Improving nursing practice as a new nurse

Tait, MSN, RN · Jun 22, 2011

Interesting. So they want you to sort of journal about your experience? I guess, if I am understanding this, I would not limit the journal to "outstanding" things, because you are right, at this point what does that mean?

I would get two journals. One for things I think I am doing well at, i.e. patient care, listening to patients, etc, and then one for things I can improve on, time management, med passes, experience with IV's/foleys/drains etc.

That way you can see what is going ok and what needs some work. Later you can compare the lists and move things you have improved on to to the other journal and see your progress!

Not sure if I am getting the jist of your post, but it seems logical?

PS. Also if a situation arises where you handle something very well, perhaps ask a colleague to write a brief statement for you as to how you handled the situation. We have to do these yearly for our Magnet nursing portfolios. It would give you something concrete to look at, as well as utilizing nurses with a better idea of what might or might not be "outstanding".

Ms. Amy · Jun 22, 2011

Thank you for replying, yes my nurse manager encouraged me to journal for my yearly proficiency, sort of to keep track of my accomplishments and to be promoted a step. That's a great idea about writing a brief statement on handling a situation.

I was also thinking of having patient's write a quick survey of their experience even before the post discharge calls, I was thinking that would be a concrete way to validate what patients tell me all the time. (your a good nurse)...although I'm so focused on not making a mistake sometimes I don't feel as confident as I should

Tait, MSN, RN · Jun 22, 2011

Thank you for replying, yes my nurse manager encouraged me to journal for my yearly proficiency, sort of to keep track of my accomplishments and to be promoted a step. That's a great idea about writing a brief statement on handling a situation.
I was also thinking of having patient's write a quick survey of their experience even before the post discharge calls, I was thinking that would be a concrete way to validate what patients tell me all the time. (your a good nurse)...although I'm so focused on not making a mistake sometimes I don't feel as confident as I should

Confidence comes with time. I am glad our hospital has a comment care program. I keep all of them from my patients in the back of my binder. Not only does it help with my reviews, it also reminds me when times are tough, why I am a nurse :)

brillohead, ADN, RN · Jun 22, 2011

I'm in clinicals right now (ADN program) and we have to turn in a weekly evaluation form documenting how we met (or didn't meet) the learning/competency expectations. Since I'm only in Med-Surg I, it's not like I'm getting tons of experience with gaping ulcers, central lines, etc., so it can be hard to "prove" some of the stuff we're supposed to document, like "communicates therapeutically with clients and families".

I've been working around this by finding a way to humanize even the most mundane events. If a patient or family member gives you a hug as they're being discharged, I would see that as proof that you're able to establish an emotional bond with your clients/families, that they feel like you're invested in their well-being (hello, Press-Ganey scores!).

Last semester, I noticed that my LOL with the broken pelvis, who had been on the unit for three days already, didn't have an incentive spirometer in her room. While it may not seem like some big "outstanding" thing to *you* that you thought to bring an IS to a patient and instruct them in how to use it, I'd be willing to bet that the patient would disagree if it prevented her from getting pneumonia (and the hospital would also disagree if it kept them from having another nosocomial infection that they wouldn't get reimbursed for by Medicare!).

Did you find a documentation error? Catch a med error? Have one of those "gut feelings" about a patient that wasn't because of anything clinical in their chart, but you just knew they were going to go south on your shift so you asked the doc to come see them? Did you hold someone's hand at night because they were afraid to go to sleep?

In other words, think along the lines of that saying, "To the world you may just be someone, but to someone you may be world." If you did something that had a positive impact on someone's life, I think that's a pretty outstanding thing to have accomplished.

joanna73, BSN, RN · Jun 23, 2011

I just had my review. I'm a nurse of 7 months. Things to consider include:

instances where you assessed and managed a challenging situation. What was the outcome? How did you go above and beyond for your patient? Culturally sensitive care? What are your team/ leadership skills like? Prioritization and time management? How do you work with your cognitively impaired clients? Do you role model the organization's values? How are you working on your continuing competency? Describe an instance where you had to advocate for your patient. What was the outcome?

So as you work, start reflecting on these aspects and keep track of specific examples. Hope that helps.

JRP1120, RN · Jun 23, 2011

I just had my review. I'm a nurse of 7 months. Things to consider include:
instances where you assessed and managed a challenging situation. What was the outcome? How did you go above and beyond for your patient? Culturally sensitive care? What are your team/ leadership skills like? Prioritization and time management? How do you work with your cognitively impaired clients? Do you role model the organization's values? How are you working on your continuing competency? Describe an instance where you had to advocate for your patient. What was the outcome?
So as you work, start reflecting on these aspects and keep track of specific examples. Hope that helps.

This is great to keep track of. Then you'll have instances to recall on if you ever interview for another position at the same hospital or another facility, when the interviewer asks these kind of behavioral-type questions (as well as using them for your own growth and retrospection). Great ideas here! :)