In Nursing School we are taught a little about a lot. Other than the foundation skills such as hand washing, vital signs, physical assessments, and dosage calculations, I think the goal of our education is exposure more so than mastery. There’s so much information in so many areas of healthcare that no one could possibly master everything there is to know. Instead, our instructors teach us how to seek and find relevant information, and assure us that we will master the skills as we need them – typically during OJT (on the job training). I’m just guessing here, but other fields of study are probably the same.

Lay people don’t always understand this. With all my years of experience and acquired knowledge, I still cringe a little whenever somebody starts a sentence with “You’re a nurse..” and then proceeds to share whatever medical angst they’re facing, fully expecting a solution to their problem. They always seem so surprised, and disappointed, when my answer is, “I’m sorry, I’m not familiar with that area.” Then they give me a look that says, “Oh, well you must not be a real nurse.’ It’s as if the title automatically implies you’re supposed to know everything there is to know about healthcare.

I can’t really fault them. I have done the same thing to other professionals – my mechanic, my computer guy, my pharmacist. I remember the first time I called a pharmacist about a med one of my patients was taking. When I heard “I don’t know. I’m not familiar with that drug,” come over the line I immediately thought, “What! What do you mean you’re not familiar with that drug? You’re a pharmacist…” So I do understand.

To further complicate matters, nurses often have a tendency to specialize in a narrowly specific area of practice. I migrated to the Neonatal ICU. I worked, I studied, and I mastered that area of practice. But, what I know about Psych Nursing would fit in a thimble. With room to spare.

This has been a very long and round-about story to make this observation – when we move into a new area of practice, the people/clients/patients we are assigned to care for are most likely expecting us to come in fully prepared to meet their needs. They expect us to know whatever it is that needs to be known before we grace their presence. While that would be ideal, the reality is that it probably won’t happen that way. In fact, I can’t think of anything in the entire field of healthcare that is ideal. And trying to explain the concept of OJT doesn’t always go over well.

Lia’s parents were a little concerned when I came to them with limited exposure and zero training in the area of autism. Heck, I was a little concerned. I knew I could manage Lia’s medical needs, these were skills I had mastered long ago, but, autism is Lia’s squeaky wheel, and I had a lot to learn in that area. In this particular case, a background in Psych Nursing would have been a lot more helpful than my background in Neonatal ICU.

So far, the learning curve has been pretty steep, but, I can honestly say that I know a lot more about autism now than I did the day I met Lia and her parents – thanks to my OJT and the ability to seek and find relevant information. I can also say “mastery” is not a term that I would use any time soon to describe this level of knowledge, it’s a work in progress.

As for Lia’s parents, confidence has replaced concern, and they understand that I’m not “all knowing”. They still ask a lot of hard questions about autism, and sometimes I have answers for them, but a response of “I don’t know,” elicits expectancy rather than disappointment. They know that I will work to find an answer, or, at the very least, point them in the right direction to find it for themselves. We are a team, working together to help Lia live her best possible life, and they hardly ever start a sentence with, “You’re a nurse…”