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OT but a friend of mine is doing his RN degree and thinks some of the things being taught are downright idiotic. Anyhow...
A lot of what you learn in school is idealistic - which is actually a pretty good idea even though most of your idealism will be crushed in the first year. You should always remember best practices and especially remember to avoid the dumb mistakes that are the deadliest. My frustration with nursing has more to do with the fact that the hierarchical power structures are so resistant to change. There's a hearty disrespect amongst MDs for RNs. We are talked down to because we don't know as much as they do, but we don't have nearly the amount of training that they do. If we had their expertise, we would be...I dunno....Doctors, maybe? Much of the stress of this job is conforming to what each MD expects of you because those expectations can be radically different. I must say though, what a joy it is to come across a doctor who is willing to teach! I can't blame them for not all being so willing to do it, as doctors have an inhuman schedule and an impossible list of demands placed upon them pretty much at all times. I meet precious few happy nurses if they don't have incredibly supportive 'outside-of-work' lives. It takes an awful lot to recharge those batteries when they've been depleted. What I just said about RNs goes about 10x for doctors. Few of them are happy.
That said, it's 2013. WHY for the love of all we hold dear am I being subjected to poorly handwritten orders for ANYTHING? Our charting system is computerized, but the computer doesn't collate data very well and so we actually replicate what's in the computer chart in a mind-numbingly large amount of paper documentation simply because the computer system does not allow us to easily and intelligently assemble important data simultaneously - so we have to hand-write and replicate documents that DO put it all in a coherent and useful place. My computer charting is strictly for the lawyers, as it documents time of documentation and clearly delineates WHO is doing the charting and when or how it has been modified. Data entry is done on truly ancient computers using drop boxes and mouse clicks in teeny-tiny boxes even though F-key 'enter-through' charting is vastly faster to do and encourages more charting and more access to charting for diagnostics and 'past-and-current-state-of-patient' look-ups.
What would be most helpful in nursing would be efficient charting that carries over from ED to holding (if they go to holding) to floor so that data entry isn't being replicated in triplicate. By the third time a patient is asked about an important part of his health history, he or she has begun to lose faith in the process - as he or she has, I believe, a reasonable expectation that 'once requested, once documented' makes sense. He or she thinks no one has listened to him or her because we're asking about something incredibly important for the second or third time. Why don't we already know this? Indeed, we do, or SOMEONE does - but that data was merely collected to determine whether the patient stays in hospital and to what floor they should go. Then, because systems don't talk to one another, or it was all recorded on paper that gets lost in the unbelievably chaotic environment of the ED, it must be recollected again from a patient who has already often spent EIGHT HOURS in ED, typically without being given food and possibly not having assistance to the bathroom.
We have a long way to go towards making our medical care efficient, expedient, and satisfying to all involved. Nurses are the glue that keeps the creaking ship from sinking, but we are spread thinner and thinner and it takes a toll on those of us in the profession.
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