Being at the Top of Your Nurse Game

by | Feb 17, 2014 | New Nurse | 0 comments

One of the things that I love about being someone’s nurse is that I’m in charge. I’m calling the shots (ha!), and other than the 10 minutes that the doctor is at the bedside, I’m the boss. Nurses have so much autonomy now. When your critical thinking skills are on point, you know all your resources, and you feel confident in what you’re doing, you are, well, a rock star.

I love that there is so much I do and initiate because of my nursing judgment. I love it when other nurses and physicians come and ask me, “So what do you think? What should we do?” Or when I catch something, call the doc and suggest something, and they’re like, “Hey, great idea!” or “good catch!” That is some serious job satisfaction right there.

So, how do you get there? If you’re a brand new nurse, getting to that point seems impossible. Well, it is not. You will get there. I believe that something important to becoming an excellent, safe, and confident nurse with sharp critical thinking skills is knowing your weakness. We need to be aware of things we aren’t so hot at to reasonably be hot.

I have a few nurse practitioners, physician assistants, and physician friends who work in different hospital areas. I highly value their opinion because they are great providers, but they also are highly respected by the nursing staff. They know how tough our job is and know they need us on their team. Because of their keen understanding of nursing, I asked them the following questions:

What Are Some Common Mistakes That Newer Nurses Typically Make?

I asked this because we, as nurses, can ask/answer each other this question and get similar answers, but I think it’s important to ask the same question to people that are not nurses. We need to ask the non-nursing members of the health care team this question to ensure we are at the top of our game because we work so closely with other departments and members of the health care team. Below, I have paraphrased their answers.

Using Prn Medications Incorrectly

For example, if Ativan is ordered and the indication is listed as “seizures,” and the MD rounds to see what PRN meds they’ve received in the last 24 hours, and they got two doses of Ativan for agitation. They’re zonked; it’s not appropriate. So, make sure to check your indication for the med before you use it.

Also, legally speaking, you can’t use a med for something other than its indicated use. Just because it’s listed as a PRN doesn’t mean you can use it whenever you want. You must use it for its stated use.

Giving a Definitive Time for When the Doctor Will Round

As we know, lots of unpredictable things can occur during the day. The same is true for MD. They may intend to round at 1400, but they’re also the first call and have an emergency case and can’t round now until 1700. A good rule of thumb when you get that dreaded “when will the doctor be by?”

Always let them know the general time they round and then add in that “if an emergency occurs, it could be much later, so it is difficult to predict.” That’ll cover both of you. I also say to the families that if for some reason they’re not there when the doc comes by, I’ll ask them to call the family member for an update.

Not Painting the Same Picture as the Medical Team

Death/dying/poor prognosis conversations are tough, and you want to be consistent with the groundwork they’ve laid. I’ve screwed this up before and felt terrible.

A personal story from my first year: I got a stroke from the ED. The MD told the fam how dire the circumstances were. I didn’t read his note, and I just went off of the small amount of info I knew about stroke recovery to educate the family. I gave too much hope after the doc had already worked hard for them to understand their mother was essentially dying. I undid all of that. I gave this poor mourning daughter a speck of hope that she clung to when I should have just said, “I’m so sorry,” and comforted her.

I suggest reading notes if you can’t touch base with the doctor or if the previous RN is unsure about care goals. You don’t want to undo work they’ve done or confuse the family. Also, if you disagree with the way the physician is handling it (which is okay and happens sometimes), talk to your manager and see what to do next.

Have Mutual Respect for the Entire Care Team

Suppose you’re a jerk to CNA’s, transporters, and pharmacies. Everyone, including the doctors, notices that. However, it doesn’t make them think you’re a good nurse. On the contrary, it makes them respect and trust you less.

Maintain Professionalism

Nurses and techs joke around a lot in the nursing station, and it can get quite dicey. Sometimes docs do, too but know when to pump the brakes. Talking about needing personal scripts in front of a doctor that’s your coworker is an unwritten, never-ever make that rule. 

So, if you need your ADHD med refilled or your PCP didn’t listen to you when you said you needed something to relax, don’t vent about it in the nurse’s station within earshot of your physician coworkers or patients/families. It’s awkward and unprofessional, but that line can get easily blurred when everyone has a good time.

Also, joking around is good because it does foster a fun work environment, however, knowing when to get serious or do something quickly. If you’re laughing with a doc while they’re putting in orders for STAT labs you need to stop joking and get the labs. 

