I just had a quiz in psychiatric nursing. We were told it would be on the reading assigned for today, so I spent last evening going over the readings. On a ten-question quiz, at least 3 of the questions were not on material from the readings, including this one:
"You are at a soup kitchen and see a known pedophile coming out of the bathroom with a child. What is the priority nursing intervention?So what would you do? In this situation, there is no information about things like, for example, where the telephone is or how many people are in the building. It's possible that the telephone is in an office down the hallway, and the building is filled with people. Would you leave the pedophile and child together to go call the Child Abuse Hotline? Or would you do something to secure the child and then call? The instructor's answer was (a), although I would do (b).
(a) to call the child abuse hotline.
(b) to protect the child without intervening the self with the perpetrator
(c) to blah, blah, obviously wrong
(d) to blah, blah, obviously wrong"
Do you agree with the instructor? If you reasoned that you would ask someone else to keep an eye on the child while you called the hotline, you would, first, be making an assumption about the availability of other people that is not stated in the question and, second, be giving (b) as the de facto answer by justifying your choice by first intervening to have someone else protect the child.
My instructor said that calling the hotline would result in having authorities arrive immediately to protect the child. Is that true? According to the New York State Office of Child and Family Services, calling the Child Abuse Hotline results in an "investigation of each report within 24 hours," not an immediate response. Moreover, according to NYS OCFS, if "you believe that a child is in immediate danger, call 911 or your local police department."
If you see a situation where a child could reasonably be in danger of abuse in the immediate future, your priority should be to protect the child, not to nab the offender. The fact that the situation is a known abuser in a transient public location indicates that the situation is an immediate one, not like seeing bruises on a child who is going home with her parents.
The rationale behind NCLEX questions is that they are "hard" because they demand "critical thinking skills." In my experience, "critical thinking" for NCLEX means correctly guessing what the instructor wants or the correct set of assumptions that the instructor has made about the situation. Note to all those who have not been educated outside the nursing profession: guessing what's the in the questioner's head is not "critical thinking."
The other day in nursing, we were told that those on high have determined that nurses need intern-like immersion experiences in order to be adequately prepared. We also know that there is a lot of shock amongst new grads and a high turnover rate in the profession. Maybe these are all indicators that nursing school does a crappy job of vetting/educating nurses?