Balancing What We Learn With What We See

In nursing school we are taught textbook nursing and how we should practice our evidence-based nursing skills. Unfortunately our clinical experience doesn’t always back up and support this information. But that’s where “do as I say and not as I do” comes into play, right?

When nurses do something in our clinical experience that is not “by the book” it is, for the most part, very obvious. Such as a nurse poking a hole in her sterile glove so she can palpate a vein for a PICC insertion—definitely not by the book. But, other things are a little less vague. One such thing happened during clinical where a nurse removed an arterial line and advised us to hold pressure for 3-5 minutes. Then that very week we had a test question involving removal of an arterial line and the answer was at least 5-10 minutes (depending on if the patient is on anticoagulants or not). This and other similar occurrences can make test time and preparing for the NCLEX more complicated than we’d like it to be. We are constantly told to “go with what the books say” instead of what we see in the real world but sometimes this can be a hard juggle.

As we prepare for the NCLEX, I think the most important thing we can do is to remember what we read and what we were taught in lecture first and foremost. This is not to say that some questions may be answered from our clinical experiences, but that our primary focus should be coming from the theory part of our education.

Has anyone else had similar experiences? Or any tips on how to balance what we learn with what we see?