Monday, February 3, 2014

New Nurse Success Tip: The best predictor of competence

confidence, student nurse, new nurse, nurse confidence, renee thompson, rtconnections

In my business, I spend a lot of time helping organizations successfully onboard new nurses. From their first interview, first day of work, and clinical orientation to independent, competent professional nurse, the question is always the same - "How do we help new nurses become competent and independently care for patients?" 
As a new nurse, you may be asking yourself the same question. 
What determines new nurse competence?

Many things determine new nurse competence – how well their school prepared them, how committed they are to their learning, the relationship they have with their preceptors, etc.
However, the single most important determinate of new nurse competence is new nurse CONFIDENCE.
Not arrogance – but confidence.
You gain confidence in your skills as a nurse by mastering the simple before moving onto the complex. Many new nurses get overwhelmed when they see the other experienced nurses zip through their day doing everything fast and with ease. They compare themselves and think, “I’ll never be able to be that fast or know how to “do all of that.” What they don’t realize is that these nurses started their nursing practice the same way – slower than molasses and not knowing what the heck they were doing either!
The key is to understand that becoming a competent nurse takes time. To maximize this time and give yourself a break, follow these tips.
1.   Focus on learning simple skills first: how to put someone on a monitor; how to manage the IV pump; how to document your initial assessment, etc. Once you’ve mastered common simple skills, then move onto the more complex: setting up an arterial line; trouble shooting a central venous catheter; running a code.
2.   Focus on safety first! When you’re learning, it’s difficult to appropriately prioritize – everything feels like a crisis! However, ground yourself by always thinking “patient safety first.” Two identifiers; checking labs before giving IV electrolytes; making sure patient’s are on appropriate monitored, etc.
3.   Be okay with being slow! It took me 30 minutes to insert my first Foley catheter. Now, I could probably insert one in <5 minutes blindfolded!!! Well, maybe not blindfolded but you get my point. When you are learning a new skill, your brain uses energy until it becomes automatic. Once mastered, your technique and speed will improve because your brain doesn’t need to spend as much energy.
The bottom line is this – research tells us that the best way to become competent is to become confident. As a new nurse, you won’t feel confident until you’ve mastered certain skills. That’s okay. Successful nurses understand this and give themselves the time they need to become confident.
Thanks so much for reading and for becoming a nurse! I’m cheering for your success.
I always love reading your comments. What else can I help you with?
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  1. This is so true! I was a slow starter with acute hemodialysis & my co-worker asked supervisor to fire me. Lol. It was one of my favorite jobs & we all were a close team. Thanks for reminder of where I've been.

    1. Yikes! So sorry for the delay in responding Marian. Didn't see this comment until now! I've trained many preceptors...One of the primary reminders is for them to be patient and to give new nurses the time they need to master skills. Glad you didn't get fired!

  2. I have only been a nurse at my first job since February 21. My preceptor has me up to 4 patients and I feel like my body is not going to hold up. She was upset when I first started because it took me a half an hours to give one patient's meds and set up IV's that I had never done before. Sometimes I don't know if I can do this.

    1. Oh my Lyne. Please ask to speak with your preceptor either before or after work. Have a heart to heart with her and ask that she be a little more patient with you. We all start out slow. It takes time before some of these skills (like giving meds, setting up IVs) become automatic. If you're still having trouble, please reach out to your manager or educator for support!!

      Don't give up! You will get there. Trust me. I was as slow as molasses!!!