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What if I don’t know the answer? How nurses can stay confident and competent under pressure.

In many hospitals, your resource nurse was often your charge or the nurse who had been on the unit for the longest. You may have also asked the person who trained you or the grey-haired nurse who has literally seen it all. We have so much respect for those nurses, but they are fewer and farther between. While staffing is in crisis, the team you are with may have tons of patient experience but aren’t sure of hospital policies, or you may be the most experienced nurse on the floor.  (gulp.)

What happens when you are the adultier adult who is still new at adulting?

No matter how many years of experience you have, there are some questions that will stump you, procedures you’ve never done or seen before, and scenarios you wouldn’t have guessed could ever happen.  That’s okay, as long as you stay calm and know what your resources are.  No matter where you work or what role you are in (hello travel nurses) you need to find a few key resources that can make a huge difference.

The policy repository

Ok, we will consider this a bit of dry reading you probably don’t have time for, but when you need it, knowing where to look up the hospital’s policies on urgent blood transfusions, suicidal patients, or even visitor restrictions can be a lifesaver.  Your hospital is required to have these policies available to all colleagues, but they aren’t always the easiest to search through.  Ask about where you can find policies during your orientation.  If you can’t remember, ask the house supervisor.  Many hospitals keep that information on every desktop in an electronic filing system. Smaller facilities may have an old-school filing cabinet.  No matter what it looks like, make sure you know where to find it, and how to search for the items you need.

A clinical resource

Most hospitals have partnered with a company that specializes in evidence-based medical resources.  These companies like Elsevier or Lippencott are focused on creating step-by-step guides for procedures, important safety information, and can sometimes even provide a list of all the items you will need.  If you aren’t very familiar with things like how to treat post-op hip patients or place an NG, or how to grade a bedsore, these resources are there to help.  If your hospital doesn’t provide one, there are versions you can purchase for yourself.  This option from Elsevier is a pretty price for a year subscription but may be worth it if you’re a travel nurse learning in a new place every few weeks.  Thankfully most hospitals already have a version of this software, but many staff members don’t recognize the benefit.  Evidence-based medicine only works when you use it, why not use evidence fact-checked by some of the leaders in nursing education? You can often find links to this resource within the EHR or on the home page of the hospital intranet.

A pharmacy resource

Just like the evidence-based practice resources, many hospitals can link directly to helpful pharmacy information as well.  Here you can usually find drug calculators and information about line compatibility. There are plenty of apps you can download like Epocrates, a well-known medication tool. There is a wide range of prices and capabilities of these apps, so make sure you know what you are signing up for.  The free version is often limited.  Experienced nurses may not need much more than a compatibility reading, but new nurses may find some benefit in the paid versions to learn side effects, parameters, and uses of medication.  Some EHRs will also link the user directly to the medication guide within the med pass part of the system.  Don’t be afraid to ask your local pharmacist if you can’t find what you need.

Finally, you need a person to contact for immediate questions.  This is typically the charge nurse who can escalate any issues to the house supervisor.  If that charge nurse is you: the house supervisor is well acquainted with the tools available to nurses and can look up information or can show you how to use the resources available to you.  You may feel alone when you are the adultier adult in charge for the first time, but you can answer almost every question by looking through your resources.  Other great people to ask include your manager, educator, or charge nurses on a different unit.  No matter how much authority you have (or don’t have..) knowing where to find these three things can help you tackle whatever comes your way.

 

Amanda Ernst, DNP, RN, CEN

Amanda Ernst, DNP, RN, CEN

Author

Amanda is an ER nurse with 10 years of healthcare experience. She currently works as a nurse educator and as an adjunct professor for several schools. She also works as a freelance healthcare writer in her spare time. Amanda thinks the greatest thing about nursing is the endless possibilities and opportunities to learn. What have you learned today?

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