can critically think and reason through a problem.

I was told once that if we explain to our patients why they need to take a certain medication or why they need a procedure, they are more likely to consent or be compliant. Shouldn’t this be true for nursing students. I think nursing students will perform better in their skills if they understand why they are doing something and comply more readily if they know the importance behind it.

As a nursing student, you should always ask yourself why. “Why am I doing this and why am I doing it this way?” If you can answer the question of why, you are well on your way to being a fully competent nurse. If an instructor asks you why, please do not be content in saying “I don’t know”. That is not the right answer. Think through and give it your best shot and then go look it up. Nurses should and will always have a reason as to why they do something. If you ask them their reasoning behind a certain task, and they can’t tell you, think long and hard if you want to trust what they are doing.

I always try to educate my patients as to why they are getting a medication, what to expect while it is infusing and the side effects that may occur later. One of my patients went to the local emergency room for urgent care and his wife asked the nurse what medication he was getting and why he was getting it. The nurse actually replied, “I don’t know”. How crazy is that? Do you ever want to look as stupid as that nurse looked to that patient and his wife? The answer is ‘no’.

Please realize that most things nurses do have good reasons behind it and knowing those reasons are the true key to being a great nurse versus a mediocre one. Those ‘whys’ are difficult until you get used to them, but as challenging as they may be, they are imperative to the independence of your skills as a professional nurse and a nurse that thinks critically and thoroughly.