Patient care is always the priority, which can be easily forgotten when everyone’s having a good time. We’ve all been there; notice when you need to get down to business. Now I’m going to share qualities that make a good nurse and you can also follow these.

Qualities that Make a Good Nurse

Nursing is a rewarding career. It offers professional respect, flexible job opportunities, and the chance to make a difference in people’s lives are just some of what it provides. That being said, like any field, healthcare has its share of challenges, too- with work that can be demanding at times as well. Here’s a closer look at the qualities that make a good nurse.


Empathy is the ability to put yourself in someone else’s shoes and feel their emotions. This is a big one with nurses. They have to be able to comfortably deal with sick patients who are perhaps scared and confused, so they can reassure them and make them feel better. Nurses are exposed to a lot of trauma and tragedy on the job.

They see human suffering and pain up close, helping patients with terminal illnesses, for example. Nurses must find peace in knowing they are doing all they can for their patients, even when they lose them to death. It helps develop empathy in nurses- seeing people at their lowest points but also in their happiest moments too.

Emotional Stability

The job of a nurse is a long one. It’s a physically and emotionally taxing career, which requires them to be mentally tough at all times. Nurses also have to deal with personal tragedy on the job, like losing their patients or people they love turning up in emergency rooms after accidents.

A good nurse can become detached from his/her emotions to help keep him/herself balanced. Because of this, emotional stability is key for nursing. Nurses have to be strong when needed but also adaptable and flexible. They need to move on from things like the death of a loved one or their tragedy so they can continue working and caring for others.


The nursing career requires you to put yourself lastly at times, and it’s an admirable trait that makes good nurses stand out because it’s not usually something you find in such abundance these days. Nurses must look after their patients before themselves if required- whether they are assisting them with getting food, giving them medications, or cleaning up after them while sick. Selfless people make good caregivers too.

They can put themselves aside for the greater good of others, and that’s one reason nurses are so good at what they do flexibility. Flexibility is must for any healthcare career, but it’s especially important for nurses. They must adapt quickly to different circumstances because their job can change instantly on the fly due to patient needs.

In addition, things like situation or health changes can suddenly occur, which requires immediate adjustments by the nurses concerned, so flexibility is key here.

Communication Skills

A good nurse can communicate effectively. They are also non-judgmental and empathetic when communicating with others, which helps them listen to their patients better. It’s not just about being a good communicator at work, either. Nurses must communicate well outside of the workplace, too, whether it’s dealing with insurance companies or family members.

A nurse needs to be able to problem-solve on the job too. They’re usually working with limited resources in emergencies, so they have to think fast and use what they have available to them while getting patients the help they need as soon as possible.

This is especially true when dealing with terminal illnesses and other similar things nobody wants to experience ever. In addition, putting yourself in someone else’s shoes makes you more sensitive towards others, making for better communication overall.

Critical Thinking Skills

Comforting others in stressful situations is no easy task. It especially applies to anyone working in a clinical setting, but nurses have to do this all the time. They must be able to comfort people while simultaneously dealing with their own emotions regarding such situations.

It’s hard for someone of any profession, so it makes you wonder what kind of people become nurses just by looking at the situation from an outside perspective like that. The ability to comfort others is known as “therapeutic” because they are seen as possibly healing factors on patients’ minds and bodies which help them get better, if not happier, and more relaxed.

Nurses are often seen as godsends or angels, sometimes due to their compassionate and kind actions, which should be seen as normal human behavior. Being a nurse means they have to put their feelings and emotions aside, which is a difficult thing for most people, so being able to do that with ease usually means a person has some excellent character traits.

Ending Words

Becoming a nurse is one of the best career choices you can make. You’ll find fulfillment in knowing that your work will be making an impact on others’ lives. It’s comforting to know that nurses who possess these qualities are more likely to succeed and do something they love.

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Picture of Kati Kleber, founder of FRESHRN

Hi, I’m Kati.

Kati Kleber, MSN RN is a nurse educator, author, national speaker, host of the FreshRN® Podcast, and owner of FreshRN® – an online platform created to educate, encourage, and motivate newly licensed nurses in innovative ways.

Connect with her on YouTube, Pinterest, TikTok, Instagram, and Facebook, and sign-up for her free email newsletter for new nurses.


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