As nurses and nursing students, our profession is rooted in scientific knowledge. We can discuss in-depth about the pathophysiology of acute kidney injury perceived in critically ill patients to medications that are classified as Cytochrome P450 inhibitors. And to the ladies of The View, I didn’t need a doctor’s stethoscope to grace you with that tad bit of knowledge. Readers, please excuse my banter. As you can see, I am insulted by their senseless remarks. Seemingly, I have digressed from the topic at hand. So, I will get back to the point.
Certainly, nurses and nursing students are well versed in disease pathophysiology and advanced pharmacology. Moreover, we play many roles that range from caregiver to advocator. However, one of the most important roles that we play is as an educator. Frequently, patients ask us to restate in simple terms what a physician said after he or she exited stage left. Some doctors are notorious for dropping big medical terms to patients, and it causes the bewildered look seen below.
A patient’s reaction when a healthcare provider drops big medical words.
At one time or another, as nurses, we may have incited the same look when explaining a procedure or a medication’s intended action. As a nurse practitioner student, I was guilty of evoking the same expression that I lovingly labeled the ” Tim Gunn Look”. One day, a patient presented to the clinic with symptoms of atrial fibrillation. So, I informed him that I would be performing a diagnostic exam called an ECG. Unfortunately, I provided the patient with an in-depth analysis. Midway through my explanation, I realized that I was dropping medical terminology because I induced the “Tim Gunn Look” on my patient. Consequently, I apologized to the patient and restarted. Here’s how I explained it the second time.
“An ECG is a test that measures the electrical activity of your heart. I will place several sticky pads on your body and wires will be connected to those pads. This test won’t hurt. Those pads and wires will pick-up your heart beats, and the machine will draw me a picture of how your heart is performing. This printout shows me if your heart is beating normally or abnormally, and this test can give me clues about heart conditions like atrial fibrillation. Healthcare providers may order this test if a person has chest pain, shortness of breath, palpitations, or before a person has surgery.“
From that experience, I learned a valuable lesson. Nurses and nursing students must be cognizant in the way they are presenting information to patients. Here’s the recap.
Provide the information in short sentences
Limit the use of medical lingo.
Use layman terms that the patient will grasp
However, don’t sacrifice important info if it doesn’t translate well
As healthcare providers, we must remember that most patients are not versed in the medical language. In the future, remember Tim Gunn’s expression when you provide patient education. You don’t want that face gazing back at you.
I encourage you to share your thoughts in the comments section below. I can’t wait to read and learn from your experiences!
Communication breakdown is the leading cause of medical errors such as gaps in health care, incomplete or missing information, and medication errors. Most importantly, communication supports the foundation of patient care. So, hand-off reporting during shift change is a critical process that is crucial in protecting a patient’s safety. Throughout the hand-off report, it is vital to provide accurate, up-to-date, and pertinent information to the oncoming nurse. Not only are nurses transferring responsibility, but we are also shepherding and ensuring a safe passage.
Pitfalls…
Often, shift change is a chaotic period. The phone is ringing. Attendings and a cluster of residents are rounding and subsequently adding twenty new orders that must be implemented before 9 a.m. Eager nursing students are searching for their assigned preceptor, and I discover that the night shift nurse that I am receiving report from is exhausted. She expresses that she had a hard shift and desires to leave the unit before her sanity and patience is tested. So, she provides a brief, unfocused hand-off report and offers no opportunity for questions and irritation ensue at the meager utterance of a syllable or my inquisitive glance. As a result, I am given shattered fragments of the last 12 hours. Yet, I know that I am accountable and responsible for safe, quality, and efficient patient care. Because of this encounter, I have implemented and developed a standardized process throughout my hand-off report.
How you feel after receiving a terrible hand-off report.
My approach…
My preceptor drilled the importance of this task. Moreover, she expressed that this event is vital because it directs the care of my patient, and it is essential that I provide a relevant, timely, and clear account.
The process:
Patient Overview. I give a brief narrative of the shift by providing a broad picture. For instance, I mention critical facts.
Assessment. The first segment includes the patient’s name, age, gender, allergies, code status, code word, admission history, IV access, and medical history. The second part includes the neurological, cardio, pulmonary, gastrointestinal, genitourinary, skin/ wounds, and musculoskeletal exam. Also, I state critical labs and the most recent vital signs.
Safety Concerns. I note the patient’s environment and the potential risks that may lead to patient harm (i.e., fall risks).
Plan of Care. At this point, I share upcoming procedures, patient education, and actionable plans.
Questioning. I provide the opportunity for questions to ensure communication is clear.
In the end, hand-off reporting is significant. It is our responsibility to ensure that pertinent information is reviewed. All things considered, we are obligated to deliver safe and efficient care.
I encourage you to share your thoughts and experiences. What’s your method for hand-off reporting? I can’t wait to read and learn from your experiences!
Hi, everyone! Today’s discussion focuses on recognizing common ECG rhythms. To some readers, this topic brings to mind painful memories. Certainly, I can relate to those feelings. Mastering the skill of reading an ECG strip is analogous to fluently speaking a foreign language in approximately two weeks. It is challenging, but it can be accomplished.
