My Best Clinical Tip

My students often ask me for tips to help them be successful in the clinical setting, and I come back to one that has served me well many times in my nearly 30 years of nursing practice.

Here it is:

When you first learn about what is going on with your patient, think through all the bad things that could happen to them as a result of their condition.  As you think through those things, consider how you would respond and what equipment, interventions, and resources you would need. Then you are better prepared for the worst case scenario.

I often use this example: My patient has a head injury, which puts them at risk for seizures. If they were to have a seizure, I would need to keep them safe. Do I have padding? Suction? Oxygen?  Do I have a pulse oximeter in the room? If I needed to give seizure medications, I might give Ativan.  Do I have IV access to be able to give that? If not, should I start an IV now?  If that didn’t stop the seizure, what medications might I give next?

By going down this line of thinking, it shifts you from reacting to being proactive in how you respond.  It allows your response to be more measured and calmer.

I can’t claim credit for this tip, though.  It came from my senior med-surg clinical nursing instructor, Janis Carelock.  She had been an ICU nurse and already thought this way about her patients.  Janis died in 2013 from cancer after teaching nursing for 20 years.  I can’t help but think how many patients have received excellent care as a result of her efforts as a teacher.

Janis Carelock, MSN, RN, CCRN (1948-2013)