Criticism

classicdame, MSN, EdD · Oct 28, 2014

without specific examples it is difficult to improve on performance. I would ask for those and for any assistance your manager can provide. As for the ONE patient, if it is not a trend I would not dwell on it. Some people hate a talky nurse. Some want lots of attention. Being polite is always a good bet but you will never suit everyone.Overall, I think you did pretty well.

roser13, ASN, RN · Oct 28, 2014

It sounds to me as if your evaluation went pretty well! The only deficiencies mentioned were two areas in which you already knew you needed to focus? Outstanding!

Every.single.nurse with one year of experience needs to focus on critical thinking skills and decision making. Every single one. You likely have just now learned how to prioritize your tasks well enough to leave time for critical thinking! Please don't stop asking questions. A nurse who doesn't ask questions as necessary is a dangerous nurse. Just make sure you've exhausted all your resources to find the answer before you go to someone else.

The small talk issue comes from the "outstanding customer service" model that we're all obliged to follow these days. Efficient, competent care is no longer enough. We must charm the pants off our "customers" as well. Don't worry, it will come with practice.

Bottom line: Evaluations come with critiques - some would even say that's the point of annual evaluations. Your critiques are very understandable for a first-year nurse, and very, very doable. Just hang in there and be proud of how far you've come in one short year!

Kittery · Oct 28, 2014

Just wanted to reiterate PP's point that you should never stop asking questions. I completely agree that a nurse who doesn't ask questions is a dangerous nurse. Doesn't matter if the only person around to ask is the one most annoyed by your questions---ask anyway. It could mean the difference between good patient outcomes and bad. I've worked with plenty of seasoned nurses who asked questions everyday. Could you maybe have the evaluator clarify what she meant by "decision making"? I highly doubt she intended that to mean "stop asking questions."

And the communication bit? It almost sounds like they needed at least 2 items to critique, and they couldn't find anything else so they made a far reach for that. :) Honestly, in my first year, I had way too many other things going on in my head to even think about small talk. That said, I think for many patients, getting to talk about and share parts of their lives outside of their illness/the hospital can be very therapeutic. Just something else to think about for a bit, you know? That piece of patient interaction may come more naturally as you continue to adjust and feel comfortable in your role. My go to was always asking about their families---kids, grandkids, etc. Sometimes patients just light up when they get to talk about their kids (or their four-legged babies!)

As previous commenters said, your evaluation went fairly well for a new nurse. Don't sweat it. Even the most experienced nurses always have something they could improve.

LadyFree28, BSN, LPN, RN · Oct 28, 2014

OP, since you state you don't handle criticism well, your issue seems to be that you need to learn how to improve your practice; it behooves you to improve on those two points of practice because you are new nurse.

Look at this as ways to improve your nursing practice, nothing more, nothing less.

Katniss88 · Oct 31, 2014

Some of my problem with decision making has to do with my confidence. Even though I have improved a lot in that respect, I still do not feel like I have a lot of confidence and still at times I doubt myself. I struggled with it so much in nursing school, that one of my instructors finally decided to take me aside and talk to me about it, telling me that hospitals today expect you to "hit the ground running" once you begin working. Whenever I have done something before, then of course I feel more confident. The first time I inserted a foley I was very nervous, now I have done it so much it's no problem. Nursing is so much more than being able to insert foleys, NG tubes, and start IV's. I have gotten better at prioritizing and fitting into my role as a nurse, at times it's hard for me to believe that I'm actually a nurse. Some of the questions I ask for example, should I give this BP medicine based on the pt's current blood pressure when they are currently taking pain meds around the clock, when I had a pt with an NG for the first time I asked a nurse to come with me to check the placement, whenever I had a pt with CHF and I heard some lung sounds that were different I asked a nurse to listen too so I could compare with her about what I was hearing. Thankfully, I work with a wonderful group of nurses that are very helpful.

firstinfamily, RN · Oct 31, 2014

I agree with the above posts that you really had a great evaluation!!! I don't think any of us have ever had a perfect evaluation, and there are a lot of nurses here!!! Your manager should also provide you with ways to improve your performance, not just the constructive criticism. Return to her and ask for examples of how you can improve in these areas. Communication is a skill that takes time to develop. Some patients do want first class service. Sometimes you have to remind them that you are there as their nurse. Make sure everyone has what they need to drink, to be comfortable. I find giving this little touch lets them know you are in tune with what their personal needs are. If having their hair washed will make their day then find a way for someone to get the patient's hair washed!!! The nurse has the power to make the patient's stay a positive one, both by meeting the medical needs and personal needs. As someone suggested always ask about their family, or pets. Make a personal connection. Don't worry about not being a chatty cathy. Most patients do not want someone who talks their ears off, but they do want attention. Before you go on your break or lunch check with each of your patients let them know you are leaving the floor and who will be there to help them and when you will return. That lets them know that you "own" their care!!! Always, always, always ask questions. The only stupid question is the unasked question. You are learning as all of us are, and no one should ever feel a question is not warranted. Yes, by all means try to find the answer yourself using resources available to you, but never feel intimidated by others to the point where you are afraid to ask a question. That is called Team Work, something your manager should endorse!!! Good Luck, and welcome to the real world of nursing!!!

brownbook · Oct 31, 2014

I have posted this many times.

