Fake it til' you make it!

Long Term Care Columnist / Guide · Apr 16, 2012

Hey, sometimes I STILL have to "fake it till I make it"! Nursing has so many variables that you could never encounter everything in the course of a career....there will always be something new to deal with. =)

anotherone, BSN, RN · Apr 16, 2012

I dunno maybe confidence when talking to patients, other nurses and drs but after a few months they all became easier except for the patients and their families. maybe because it is a teaching hospital, so employees are pretty understanding when you are new to an extent.. But I try to not fake anything else. always ask for advice, even after looking up procedures or policies. if you are not sure ask, please! I may be a bit annoyed at having to slow down to show a student/newer nurse something if i am super busy but in reality I am glad they ask, and that they asked me! lol those nurses who ask a ton of questions may be complained about but the ones who don't ask and make huge mistakes are discussed 234324132413 times more and possibly fired.

GitanoRN, BSN, MSN, RN · Apr 16, 2012

this subject brings back memories of my first days after graduating from nursing school on my first job, here's the scenario a doctor wrote an order for kvo, and a foley regarding a pt. of mine, which i was told he had difficult veins and he was a demanding pt. needless to say, i had only done this procedure a couple of times with supervision never on my own. as i walked towards the pt. room, i must admit my hands were shaking a bit that's when i took a deep breath and inform the pt. the procedures that i was about to perform, and he said "have you done this before? or they just grabbed you from the street":eek: which i reply without missing a beat and with an authority tone to my voice "close... i was working at the cafeteria" which he then said "fine! you only have one chance to get the vein" i didn't answered, i just kept my focus and before i knew it i had successfully accomplished both task. certainly, it has been said the more assertive and energetic an individual acts the more confident they become.

classicdame, MSN, EdD · Apr 16, 2012

I was an older graduate. Make that old graduate. Anyway, as a pedi nurse the parents would come to me for all kinds of questions, thinking I had all the experience. HA! So I drew on life experience. Mostly people wanted to talk and have someone show they care

OncRNMichelle · Apr 16, 2012

i was an older graduate. make that old graduate. anyway, as a pedi nurse the parents would come to me for all kinds of questions, thinking i had all the experience. ha! so i drew on life experience. mostly people wanted to talk and have someone show they care

[color=#0099ff]i don't have children of my own so i can imagine parents have tons of questions when their babies are sick or in the hospital. i'm sure you gave them some peace of mind.

MPKH, BSN, RN · Apr 17, 2012

I'm a old-ish new grad, been working for 7 months now...and the first day that I was put to being Charge Nurse? I was faking it the entire 12 hours, hoping that if I fake it enough, I might make it! Now with 2 months of Charge experience...there's less and less "faking" and more and more "making"!

LobotRN, BSN, RN · Apr 17, 2012

Best line for just about anything regarding "fake it til you make it".....assessment and setting the tone!

"Good morning/evening Mr/Mrs Smith.....I'm Nurse Jane, and I'll be with you for the next 12 hours. I've reviewed your chart and we have a few things to accomplish while we are together for this next little while. First, I'd like to listen to your heart and lungs..."

Come on shift, get some basic pt info, do bedside report, then circle back on all your assessments, chart right away!, and get ready to pass meds. If anything comes up during the assessment that you cannot confidently answer on the fly, just say...

"Excellent question Mrs. Jones, so want to know X? I want to be sure to get you the answer that is specific to your situation, so while I gather your am/pm/prn medications, I'm going to find that out for you. I'll be back shortly...if you need anything in the meantime, here is your call light. I'll have answers or an update when I return in about the next 45 minutes."

Of course, this sounds stilted, but the concept is walk in with confidence, use confident language, exit with confidence, and then run like crazy to find the staff with the answers you can find, until......

"Mrs. Jones, I checked and you are scheduled for that lexiscan at 10:00 this morning. Jenny from transport will be here very soon to take you down in a wheel chair. While I'm here, I need you to use the bathroom so that that is taken care of before the test...."

With gentle assertion, telling (rather than asking, as in voiding before a procedure) a patient what to do so they can be ready for whatever needs to be done can convey calm assertiveness that lets them trust you and the process.

Wild Irish LPN, LPN · Apr 17, 2012

well technically I am not quite a nurse yet, soon though, very soon....My first live Foley scared me to death....after months of practicing in the lab my time had finally come....with my very intense CI at my side I went to work.....sweaty hands like no other, and repeatedly running through all the steps in my head, "Stay Sterile!"....it took all of 60 seconds but felt like an eternity....she never knew how scared I was, I truly faked it.... :specs:

LobotRN, BSN, RN · Apr 17, 2012

Be proud Wild!

There will be many of those moments on the "other side." I don't get to do many IV starts because almost all of my pt come from ER pending a procedure or come post op from a planned one. BUT last shift, I walked in and said, "You're right Mrs. X......I can see why that IV is painful, it has begun to leak. I will be restarting one in your other arm so that we can continue getting you the fluids and antibiotics you need, and to make your arm feel better, ok? Alrighty, I'm going to turn on a bright light so I can start your new IV....."

I hate HATE starting IVs because I feel like I don't know how to do them well. I mean, I get the steps and do them, but miss quite a bit. I've watched countless videos and "live sticks" when I've called for reinforcements......I asked my mentor/prior preceptor who shrugged me off in a very good way....."Go practice. You get two tries per pt, take every opportunity. Act confident, don't waste any opportunity."

:) I got it on the first try.....

wooh, BSN, RN · Apr 17, 2012

It's funny, the more comfy I am in my own skin, I'm more willing to let patients/families know that I don't know the answer. But I like the going over the plan for the day with the family as said above. It gives you a little speech to get started with, set the tone, before you might have to break into things that you aren't as confident about.

dudette10, MSN, RN · Apr 17, 2012

One time, early in my orientation. I had never done a lot of things in school, including putting in a Foley. I had seen a placement lots of times, knew what to do, but had never done it myself. The patient was alert/oriented and feisty, and he was nervous about having a cath placed. My preceptor that day asked me if I wanted to do it. Yes, of course I did.

I went in there making sure I looked like I had done this a million times, and the patient asked me if I'd done it before. "Oh, yeah...plenty of times." The placement went off without a hitch.

When we left the room, my preceptor giggled and said, "You're a good actress." :thankya: