Nurses are fortunate to work in a profession where intellectual property is valued as a shareable resource to improve our understanding of our patients, rather than hoarded as a commodity to be bought and sold. Nurses are such givers; it is hard to remember to ask for things sometimes. This blog illustrates the power of asking questions. Whether seeking information, clarification or doing an assessment, good nurses learn to ask good questions. There are two kinds of questions: closed and open ended.
Closed questions are highly specific. Prepared well, they can be a great source of quality communication in an acute area. We use them regularly to elicit controlled responses; tell us about the patient, tell us what is happening, what have you assessed, what happens next? With closed questions an experienced nurse can ask for a specific order, and a graduate nurse can communicate an issue with less risk of missing an important piece of information. With telehealth becoming more common, these skills/experience can provide nurses with opportunities take a lot of responsibility and accept leadership role in the health care team as a critical analyst of a changing situation.
Open ended questions provide in-depth insights to patient’s behaviour and opinions. This is because the patient can have the opportunity to answer questions freely and explain their reasoning. This type of questions can uncover information for new situations and foster innovation and new sources of knowledge. Asking “how can I help my patient find public funded community resources for support while she/he recovers from an illness?” leads to talking about shared experiences, support systems, and relationships. Asking “what is the best diabetic and heart disease monitoring practice for my patient with a combination of well-managed risk factors?” inspires a discussion that can incorporate clinical judgment, basic science knowledge, and practice standards into an innovative plan to support safety, and preferences of family and health care team.
In a health care work environment, questions—and even dissenting views—are valuable and encouraged. Graduate and novice nurses sometimes express fear of appearing ignorant before their colleagues, and this may result in some holding back from asking questions. Some are afraid of entering practice in a fast-moving, ever changing hospital environment, not knowing everything. I would like to assure them that it is ok to ask questions, in fact an experienced charge nurse would be concerned if they did not ask questions. Asking questions can enable a novice nurse to take advantage of valuable opportunities.
Reflecting on my experience, the most useful outcomes of Bachelor of Nursing Education was learning the basics of assessment and communicating to “paint a picture” of a patient situation. Even when working in a highly specialised critical care area, when I speak to a doctor to ask for a plan of care for a patient, I know better how to describe their demographics and their history in context, and to have my assessment results at hand. Being prepared to ask a good question saves time, develops trusting relationships, and shows that I know what to expect.
So how have I benefited in my role as a registered nurse by reaching out and asking for something? I have benefited in knowledge, and this has also helped me at getting better at my job which is deeply satisfying. Through asking questions, and observing other nurses’ actions and responses, I can detect changing signs and symptoms in patient’s conditions, and able to notice when something is different even if I do not yet know what to make of it.
Gaining the trust of my team has been a rollercoaster journey of confidence highs and lows. But asking for things has been beyond rewarding every time I do it. I firmly believe that there are many positive nurse leaders who want to help every nurse succeed and will give above and beyond what is requested.
Creating a collective strength can overcome the fear of asking questions especially for a new member of the team who may have other valuable experiences. Nurses in leadership positions should encourage discussion about patient care and provide a trusted space where colleagues can ask questions and receive feedback. All staff can be involved in questioning and developing systems-based solutions.
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