Nursing school prepares us for the reality of life as a nurse. You jump through the hypothetical hoops taking one step carefully after another and hope that you make it through alive. Years out now, I still find myself referring back to my earliest days in Professor Whitwam’s Introduction to Nursing Process. In those months I learned some of the most critical nursing skills that can easily be overshadowed after years of practice. From proper handwashing to taking the time to listen to your patient, it is essential to hold oneself always to the highest standards. I like to call them the little things in nursing.
According to the World Health Organization, “while hand hygiene is not the only measure to counter HAI, compliance with it alone can dramatically enhance patient safety, because there is much scientific evidence showing that microbes causing HAI are most frequently spread between patients on the hands of health-care workers.” It starts with thorough hand washing before and after contact with patients. Don’t ever rush through hand washing, no matter how busy you are. Be sure your patient and patient’s area remain clean. Wipe the pumps down thoroughly at the start of your shift. Wipe your work station down thoroughly at the start of your shift.
I still triple check my medications. Right patient, right medication, right time, right dose, right route. It’s easy to get caught up in the routine of passing meds, but it should never be routine. Know your medications thoroughly. Can this antibiotic cause autotoxicity if given too quickly? If you have never given the medication before, look it up.
Our practice is constantly evolving, so asking questions if unsure are critical in the care of our patients. It makes no difference if you have been a nurse for thirty years. In fact, it is even more critical for veteran nurses to still ask questions. It sets an example and teaches younger nurses that it is a perfectly normal part of a nurse’s practice and duty to ask.
I recall my first clinical rotation in a nursing home. I observed Professor Whitwam interacting with an elderly patient. She sat next to him, eye level, with her hand on his as she spoke to him. She talked with him and listened as if she had all day, even with a line of students waiting to ask questions. This was our exemplary example of a woman who found her true calling. You can call yourself a nurse because you have skill and knowledge, but an exemplary nurse is one that combines all of this with patience.
Imagine the homeless guy or junky in the E.R. waiting room is your brother, best friend. It’s easy to become indifferent to this patient population. Our work is stressful enough. The thing is, you have no idea where this person is coming from or what led them in this direction. Have empathy toward even your most difficult patients or family members.
None of the above suggestions take years of education or critical thinking, but are so critical in caring for patients. They should never be rushed through or skipped. They should be part of a daily routine. What do you consider “the little things” in nursing?