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How to Trust Your Nursing Judgment

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I’ve received a lot of questions from new nurses saying that one of their biggest struggles is when they’ve learned a lot but are having trouble learning how to trust your nursing judgement. You think you know what you’re doing, but you’re not sure...

I’ve received a lot of questions from new nurses saying that one of their biggest struggles is learning how to trust your nursing judgement. You think you know what you’re doing, but you’re not sure… and are constantly questioning yourself, doubting yourself… how do you get over the hump? How do you go from unsure newbie to confident nurse?

I posed this question on my Facebook Page to experienced nurses and they had some amazing responses.

I’ve received a lot of questions from new nurses saying that one of their biggest struggles is when they’ve learned a lot but are having trouble learning how to trust your nursing judgement. You think you know what you’re doing, but you’re not sure...

As a new nurse, I also struggled with this and wanted to compile their responses with my own experiences. Onward!

When I had to trust my nursing judgement

“When I was forced to rely on it,” is what Micki P., RN said and I couldn’t agree more. There were times when I wasn’t 100% totally sure… but everyone else was slammed, nowhere nearby, or whatever the circumstances, and I was forced to stand on my own two feet. While I was nervous, I thought critically about the situation, and asked myself, “if another nurse came up to me and asked me this question, what would I tell them?”

When you’re right again and again

Anastasia M, RN answered the question by saying, “When my observations were confirmed with increasing frequency.”

Again, I completely identified with this. I started to notice I went from being way off base or almost correct… to being right most of the time. And it. felt. amazing.

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I know, it feels pretty awesome.

“Hey, he feels a little warm and his heart rate seems to be above baseline. Let’s check a temp and I’ll peek at his CBC from this am, and circle back with the doc.”

“Hey her lungs aren’t as clear as before, she’s not urinating as much… maybe she needs some Lasix.”

“Hummmm… maybe we wait on getting that non-STAT chest x-ray until after the resident puts this central venous catheter in and I put the feeding tube down to save the patient an x-ray and radiology another trip up to the room…”

The pieces just sort of start to fall together and all of the pathophysiology you learned in nursing school comes together with all of that time management / patient care you’ve been learning throughout orientation.

When others come to you for your opinion

Jackie T, RN said, “When co-workers started asking my thoughts and opinions (more experienced nurses). I felt like if they thought I was good enough, that what I thought mattered, I must be then.”

Ding ding ding! YES! A few months after I started as a newbie, a new crop of nurses started as well as a few new CNA’s. I was thankful to have more new people on the unit who were hopefully as lost as I was. Yay friends! But, I noticed that when they started asking me questions… I actually knew some of the answers.

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I quickly went from the most lost person on the unit to someone who knew the unit relatively well, could navigate many issues, and knew who to call when I was stuck.

And soon, it wasn’t just the other new employees asking me questions, fellow nurses starting asking me what I would do or what I thought about a certain situation. The first time it happened, I had one of those, “did he just ask ME what I thought!? What parallel universe is this!? I’m the new one who doesn’t know what she’s doing!” moments. I collected myself and provided the answer I thought was best, and he agreed.

And I immediately

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When you confidently teach can others

Stephanie B, RN said that this kicks in, “when you can confidently teach others.” Going back to this group who started after me, I had one new nurse ask me some questions about a Cardizem drip. I answered her questions and then dove a little deeper into the why. I was a little on autopilot and didn’t really think about it until after. As I was walking away from the conversation I thought, “waaaaaiiitt a minute… did I just teach another nurse something!?”

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Yes. Yes, I did.

*** Confidence building….***

Time

And finally, of course… I would be remiss if I didn’t mention how important it is so give it time.

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Stephanie D, RN said,

“Time. As it went on and my gut continues to be right about patients, I trust it more and more. I value being able to ask more experienced nurses their opinion. But I’ve loved the strengthening feeling of “I got this!” With each shift and with each health issue I’ve caught that could’ve been missed (or had already been by others). I’m not perfect, but I do my best to also learn from my mistakes, which I also feel makes me a stronger nurse.”

And I think that is a wonderful note to end on.

Thank you to all of the experienced nurses who responded on FB, offering their advice and encouragement to all of the newbies out there.

Did we leave anything out? What’s been your experience with learning how to trust your nursing judgement? Are you currently on orientation – what are you struggling with?

Resources to help you to gain confidence and trust your nursing judgement:

  • The FreshRN Podcast 
    • FREE + tons of episodes on all of the important things to know as a new nurse that tend to get glossed over
  • NRSNG MedMaster Course
    • The best explanations of the mechanism of action behind medications I’ve personally ever seen – this can help really solidify the why behind the medications you give frequently
  • NRSNG Academy
    • Monthly subscription to a ton of nursing resources, which includes the MedMaster course + test-taking, EKG’s (incredible explanations of this as well!), NCLEX® questions, med-surg, fundamentals, OB, cardiac, and more.

Critical Thinking, Clinical Reasoning, and Clinical Judgment: A Practical Approach, 6eCritical Thinking, Clinical Reasoning, and Clinical Judgment: A Practical Approach, 6eClinical Judgement and Decision Making in Nursing (Transforming Nursing Practice Series)Clinical Judgement and Decision Making in Nursing (Transforming Nursing Practice Series)Critical Thinking and Clinical Judgement: A Practical Approach to Outcome-Focused ThinkingCritical Thinking and Clinical Judgement: A Practical Approach to Outcome-Focused Thinking

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