What do you do that makes your work exceptional?

[tomjones200824]

I am new to nursing, but worked as a tech for 3+yrs in the ED-place of nursing hire. I have worked as a new RN for about 7 weeks now. I am functioning well and have received positive recognition from colleagues, even the ones that are considered "unapproachable and mean." Anyway, long story short, my preceptors, including charge nurses, feel I'm able to provide complete patient care- start to end. I started out with 1-2 patients for the first week or two then picked up 3rd and picked up a 4th more so recently. Fortunately, I remain able to provide quality care, but I am missing out on witnessing those "special things" a nurse does that makes him/her exceptional, as I am mostly functioning alone.

I have learned about maintaining a clean room for my patients and their family. I have learned to look up all medications I have yet to push before I do it. I have learned to provide dignified care to my patients and their family. I have learned to explain all procedures and follow up with my patients before they go for any imaging or after a physician informs them of something that may be new to them.

Without me going on and on, these are some of the things I picked up and practice. But I do not feel this is enough. I am a firm believer if you do something be the best or give it your best . So what are those things you try to do or practice that you think provides "the best quality care."

[mybrowneyedgirl, BSN, RN]

In my opinion, the next step is putting the pieces together. No urine in the Foley after numerous hours? Make sure the doctor is aware. Came in with a low temp? Recheck rectally and be proactive with approaching the doctor for warm fluids (if appropriate) and a blanket warmer. Did you review their labs? Maybe the doctor didn't notice their electrolytes are out of balance. Is their blood hemolyzed? Redraw the labs and send to get accurate results. Has their EKG changed? Did you redo a GCS on a stroke patient? Post breathing treatments, what do their lungs sound like? Starting someone on Nitro? Ask the doc for a Tylenol order in anticipation of that headache. I could go on and on, but once I started tackling these "small things" I felt like I was going beyond the basics and starting to become a better nurse. Good luck to you. It's great that you're trying to step up your game.