I’ve received a lot of questions from new nurses saying that one of their biggest struggles is learning how to trust your nursing judgment. You think you know what you’re doing, but you’re not sure… and are constantly questioning yourself, doubting yourself… how do you get over the hump? How do you go from an unsure newbie to a confident nurse?
I posed this question on my Facebook Page to experienced nurses and they had some amazing responses.
As a new nurse, I also struggled with this and wanted to compile their responses with my own experiences. Onward!
How important is trust in nursing?
Trust is a critical aspect of nursing and patient care. Trust extends to the nursing peers you work with, the physicians that manage your patients, and any support staff like CNAs, unit secretaries, housekeeping, or other technical staff. It’s important to have some level of trust with your interdisciplinary team, but trust in nursing also extends to yourself and the ability to trust your nursing judgement.
When I had to trust my nursing judgment
“When I was forced to rely on it,” is what Micki P., RN said and I couldn’t agree more. There were times when I wasn’t 100% totally sure… but everyone else was slammed, nowhere nearby, or whatever the circumstances, and I was forced to stand on my own two feet. While I was nervous, I thought critically about the situation, and asked myself, “if another nurse came up to me and asked me this question, what would I tell them?”
When you’re right again and again
Anastasia M, RN answered the question by saying, “When my observations were confirmed with increasing frequency.”
Again, I completely identified with this. I started to notice I went from being way off base or almost correct… to being right most of the time. And it. felt. amazing.
I know, it feels pretty awesome.
“Hey, he feels a little warm and his heart rate seems to be above baseline. Let’s check a temp and I’ll peek at his CBC from this am, and circle back with the doc.”
“Hey her lungs aren’t as clear as before, she’s not urinating as much… maybe she needs some Lasix.”
“Hummmm… maybe we wait on getting that non-STAT chest x-ray until after the resident puts this central venous catheter in and I put the feeding tube down to save the patient an x-ray and radiology another trip up to the room…”
The pieces just sort of start to fall together and all of the pathophysiology you learned in nursing school comes together with all of that time management/patient care you’ve been learning throughout orientation.
When others come to you for your opinion
Jackie T, RN said, “When co-workers started asking my thoughts and opinions (more experienced nurses). I felt like if they thought I was good enough, that what I thought mattered, I must be then.”
Ding ding ding! YES! A few months after I started as a newbie, a new crop of nurses started as well as a few new CNA’s. I was thankful to have more new people on the unit who were hopefully as lost as I was. Yay friends! But, I noticed that when they started asking me questions… I actually knew some of the answers.
I quickly went from the most lost person on the unit to someone who knew the unit relatively well, could navigate many issues, and knew who to call when I was stuck.
And soon, it wasn’t just the other new employees asking me questions, fellow nurses starting asking me what I would do or what I thought about a certain situation. The first time it happened, I had one of those, “did he just ask ME what I thought!? What parallel universe is this!? I’m the new one who doesn’t know what she’s doing!” moments. I collected myself and provided the answer I thought was best, and he agreed.
And I immediately
When you confidently teach can others
Stephanie B, RN said that this kicks in, “when you can confidently teach others.” Going back to this group who started after me, I had one new nurse ask me some questions about a Cardizem drip. I answered her questions and then dove a little deeper into the why. I was a little on autopilot and didn’t really think about it until after. As I was walking away from the conversation I thought, “waaaaaiiitt a minute… did I just teach another nurse something!?”
Yes. Yes, I did.
*** Confidence building….***
Time
And finally, of course… I would be remiss if I didn’t mention how important it is, so give it time.
Stephanie D, RN said,
“Time. As it went on and my gut continues to be right about patients, I trust it more and more. I value being able to ask more experienced nurses their opinion. But I’ve loved the strengthening feeling of “I got this!” With each shift and with each health issue I’ve caught that could’ve been missed (or had already been by others). I’m not perfect, but I do my best to also learn from my mistakes, which I also feel makes me a stronger nurse.”
And I think that is a wonderful note to end on.
Thank you to all of the experienced nurses who responded on FB, offering their advice and encouragement to all of the newbies out there.
Did we leave anything out? What’s been your experience with learning how to trust your nursing judgment? Are you currently on orientation – what are you struggling with?
FAQ About Nursing Clinical Judgement
According to the National League for Nursing, “Clinical judgment refers to ways nurses come to understand the problems, issues, or concerns of clients/patients, to attend to salient information, and to respond in concerned and involved ways (Benner, 2010). ”
Clinical judgement is important in nursing because it allows nurses to make confident decisions in the care for their patients. Good clinical judgement means a nurse can confidently assess a patient, put in place interventions, and execute to deliver the best results possible for the patient.
Clinical judgment includes the ability to make assessments, good clinical reasoning, clinical decision making, intuition, reflection, and practical wisdom. – Sound clinical judgment in nursing: A concept analysis
Having good clinical judgement means a nurse can make and execute on good decisions using nursing intuition, reflection, wisdom, and reasoning.
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- A subscription to a ton of nursing resources, which includes the MedMaster course + test-taking, EKG’s (incredible explanations of this as well!), NCLEX® questions, med-surg, fundamentals, OB, cardiac, and more.Nursing.com Nursing Student Nursing.com
I’m a new nurse (7 weeks into my 12 week orientation) and I have asked myself and my preceptor this question. She says to give it time. It’s encouraging to know that nursing judgement will come. My thing is, I ask so many questions right now, and I’m hoping by the 12-week mark I’ll be able to ask less, because it can be time consuming to have to ask so many questions. I want to be safe, so I will still ask questions if I have them. I’m just wondering, is there a timeline for the average orientee where we are able to ask less questions…or does that come with growing in our nursing judgment?
It just comes as your nursing judgement grows. And do not ever put a deadline on asking questions. If you have them, ask!