The Footnotes

HEALTHCARE & NURSING

The four rules for a career in nursing

Why didn’t an older and wiser nurse tell ME this?

There are numerous meanings given to the four wise monkeys and the proverb of see no evil, speak no evil, hear no evil and do no evil- including associations being of good mind, speech and action. But if nurses were monkeys (I’m sure you’re already picturing a nurse you think fits the bill)- how would the four wise nurses translate this to our young nurses?

  1. Speak no evil

So you’re a new nurse and everyone at the hospital knows it. The nurses, the doctors and the patients all recognise that you don’t have the most refined skills yet and that’s okay, they are prepared to supervise and field your every question. So ask away!

When it comes to being a young nurse, you need to throw all humility out the window and be okay with not knowing everything, because you are dealing with life’s greatest commodity, and the reality of your mistakes can mean death.

Your seniors would much rather you question the route or dosage of a medication than have to fill out the paperwork for a medication error. Ask your preceptors for any resources they have so you can familiarise yourself on frequent topics and be comfortable with what you’re doing and know where the gaps in your knowledge are.

There is no such thing as a dumb question, so even if you’re 95 per cent sure, ask the question- and before you kill someone!

  1. See no evil

There is not one procedure, operation, or patient that you will be worse off for observing. We all know how long a shift can be and how incredibly draining the experience is on a nurse, especially as a grad- but you will regret finishing your shift on time, rather than staying on to watch something that you can learn from.

No patient is the same. With a million different variables to consider, every patient approach is varied and carefully calculated. So while many of your day-to-day happenings may seem ‘standard procedure’, each one is unique and one of a kind; and because of this, you need to take note.

Everything moves fast in nursing, and despite your best efforts at taking a stable patient, it could be on its tail in disaster by the end of the night. Take a deep breath, rely on your resources (there will always be someone to help) and know that you can (and should) step up to the challenge. Flexibility is key in these situations, and also not letting fear impede your ability to perform your job.

Some procedures aren’t done too often so you may only get one chance to observe before it’s your patient the next time. Observe all that you can. See one, do one, teach one.

  1. Hear no evil

We work together for long hours, in stressful situations and in tight circles; its no wonder the whispers of the workplace can be frequent and negative. Difficult as it may be however, you need to unsubscribe.

A study of the effects of negative gossip in hospital workplaces found it had a positive relationship with emotional exhaustion and depersonalisation; but more concerning is that it positively correlated with suboptimal care, even after controlling for burnout.

Hospital halls have long been lined with the understanding that “nurses eat their young,” but at what expense? You can’t allow yourself to be belittled by seniors or the victim of workplace slander. As this study proves- it’s not only impacting you, but your patients.

  1. Do no evil

In almost any other industry, there’s deemed to be an insidious side to seeking perfection – that unobtainable Utopia that can drive you (and your team) to madness, hindering you getting into market, quick. When it comes to nursing and any other medical profession however, seeking perfection is not an evil; it’s a necessity of the job.

Know that you will make more mistakes while you’re inexperienced and still finding your feet, and that they will also become more common as shifts are extended and workloads are heavier. Your best chance at avoiding these errors is to make yourself aware of the common ones you’re most at risk of making.

Keep your eye on the ball or these are the top three ways you’ll drop it:

  1. Medication Errors

Whether you’re fresh out of graduation or a veteran nurse, anyone can make this mistake; and it could prove fatal to your patients. For new nurses, you need to be wary of your nerves as well as your ‘presence of mind’- studies have shown that administration errors can account for up to 32% of medication errors. Leave your personal life at the door, and focus entirely on your patient.

Remember to identify, verify, and highlight that your patient is the right patient, and that you’re accurately versed on their other medications, their weight/height, and any reactions, allergies, conditions or critical diagnosis they have.

  1. Infection Issues

It’s a common problem, and one that should be dealt with proactively, not reactively. You have the opportunity to reduce the risk of infection and complications; take it. Ensure that you and your colleagues are aware of standard precautions, aseptic techniques and strategies for prevention. Don’t let your negligence or sheer laziness be laid on your patient.

  1. Documentation Errors

Record everything.

Paperwork should not be an afterthought. This essential part of your job keeps the patient safe and also protects your own back from potential lawsuits down the track. From their health and drug information, medications given, your actions and any changes to the patient’s condition- take it down. Using pen and paper? Make it legible!

Baby nurses, wisdom comes with age, and so as you don’t have time and experience on your side- listen to the proverbs of the four wise nurses.

 

Do you know the ups, downs and realities of a career in nursing? Read now

The four rules for a career in nursing
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