For two and a half years, nursing lectures and exams consumed my thoughts knowingly and unknowingly. Whether I attended family events hosted by my parents or social gatherings planned by my friends, my attendance was ultimately determined by my second bible, my notorious planner. In years past, I would not have imagined that that lilac bound book comprised of fast approaching exam dates, hundreds of clinical hours, and jam-packed study sessions at Moe’s would lead to the tremendous joy I felt when I earned my degree.
During that time, impromptu weekend road trips were replaced with Saturday night treks to the library and early morning strides to Harry’s Coffee Shop. Textbooks and jellybean colored notecards became a permanent extension of my body. Wherever I went, heavy textbooks and rubber band bound stacks of notecards followed. Often times, I could be found in my new favorite hangout, which was Dr. Rosemary Fisk’s office drafting and editing graduate school application packets. Plus, from time to time, she became my life coach and my off-book therapist.
Before I knew it, graduation was fast approaching, and I was shopping for the perfect white uniform dress for the Nurse Pinning Ceremony. Finally, the big day arrived! Five semesters worth of meltdowns and hours of devout studying and preparation had led me to that moment. As I confidently and joyously walked down the aisle, I was certain that my nursing program prepared me to be a caring, compassionate nurse.
Since nursing school differs from other programs, Dr. Fisk imparted invaluable guidance and wisdom that certainly navigated my path. Frequently, she emphasized three principal themes that create a prescription for success while enrolled in any program:
Rosemary Fisk, Associate Dean of Howard College of Arts and Sciences at Samford University
First things first: Make college your job.
Make earning your nursing degree priority #1. Don’t allow other interferences, such as a taxing social life or a job, interfere with your ultimate goal.
Set personal and academic goals. At the launch of the new semester, get ahead and stay ahead!
Get to know your faculty and clinical instructors. These individuals may serve as a resource, a mentor, or a reference. Honestly, faculty and instructors enjoy helping students!
In class…
Develop strong listening and note-taking skills. Developing listening skills is paramount since this will be your prime source of information. Remember: Listening and hearing are completely different. Listening is active by nature, and hearing is passive.
Recognize that mastering the information is your responsibility. Don’t blame the professor for your lack of success. Participate in lectures and ask questions.
Read notes or required reading before lecture. Before class, make a note to remind yourself to inquire about any unclear topics and ask yourself: “What do I want to learn today?”
Look for the professor’s pattern. In lectures, professors are referring to notes on specific pages or references. You can recognize what professors are signifying as important and identify the main idea of the presentation.
Study, study, study
Manage your time. You remember 70% of what you say and 90% of what you do so be sure to schedule your study time.
Rephrase and explain. Explain the material in your own words to a fellow classmate. If you can’t explain it, you don’t know it!
Make note cards. They are easy to carry and study during short breaks in-between lectures. Making note cards creates a stronger imprint on the brain; thus, increasing memory.
Join a study group. In study groups, several of my classmates brought something to the table that I did not grasp. Likewise, I shared my ideas. I recommend a maximum of 5 people. It is imperative to come prepared and engaged. This is an opportunity to strengthen your knowledge on your subject. It is not a time where you teach or be taught by another student!
Applying her recommendations made school easier and at times enjoyable. I urge you to share your stories and experiences that helped you succeed throughout nursing school. I can’t wait to read your posts!
Not too long ago, I was a nursing student whose very existence revolved around participating in study groups with Mandy and Yolanda, creating mountains of index cards, and conquering new skills in the nursing lab. Although those things are critical in completing any nursing program, at times, I found myself on the brink of an all-out breakdown if I could not master an individual concept or visualize a disease process. So, Jennifer Coleman, Ph.D., RN, CNE, my nursing professor and mentor, instructed me to watch specific films or a TV series that examined diseases. And afterward, I would discuss the disorder the video explored implicitly or explicitly.
Jennifer Coleman, Professor at Samford University’s Ida V. Moffett School of Nursing
Initially, this task proved to be difficult since I would just identify diseases or symptoms that were readily superficial. Frequently, Dr. Coleman pushed me to offer a deeper evaluation and provide supporting evidence. After the 4th assignment, I discovered that watching those films and TV episodes honed my assessment skills. For instance, in clinicals, I would comprehensively evaluate each patient but specifically noting how each symptom may adversely affect multiple organ systems. Without question, this method has shaped my thinking and assessment process.
As a new nurse practitioner, I utilize these skills that I developed in nursing school to diagnose and treat patients. Reflecting back, often, Dr. Coleman affirmed that keywords, phrases, and subtle actions expressed by the actors might be representative of actual patients that I may encounter. Without question, as a clinician, her advice reigns true. So, in the spirit of Dr. Coleman, each week we will explore and discuss a film or TV series that explicitly or implicitly highlight medical disorders. Soon enough, after participating in this exercise, you will see an improvement in your assessment skills. First up, we will screen the documentary entitled What Happened, Miss Simone?
Here is the complete documentary for your viewing pleasure! Click on the hyperlink below.
