Sometimes being in nursing school can be like leading a double life. One foot is bravely stepping into the medical world, while the other foot still very much relies on its foundation of the common knowledge of laypeople to keep balanced.
This unbalance continues until the experienced nurse is able to gracefully cross the divide and plant both feet firmly onto fresh territory. In the meantime, the nursing student must be able to navigate this foreign language of using Latin terminology and industry vernacular to more accurately describe a patients’ state to the rest of the health care team.
Here are some strategies that will help you communicate amongst your colleagues as your nursing knowledge continues to expand and evolve:
1. Trust your own judgment.
Nurses seem to have a sixth sense when it comes to their patients. Having the opportunity to spend up to 12 hours at a patients’ bedside makes the nurse exceptionally attune to subtle changes in mental status or perfusion even if vital signs are unchanged. Remember that unstable vitals are a late sign of decompensation.
When you get a “gut feeling” that something just isn’t right, even if you can’t put your finger on exactly why, be sure to escalate your concerns to your instructor or the patient’s nurse as soon as possible. The team would always rather check into a false alarm than miss a dangerous clue, and your quick thinking could save a life.
2. Speak concisely using a method like SBARQ.
In patient care, seconds can mean the difference between a good or terrible outcome. Instead of becoming flustered when communicating a lot of information in a short time frame, make sure to convey your message clearly.
An example of SBARQ in work is:
- Situation: Mr. Jones’ blood pressure has been dropping over the past hour.
- Background: He is a 54 year old who had a bowel resection this morning. When he first arrived from the OR, his pressure was 124/81, but has been trending downward with a most recent BP of 93/44 and a heart rate of 111. He is also complaining of dizziness and increased abdominal pain.
- Assessment: I feel that his symptomatic hypotension may be due to surgical complications such as hemorrhage or bowel perforation.
- Recommendation: I recommend beginning a liter bonus of normal saline solution and for the doctors to evaluate Mr. Jones immediately as he needs more interventions.
- Questions: If you have questions you can page me at 20002 or see me in Mr. Jones room, number 105.
3. Do not gossip, complain, or otherwise bring negativity into your work space.
All experienced nurses remember how scary and difficult nursing school can be, but also have a low threshold for irritation when hearing a student whine about having to do vital signs, bed baths, or give meds. You chose this profession despite the fact that it is far from glamorous, so be sure to keep your thoughts and words focused on the positives.
4. Do not point out a problem without also suggesting a solution.
Nobody likes an idle complainer, and it is not productive to wallow. Thoughts become words, and words become actions. Keep yourself moving forward by being a force for good in your class and unit by bringing solutions to the table when coming against an obstacle. Your attitude is your most powerful ally in a challenging situation.
5. Be a true teammate.
Have a heavy assignment that is tying up your time? Try asking another student to help you with a bed bath so you can give meds, but follow up by offering to help them with their Q2 hour turns later in the day once you are caught up. Instead of feeling that you are dumping your work on them, your classmate will have a better understanding of the benefits of working together to ensure quality patient care.
6. Only ask questions after being unable to find the answer yourself.
Even the most senior nurses have moments when they are unsure of how to take care of a complicated patient. When asking a question, try prefacing it by explaining that you’ve already conducted your own search, but need some guidance in finding the information. This comes off much more professionally and also lets your colleague know that you are proactive, but still in need of assistance.
As always, if you are unsure in your knowledge, make sure to escalate concerns to the appropriate leadership before attempting a new procedure unsupervised.
7. Have go-to phrases for difficult situations.
Inevitably, there will be many times in your career where you are questioned or berated by doctors, patients, or family members. Having a mental escape plan will help you navigate these murky waters like a pro. Try the ‘blameless apology’: “I’m so sorry you are having this problem, I’m sure it must be very difficult for you” when dealing with an irate person. Compassion and professionalism will help you escape even the most intense confrontations unscathed.
8. Literally NEVER lose your temper with a patient or family.
In the event that your smooth talking is unsuccessful in resolving a conflict, make sure that you insulate your personal anger and don’t give into the temptation to become agitated in turn. I have been called racial slurs, hit, kicked, punched, spit at, peed on (on purpose), and cursed out in my time as a nurse.
Now, of course it isn’t ever ok for a patient to treat their nurse this way, and this is not about letting them ‘get away with it’. This is about being the bigger person, always, in any patient care scenario. Nursing is just one of those professions where we are expected to just be ‘on’ all day, like a choreographed performance.
If a situation is escalating to a point where you are afraid for your safety or that you might snap, remove yourself before it turns ugly. Remember the support system you have in place with your instructors and charge nurse and let them know that you might not be able to care for a patient who has been verbally or physically abusive to you. Trust me, we’ve all been there, more than once.
9. Treat each and every hospital employee with the same respect you would give to the CEO.
Never look down at a role that you consider ‘inferior’, because in health care, no one could do his or her job without the support of this incredible system. From environmental services, to security, to supply and maintenance, each hand plays a crucial role in our ability to care for our patients safely and efficiently.
When interacting with non-clinical staff, always follow the golden rule: treat others as you would want to be treated. You will be rewarded in turn by a team that values each of its vitally important members.
10. Speak confidently about yourself as a student nurse.
I always feel sad when I think about how I used to talk down to myself when I was in nursing school. Instead of allowing thoughts of failure, give yourself a pep talk in the mirror about how prepared you are for success. Always pump yourself up before a big test or clinical day. You have chosen this profession to help people but how can you give yourself to the service of others, if you aren’t even being kind to yourself? Love who you are, flaws and all.