What Makes a Great Nurse
Posted by Shanna S. RN, BSN on February 19, 2014
As nurses, we learn day in and day out, constantly expanding our skills and our knowledge base accordingly. From the day you entered nursing school, you have been absorbing information and anecdotal evidence in order to provide your patients with the safest, most effective nursing care possible. This week, I'd like to remind you all of one of the most important, yet overlooked sources of nursing education: your patients.
As a nurse that has cared for patients across the spectrum, I always appreciate those patients who are willing to explain what they know about their own health, as it is a great way to gain perspective, procedural knowledge and insight into your patients' needs. From the home health patient who knows just how to dress the G-tube so it doesn't leak, to the juvenile diabetic who is acutely aware of what unsafe fluctuations in blood sugar feel like, patients are a valuable source of nursing knowledge.
I know this firsthand, and was reminded of it again the other night, as I spoke with my sister who was on her way to admit herself to the hospital for treatment of pneumonia. We were discussing pre-admission plans to ensure that she would receive the appropriate care for her Cystic Fibrosis, including the orders in the ER, her dietary needs, the expected course of treatment, and her preferences while hospitalized. You see, she's been hospitalized over half a dozen times in the last year, each time being thrust into the hands of nurses who know very little about her disease, its effects, its limitations, and what she requires for treatment.
My sister, like many others, is a well educated patient, who is willing to share the details of her own illness with the professionals providing her care. She can not ensure that her nurses, dietitians or ancillary personnel will know anything about Cystic Fibrosis Related Diabetes (CFRD), so she teaches them, and asks for what she needs. She can't even ensure that her nurses know about Cystic Fibrosis itself, which is a frightful truth that she deals with each time she checks in.
As nurses, we are tasked with being proficient at caring for those with a myriad of illnesses and health conditions, which is no easy task. Think of how many times you have read a diagnosis you were not familiar with, or had not treated before. What did you do? Did you have time to look it up and find out what you were dealing with, or did you plunge headlong into your care giving, assuming that you had enough knowledge to get by?
Have you taken the time to ask your patients about how they heal best? Have you asked them what works well when they are caring for themselves at home? Have you asked them to share their knowledge with you?
If you answered no to any of the questions above, I have an assignment for you:
Take the time to ask, listen, and learn from your patients this week.
To help you get started, I asked my sister some questions as she drove herself to the hospital, about what makes a nurse a good nurse...here is what she had to say.
Patient Perspective: What Makes a Good Nurse
Listen to your Patients
If you are caring for someone whose illness you are not familiar with, especially those with chronic conditions, ask them about their needs, preferences and prior successes. Each patient is an individual, and though you may deal with many patients who have the same admitting diagnosis, their care is not always cookie-cutter perfect. Patients who are repeatedly hospitalized know a great deal about what they need. They also know when their nurses are not providing the care that is optimal, but may be afraid to say anything.
It took my sister almost 25 years to gather the courage to speak up for herself, but now that she has, her care is self directed and effective. She knows when, why and how to administer her own medications, including IV medications, and is happy to remind any nurse that forgets just how important it is to scrub the hub and put on a mask when dealing with her port. She knows that she needs a calorie rich, nutrient dense diet, despite being labeled as diabetic in the orders. She knows that a sputum culture should be ordered as soon as she sets foot in the hospital, and she knows when to expect results.
Listen to what your patients are telling you about what they need, and you will be able to give them the nursing care they deserve.
Be Accountable and Timely
If you tell your patient that you will check the orders, you will call the doctor, or you will do something as simple as check into why the twice daily snacks aren't arriving...do it! Don't wait until the end of your shift, until the doctor makes rounds, or until after lunch. As nurses, we are already professional multi-taskers, so make sure that your tasks are centered around your patients' needs. When you say you are going to do something, do it, and do it before you move on to the next thing.
"The last two days it has seemed like everything I asked for took over an hour to 'get back to me' about. I asked my nurse this morning to check on my daily snacks that I haven't been getting and she left. I figured it would be at least an hour before she would even look into it, but she came back twenty minutes later and said that she took care of it. That was nice. I know nurses are busy, but it's not like I ask for a lot." ~Abigail Dunning, Cystic Fibrosis patient extraordinaire
Put Yourself in Your Patient's Shoes
My sister has had multiple admissions, multiple hospital stays, and multiple episodes of me asking her what is going well and what is not while she is living in inpatient status. Each time, it comes down to wanting to be treated like a human being, with real needs, real wants, and real health issues. She told me once that the best way to be a good nurse is to "try imagining being in their [the patient's] shoes, and then care for them that way." I still think this is one of the most important things we can do as nurses.
Imagine that you are the one sitting in that hospital bed, waiting for your medication, your meal, your respiratory treatment, your shower, your discharge orders. Imagine how long it would take for you to lose your patience. Imagine how many medical errors you would catch and prevent from your own hospital bed before you lost some trust in the medical community. Imagine how you would feel correcting your own orders and coordinating your own care while you are short of breath, tired, coughing, and only wanting to rest while the medical professionals do the work to help you heal.
It's been said that nurses make the worst patients. Why do you suppose that is? When it is our turn to be the patient, we know what kind of care we deserve, we know when our care givers are falling short, and we are not afraid to speak up and tell our providers what we need and hold them accountable for meeting our needs. Imagine if every patient you encountered were as knowledgeable as you are. Guess what?! Some of them do know more than you about the health issues they are dealing with.
I encourage you to imagine yourself as your own patient each time you step into a room this week. Put yourself in each person's shoes (or slipper socks, more accurately) as you care for them. Ask them what they need, what they prefer, what they think will help them heal, and then be accountable for making it happen. Consider what you would want if it were you. Nurse from the patient's perspective for a change, and see how it changes your practice.
Patient centered care is more than just a buzz word, it is a guideline for the provision of high quality services within healthcare. I encourage you all to take patient centered care to heart this week, utilizing the guidelines my own favorite patient has shared with me, and which I now share with you. Ask questions. Be accountable. Allow yourself to nurse from the patient perspective, and see what happens. I'd wager that your patients will notice, and that they will report off to their own families about what a good nurse they had.
Shanna Shafer RN, BSN is driven by the impact nursing, and nursing education, can have on the health of our patients, families, communities, and nation. She has almost ten years of nursing experience in a variety of settings, and currently serves as the Managing Editor at BestNursingDegree.com