I was in administration for 5 years. The first evaluation I was asked to do was on a night time medical unit clerk. He was wonderful, efficient, always telling me if he wasn't busy and was there some other job, task, he could be doing.

I evaluated him highly. Before I gave him his evaluation my boss looked it over. She said...."You can't give him all high marks....you won't be able to indicate he showed improvement on his next evaluation."

Well....ever since then I have just smiled and nodded at my evaluations, acknowledged the areas I needed to improve on..."Yes I know that is something I need to work on." Then try to forget about what was said. (Well...actually I do usually remember what my weak areas are and honestly do try to improve!)

They are NEVER going to say what a wonderful nurse you are, you are the greatest, we are lucky to have you working here....etc.

advsmuch08 · Nov 1, 2014

Small talk can be tough, especially with complete strangers and all of the tasks that need to be addressed on your mind. Some nights I'll have pretty much the same conversation with each of my patients. The weather is always a safe topic. People tend to open up when you start talking about how much more hot, cold, rainy, snowy, etc than years past. If they're watching tv older people open up about the quality of tv shows have changed. If they have personal items, comment on the color being pretty and it reminds you of xyz. I know these ideas may seem kind of lame but see what works for you. Small talk is a great distraction and helps patients feel more comfortable in a stressful situation.

SubSippi · Nov 1, 2014

I agree with everyone else. Your evaluation went well, the issues you're having aren't at all abnormal or unexpected, and are also going to be fixed with experience. They aren't big things you'll have to put all your effort into working on.

Small talk gets easier, and now that you know people want/need more of it, you'll make more of a point to do it. Ask people about their grandkids or their dogs...always a good one. Or, "How did you day/night go?" Anyway, I don't think this is a huge deal, and from what your post said, only one patient had an opinion on it.

As far as the confidence goes, nobody ever stops asking questions. But, I'm sure there are many instances when you know exactly what you want to do, and what you should do, but you want to run it by someone. Think about these, and how often you actually end up being wrong. The next time it comes up, don't worry so much about a second opinion if you don't really think you need one. You'll build confidence seeing yourself make the right decisions. But still, don't hesitate to ask when you truly have some doubts.

jadelpn, LPN, EMT-B · Nov 2, 2014

Your evaluation went well, I think. You also noted that there were things YOU realized you needed to work on. And we all have them. You can ask for specifics as far as how you can go about improving your communication skills. Otherwise, good job for a newer nurse!!

Ruby Vee, BSN · Nov 4, 2014

I had my first annual evaluation and it didn't go as well as I thought it would. I have been a nurse for a little over a year now and believe I have come a long way since I first started. Even though I have improved a lot I knew there were things I needed to work on.
The first comment that was made is about my performance was about patient interactions. She said one of the patients made a comment to her about it and she said she explained to them that I'm not the type of person to sit down and have a conversation with you, but once I got to know you more I was more talkative. I have always been a shy person, but I have come out of my shell more and have gotten a lot better. It's not that I'm not ever talkative, once I get to know someone and feel more comfortable I will talk more. I always greet my patients and their family by telling them my name and that I will be their nurse. I always talk to the patient about their care, medications, and any necessary information. I guess they were expecting more small talk. My preceptor in nursing school didn't talk very much either, but that didn't make her a bad nurse. Before I went to nursing school I never thought I could be a nurse because I wasn't the type of person to show sympathy with my words, as I thought all nurses were good at.
One of the areas that I needed improvement on was decision making. This is the one that bothers me the most. Even before my evaluation I knew this and also critical thinking skills were things I needed to work on. I have always been more harder on myself, and I guess hearing it from someone else is what bothered me the most because it makes me feel like I'm not doing my job. I always asks questions and will ask the opinion of another nurse sometimes when it comes to certain medications. I used to ask a lot of questions. I guess I should start relying more on myself and not asking a lot of questions. I didn't ask her to go in depth or to give me examples of what I was doing.
I know the whole point of an annual evaluation is evaluate your performance so you can improve, but I have never been able to take constructive criticism well.

You've been given two areas in which to improve. I strongly suggest you LEARN to take constructive criticism well. It's a valuable skill and will enhance your practice more than any other change you can make. When you learn to take constructive criticism well, people will be more likely to offer it. And wouldn't you rather hear that you never seem to remember to empty the foley bag before the end of your shift from the nurse who ended up with a burst Foley bag and a floor to clean than from your nurse manager weeks later after multiple nurses have complained?