What things do you feel set apart the great nurses from the good ones?

[blondy2061h]

For me:

1. Taking extra tie to just chat with patients

2. Consistently using facial expressions to show genuine happiness/sadness/concern, etc

And many more things, but I'm having a hard time coming up with them at the moment.

[Flightline, BSN, RN]

If you've done all you can do, then do this: wiggle your patients big toe when you walk out of the room and tell them to just hit their call button if they need anything at all.

It works for me, anyway.

[TakeTwoAspirin, MSN, RN, APRN]

Some of the best nurses I have observed have had an ability to make every patient feel like they are special, even the ones I know the nurses couldn't stand.

[ruralnurs]

Some very important things to be a great nurse:

• Be able to prioritize......see what needs your attention now and what can wait.
  
• Make a decision, if you don't know the answer, use your brain, you made it through school and know how to find an answer......don't let a bump become a brick wall.
  
• Be a team player......if nurses stood behind each other like docs do we would be so much better off.
  
• Don't take things that go south as personal all the time....its not always about you.
  
• Remind your patients that if they did not need help you would not have a job....even the ones you don't like.
  
• Never act like you know something you don't..... You don't have to let a patient know it is the first time you did X but ask a co-worker or look things up if you don't know.
  
• Always be learning....when you know everything you better quit nursing and go be a Wal Mart Greeter.
  
• Leave it at the door....your problems at home, school, your other job, etc. are no more valid or important or horrendous than anyone else's. When you are at work, be at work.

[rhondaa83]

You have nailed it on the head!

[Babs0512]

Nurses who are staunch patient advocates, who understand pathophysiology and how diagnosis relates to labs, xrays, assessments, CT scans, etc... The nurse should have excellent assessment skills, be great at prioritizing and re-prioritizing throughout the shift. The nurse should have good instincts and not be afraid to question authority on behalf of their patient. This nurse trusts in his/her knowledge and not afraid to stand his/her ground when necessary.

He/she is also aware of their limitations, and is not afraid to ask for help or to admit not knowing an answer - providing he/she knows where to look to find the answer.

Good bedside manner, and good communication skills. Advanced assessment or credentialing a plus.

[justmurphy]

Many good answers on here and also I'd like to say being the patients advocate. This means putting in place measures necessary to make sure the physician listens to you - sometimes the patient is too sick, tired, awestruck to make their needs known to the physician. Same goes for overbearing families.

My only connection to the medical field is I am a patient. I have COPD and I take full responsibility for putting myself in the position I now find myself. I find myself hospitalized three (3) or four (4) times a year with COPD exacerbations despite going to my physician as often as she requests, taking my medication as directed by my physician, exercising to the best of my ability and trying to eat as healthy as possible.

I write this to thank all the wonderful nurses who literally have saved my live, who have taken care of me over the years in the ER and on the floor. I want to thank the nurses who are advocates for their patients and who go head to head with whomever when necessary. In particular, it was an ER nurse the week before last that did just that.

I am on oxygen at home 2 liters, 24 hours a day. I woke up out of a sound sleep gasping for air, I immediately did a neb treatment using an oxygen tank at 8 liters using a mask, called 911 and was transported to the ER 45 minutes away. On the way to the ER, the EMT put me on a BIPAP, continued with Albuterol and a dose of Salmeterol through an IV. By the time we reached the ER, my sats had gone up from 74% to 100%. The doctor that saw me said we will keep you for a couple of hours and you can go home. At this point, my sats were 93, which are okay, but I was still short of breath, so short of breath it was difficult to even speak. The ER doc reluctantly ordered an X-ray and X-Ray came back okay and lungs were clear but very diminished. The RN who was taking care of me came in and told me about the X-Ray being okay but was really concerned about my shortness of breath and said she was going to speak to the ER doc about not sending me home within the next couple of hours, she said she felt I need to be admitted if for nothing else but observation. The suggestion from my nurse to the ER doc did not go over so well. He said he did not understand my not wanting to go home because my sats were good. While that part was true, I was still having a very difficult time breathing. Again my nurse came to my rescue, she explained to my doctor that I lived quite a ways from the hospital --- 45 minutes, and in all probability if he send me home, I would just be returning via ambulance again and I was home by myself. I do not understand what part of I was having difficulty breathing and short of breath he was not getting, what my nurse was getting the doctor was not. Maybe he was having a bad day, maybe he had a distain for people with COPD, who knows but he was not happy about admitting me, but did so, but I can tell you it would not have happened with my nurse going to bat for me. As things turned out, I did have an upper respiratory infection and was hospitalized for eight (8) days. I do not know what shows up on X-rays and what does not and if the infection should have shown up and did not, I do not know those things. I just know that my nurse knew I was sick, I was short of breath and I the last thing I needed was to be sent home, God love her.

I thank all of you nurses out there from the bottom of my heart, you are worth your weight in gold, over worked and underpaid and I know there is a special place for you.

[leslie :-D]

Some of the best nurses I have observed have had an ability to make every patient feel like they are special, even the ones I know the nurses couldn't stand.

i particularly like this answer.

whether we're caring for the pt who hoards twinkies under her very ample breasts, to the pt who's on the call light every minute, to the lol who is disimpacting herself, an excellent nurse can make that pt feel as if they get it, that their (pt's) behavior is perfectly reasonable and will go the extra mile to ensure the pt is (rightly) heard.

esp to those pts we all avoid.

those type nurses are my heroes.

leslie

[NursingAgainstdaOdds]

Lots of great answers in this thread.

For me, the great nurses are the ones who can do many of that which was mentioned above, and they can remain positive while they do so. Pleasant and positive, even in the face of the challenges modern medicine hurls at us.

[steelcityrn, RN]

Going the extra mile, making sure your patient feels like someone actually cares about their well being.

[Indy, LPN, LVN]

A good nurse can handle a critical patient. A great nurse will recognize problems that haven't happened yet and head them off, and tell the next shift what worked to prevent whatever problem that didn't develop, so they can benefit from his/her foresight as well.

This is something I was fortunate to have drilled into my head in school, and I've seen it in action. I still have to think- sometimes out loud and with other people- in order to do this preventative thing, but hey it's well worth the effort.

A good nurse gets all her shift tasks done. A great nurse will find ways to help the next shift with theirs, whether it be going ahead and bathing people, taking out the trash at end of shift, or nagging for more help on the next shift, maybe putting the consents on top of the chart to be done, notes to physician on doctor's orders (for stuff they need to attend to, that next shift will be too busy to tell them about), etc. These are the nurses you love to follow.

[ruralnurs]

Indy,

You are so right about helping the next shift. That is team work and as nurses we need to look out for one another more and stop "tyring to make one nurse look bad so it makes me look better"

I see it so much and don't get why it has to be that way???????????

Great additions.....I think when this post slows down I will print this off and take it to work for the bulletin board!

[RheatherN, ASN, RN, EMT-P]

i agree with everyone. one thing that stands out to me is the nurses that DO NOT pass their feelings or judgements in report on. this is ridiculous. i dont care ifyou are having a bad day, dont make it the pts fault.