New Nurses-How can we effect change?

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It seems to me that during my clinical work and preceptorship I have been able to see things both great and not so great in the clinical setting with "fresh eyes". But at the same time I am hesitant to make suggestions/observations because I am a beginner/novice. How can a new nurse effect change without stepping on toes?

Specializes in Critical Care, Education. Has 35 years experience.

First of all, make sure that you have an accurate interpretation of the phenomena in question. Clarify & obtain data/information from divergent sources to make sure that you are not misinterpreting something. Example: a new grad 'reported' an experienced colleague for not maintaining sterile technique during a dressing change because she did not understand the 'one glove' technique that was being used on the CVP dressing change. She was very embarrassed but the damage was done - experienced colleagues did not trust her.

Secondly, do your homework. Perform a literature search. Ask experts. Examine current regulations & laws. Do a gap analysis. Analyze the change that would be needed to move toward the desired outcome. What would it cost? How much effort would it take? Put your ideas together in the form of a proposal that includes all of the information you have obtained. Run it by your boss for input & direction...

If you don't think you are getting enough support, change tactics. Become active in your department's PI/Quality process & re-introduce it as a PI/Quality project.

Basically, change needs to be purposeful & clearly supportive of the organization's goals and objectives. No one will support change 'just because'.