How do you keep yourself "sharp"?

Sounds as if you need to get on the same page with the dietician and prescribing MDs as to what constitutes a liberal diabetic diet.

I can't tell you how I've been able to "strike a balance," but it has served me well to be authentic and to admit mistakes when they happen. That also might be the key, in a sense to therapeutic listening and talk. Just pay attention, empathize and do what you think is right for the patient.

I'm only a few months into my nursing career, and more and more I realize that doing things well, really being able to *teach* patients, and mastering therapeutic communication is going to take lots of time and practice (and some major humility, also). Someone was telling me that in that book called "The Outliers" (I guess it's about the habits of people who are extraordinary in their fields), the author discovered/hypothesized that all of these amazing people had practiced their craft for at least 10,000 hours. So basically, I think that it's only after a LOT of nursing shifts spent keeping your eyes and ears open that you fine-tune your practice.

I also think that adjusting your teaching to individual pt needs becomes easier as YOU know more and more about a topic. I always find that I can tell when I need to learn more about something because my pt. teaching becomes shorter and more cursory-I just don't have the knowledge to be able to customize it!

Finally, I've decided that I'll begin to feel more comfortable by taking some steps to educate myself during my offtime. I've made a commitment to learn everything I can about common meds on my unit, common pathos/interventions/etc and to ensure that I get to work early enough to do decent research on pt conditions by reading MD notes, PMH, labs, and any other pertinent info. For me at least, I believe I'll only become fully confident and a strong nurse when my knowledge base allows me to critically think and be mostly confident.