Learning Through Failure
by Nathan Koppe, BSN, RN, Park Nicollet Pulmonary Department
Walking into my last clinical assignment of my junior year, I was feeling confident. I had trudged my way through clinical paperwork, and finally could look back to all I had accomplished.
I received my final patient assignment and got to work. I researched her condition, double-checked medications, and prepared myself mentally for the long day ahead, or so I thought.
Not long after I began my day, I was pulled aside by my instructor and informed that my patient's sister had fired me from her case. Within seconds, everything crashed around me, crushing my confidence that I was capable of practicing nursing.
I began trying to frantically repair what had toppled. Internally I lashed out angry thoughts and wanted to march into the patient's room, defending myself and salvaging what little dignity remained. Despite conflicting emotions, one thought I could not shake was how utterly unsure I felt about my abilities as a future nurse. I feared I wasn't fit to take care of the sick.
Eventually, I began to question where my confidence was rooted. Where did I anchor my value as a nurse? I discovered I had slowly built a precarious tower of personal achievement and developed confidence and pride in my accomplishments. I was gauging my value on attained skills and knowledge.
Facing my failure was the admonition I needed to re-orient my confidence, strength, and courage to a source that never fails. “Let us hold unswervingly to the hope we profess, for he who promised is faithful” (Hebrews 10:23, NIV). By submitting myself and my nursing career to God, letting him guide my work and rooting my confidence in him, I can achieve my full potential and not falter when tumultuous events impact life.
Instructor Perspective by Maureen Ju´rez. Nathan was well-prepared and acted professionally in this clinical incident. Sometimes families are so stressed they lay blame where it does not belong. The patient later told me she had enjoyed my student for the short time he was with her.
While the events that occurred cannot be changed, this student learned a great deal. Sometimes our greatest successes come from places of failure.
A study of senior nursing students found a lack of confidence related to nursing responsibilities. Strategies and programs that could increase confidence included—clinical demonstration and practice, having a mentor or a peer instructor, using simulation, getting feedback and praise, use of humor, mindfulness training, and sharing stories or experiences. With increased self-confidence and empowerment, students demonstrate improved motivation for learning and better outlook on a situation (Drexler, 2009).
Handling Difficult Situations
If you haven't encountered a difficult patient situation yet, you will! What can you do to prepare? Experts say what's most helpful is to understand why patients/families may be difficult. What could be underlying reasons for anger/frustration? Is there cognitive decline? Unmet needs? Misunderstanding? In addition to illness, what stressors are occurring?
How can nurses respond? Here are helpful tips: Observe words, posture, attitudes—pick up on rising stress and address frustration early. Empower patients/families; give information, acknowledge their need, situation, abilities; thank them for cooperation. Connect; uncover and address underlying feelings/problems, express care and concern. Show Respect; address patients/families using titles (Mr. or Mrs.), speak in friendly, warm tones, look at the person. Slow down; let them know they are important to you. Stay calm; patients/families will sense your frustration. Recruit help; ask family, other staff, your supervisor for help. Don't make assumptions, put up walls, react, or take situations personally. Resolve problems; when you can, take care of what the patient/family needs. Document relevant events, especially for legal protection (Alexander, 2011; Mehallow, 2011).
Alexander Communications Group, Inc. (2011). The healthcare professional's guide to handling difficult patients
. Boonton, NJ: Author.