greetings mark boswell boswell emergency medical education how's it going so a little video short while i'm on the road today and what i wanted to do was talk about some recent uh good points that were brought up by commenters people commenting posters on some exam questions and i saw it a couple times so i figured it must be something people are thinking and i want to bring it up and discuss it so in general the comments were about some of the questions being too technical and medical diagnosis focused so i agree when you read some of the questions i construct and design they are more medical diagnosis focused or maybe the domain of medicine and the concern was that is not really within nursing's purview i understand that comment i get it i will say in response to that there's a reason for this number one remember my questions and my main purpose is to prep people for the ce and exam and so i try and construct and design materials references practice questions that are consistent with the cen theme tone scope and blueprint a few test cycles ago as the bcn was revising and refocusing the content areas and the style of the questions there was more of a push towards including more quote unquote medicine in it the bcn recognized with their needs analysis and needs assessment and nursing practice assessment which helps to find the test you know how they're going to revise it the bc and recognize that nurses do play especially emergency nurses do play an integral role arm in arm with medicine in providing care for our patients not that nurses are practicing medicine but nurses do play a partnership with their physician and provider peers in providing care for the patients there has to be some common understanding some common ground some common knowledge base so while some of these questions may seem more medical model indeed they are but they're not asking the nurse to practice medicine and i try and word them in that way in other words i don't ask a specific question like what would you order however i rephrase it to say what order might you expect to see or are most likely to see or what order might you receive or as far as the medicine goes what dose would you expect to see so not asking the nurse to practice medicine but for the nurse to be a partner in understanding that relationship we have and especially in emergency nursing is a very dynamic partnered relationship so it's and i'll also say this if you are studying for the cen exam questions like these are on the test okay they're not asking you to diagnose they're not asking to order but they're asking to understand and recognize certain things because we do have a role as nursing to be partners and to facilitate and make sure the patients get the right care the right time and safely for example it's not unrealistic for me to say what order would you expect to see for a person having chest pain and the answer would be one of the answers could be a troponin level that's not asking the nurse to order a troponin level but you know as an emergency nurse if someone's having chest pain a probable cute mi if you get some orders from your physician or provider that don't include at your opponent level you know you're probably going to ask them um hey doc or hey pa or nurse practitioner do we need a troponin level also and maybe it was an oversight maybe there's a good reason for it for not having it and if there is or isn't a reason it might be a good learning opportunity as well too so not asking you to read these questions like you're practicing medicine but we do have that shared vested interest in our patients outcomes so don't stress out about that too much again the one and the ones i construct and design i try to keep them pretty straightforward i'm not asking you the krebs cycle i'm not asking you the differential list for you know three different overlapping conditions things like that but basic stuff okay so i hope this helps understand um a little more about the theme and the tone the questions and why they seem a lot of medical stuff but actually it's our shared work relationship with our patients and yes at the end of the day nurses practice nursing physicians practice and providers practice medicine but we do have some common ground that we do share between the two of us to give good quality patient care and also so we can demonstrate our cognitive knowledge on the seeing exam all right hope that helps guys hope it explains a few things gives you a little different frame of reference or whatnot and uh good luck studying and talk to you soon