Asking Why During Your First Year of Nursing and Beyond

Two nursing professionals explain the importance of staying curious and challenging the status quo to provide the best patient care. Nurses New Nurse Article


Asking Why During Your First Year of Nursing and Beyond

Two nursing professionals explain the importance of staying curious and challenging the status quo to provide the best patient care.

By Adrianne Duvall, DNP, APRN, CNEcl, FNP-BC and Chaney Landgraf, MSN, RN, CNE, CCRN

In our experiences as clinicians and educators, neither of us has ever met a successful nurse who’s satisfied with the status quo. Nurses share a spirit of inquiry—a drive to know why and a refusal to accept care decisions due to tradition or convention. The skill of confronting "the way it is always done" is difficult, particularly early in your career. However, if the status quo doesn’t make sense, nurses must be comfortable challenging it because someone’s life may depend on it. Here are three skills you should prioritize in your first year as a new nurse—all centered on asking “Why?”—to build the foundation needed for a successful career.

Developing Situational Awareness to Prevent Errors

Situational awareness is a foundational component of nursing practice that serves as the basis for sound clinical judgment. You must be able to interpret the clinical cues around you and piece them together to understand what is going on with your patient so you can provide individualized patient-centered care. On top of that, you always need to know the reasoning behind your interventions. The heart of being a nurse is advocating for the most effective solutions for your patient—thinking like a nurse, rather than just doing nurse-related tasks. To do this, just ask, “Why?” “Why is my patient getting intervention ‘X’ instead of intervention ‘Y?’” “Why might my patient develop a complication?” “Why do some nurses on my unit perform this procedure differently than I learned it?”

It is challenging to speak out as a new nurse. You might also fear that asking questions makes you look like you don’t know what you’re doing. But as experienced nurses working with novices, we find it more concerning when new nurses aren’t asking questions. From a safety perspective, it is imperative that you ask questions in order to develop your own clinical judgment.

Research shows that novices make a large percentage of the errors caused by nurses, and the majority of those errors are related to medication administration. The National Council of State Boards of Nursing (NCSBN) recently highlighted a need to improve math education in nursing. Because learning to safely administer medications goes beyond a textbook, it is worth investing in hands-on resources that develop clinical judgment and skills to prepare you for real-world situations. Learning tools, like UWorld’s Clinical Med Math, allow nurses and nursing students to practice dosage calculations without the risk of harming a patient if they make a mistake.

Finding Outlets to Reduce Stress

Let’s face it—being a nurse is hard. Nursing is physically demanding, with hours of standing, miles of walking, endless patient needs, and often minimal to no breaks. Add the mental strain of being "on" for an entire shift and the fear of missing something or making a mistake, and it can take a toll. To address this stress, start by asking, "Why?" Why do you feel the way you do? Do you feel isolated or lack adequate support? Commit to self-reflection, perhaps using reflective journaling, and search for the “why’s” of your personal and professional experiences. Identifying your emotions and stressors will help you find the appropriate solution or support.

Finding peers in your unit to lean on for support is critical. Whether it’s a unit-based educator or a staff nurse, having someone available to provide guidance and answer questions will reduce your stress tremendously. Building relationships with your colleagues outside of work is also helpful. Group dinners where you can commiserate and discuss the challenges of the job reduce stress and help put things in perspective by taking them out with people who understand. If you’re having trouble leaving work at work, going on a walk around a local park is another healthy way to de-stress.

Throughout your career, you may encounter situations that make you question why you became a nurse, perhaps an unexpected poor patient outcome or a negative experience with a coworker. We all have unique reasons for entering the field, but sometimes we need help keeping a wider perspective of why we do what we do. Reaching out to former school faculty to share stories and challenges can be helpful. Someone removed from the situation can often provide a helpful perspective. It is also important to practice self-care, which can mean calling a friend to grab dinner after a hard day, or getting a massage after three straight shifts, or even committing to getting adequate sleep. When we take better care of ourselves, we provide better care to our patients.

Committing to Continual Growth

Becoming a nurse inherently commits you to a lifetime of learning. But how do we truly grow as nurses? It is easy to think that completing the continuing education requirements for our licenses and specialty certifications equates to career development, but growth as a nurse requires engagement and commitment.

One of the most effective ways a nurse can become a lifelong learner is to engage with a larger community. It’s so easy to become immersed in your unit’s ways—the behaviors almost become law. Broadening your perspective through different groups in your facility, nursing journals, or external professional organizations will help you find the "why" in your own practice.

Depending on your facility, there might be opportunities to engage with people who are creating or implementing research that keeps you updated on evidence-based practices. Professional associations like the National League for Nursing are also fantastic resources. They have meetings and free continuing education modules where you can read articles and test your knowledge. Of course, the most fun sources of continuing education are conferences. It’s fascinating to see what different professionals are doing across the country, and it opens your eyes to possibilities to bring to your facility.

Nurses experience so much change during their careers—change in practice, specialties, hospitals, or units—which gives you the opportunity to learn an entirely new skill set and deepen your nursing knowledge. Staying curious and asking questions is the most important thing you can do to be successful as a nurse.

Adrianne Duvall, DNP, APRN, CNEcl, FNP-BC and Chaney Landgraf, MSN, RN, CNE, CCRN are clinical nursing faculty members at a premier Texas university. Dr. Duvall also serves as the director of nursing strategy & research at UWorld. In this role, she performs student outcomes research, exhibits at student and faculty conferences around the country, and assists with planning and development of future nurse education resources. Landgraf is a certified nurse educator with expertise in online education, clinical instruction, and NCLEX-style item writing. He has a clinical background in adult pulmonary and medical critical care at high-acuity, academic medical centers and serves as a senior nursing content developer at UWorld.

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