As a new nurse starting out, I remember learning multiple new things every day. Our facility has a couple physician's that are legendary for their temperments. I have always been the type of person that wants to understand why I am doing something, and would always ask why?
Why are we doing this? Why are we doing this like this? Why is this going to work?
One day I was preparing a patient for an angioplasty and the patient had a critical high potassium level. Upon notifying the physician (and expecting a kaexylate order), I received an order for an amp of D50 and insulin. After asking every nurse on my unit, and looking in all the drug books I could find, I still didn't find the answer. I gave the medications, rechecked the patient's potassium level as instructed and sure enough it had improved.
When the physician arrived on the unit later (of course one of the famous temperments), much to the surprise of my co-workers I simply asked him, "Why did we do this, and why did it work?" He happily explained it to me, and actually thanked me for asking. He also told me it was refreshing to have a nurse want to learn and has continued to go out of his way to show me new things, and actually praises me to patients, co-workers and physicians.
Don't be afraid to ask "Why?" You just don't know what you can learn.
Nov 24, '07
Thanks for posting, Jody, and I'm glad that you spoke up and found your answer.
I do have one suggestion for you, though: next time, it may be best to ask why before giving the med or treatment.
If an order doesn't make sense to you, it might be because there's something you need to learn.... but it also might be because an error has been made. Even as new nurses, we have the right and responsibility to use our knowledge and judgement and to question or challenge an order.
I'm a new grad orienting in the NICU - a few weeks ago, my preceptor and I gave a fluid bolus to the wrong baby because the doctor had written the order on the wrong chart. The original error may have been the doctor's, but there was also a nursing error made when we gave the bolus without seeing for ourselves why this baby would need one.
No harm done, fortunately, but this incident helped me to understand the importance of checking things for myself. In the months that I've been working, I've come to realize that the hospital world is full of mistakes - prefilled syringes where the volume doesn't match the label, expired feeds sent up from pharmacy, equipment that doesn't work properly, equipment manuals that get "distal" and "proximal" mixed up. Checking for ourselves and thinking for ourselves isn't just an extra layer of caution - it's absolutely essential to safe practice.
Take care, Marion
Last edit by HealthShepherd on Nov 24, '07
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