Supporting Novice Nurses to Develop Strong Clinical Reasoning Practices
Nurse educators and leaders of staff development are often presented with opportunities to help novice nurses continue to grow their abilities to proactively approach care and recognize risk factors before they snowball, as they do sometimes, into much more clinically problematic scenarios. Becoming a competent clinician requires nurses to think critically while consistently assessing their patient. For development to become actionable, time and resources for development need to exist—a real approach with real outcomes; otherwise, the foundation for the environment to perform well is not supported. Nurses retain the competency and authority to continuously use their knowledge and skills to recognize signs and symptoms, predict risks, identify responses, and initiate interventions to ensure their patient’s safety and promote health. Let’s take a look at some strategies to support novice nurses to develop strong clinical reasoning practices.
Encourage early intervention to prevent and manage issues. This includes considering complications and identifying risk factors.
Foster collaborative and multidisciplinary approaches. This involves understanding that nursing does not function in isolation. Working across disciplines significantly impacts outcomes.
Maintain patient-centered care through nurse-patient partnerships.
Differentiate between nursing and medical diagnoses. This requires nurses to recognize when the authority is with them and when they are required to seek physician or advanced practice nurse (APN) management.
Review the process of accepting professional responsibility for treating identified problems or elevating responsibility to qualified team members.
Reinforce that nurses are accountable for their findings, along with those missed. This includes being responsible and answerable along the way.
Recognize that learning how to plan care can be challenging for novice nurses and they may feel overwhelmed with worry.
Help form connections to resources and identify strengths, along with areas for improvement. This highlights practices such as checking in with mentors, asking process questions to self, looking for flaws in one’s own process, considering overlooked cues, and seeking validation through double-checking with a peer.
Identify needs for the development of professional behaviors that promote the ongoing welfare of patients.
Actively solicit feedback from others and self-evaluate performance in addition to participating in the formal performance appraisal process.
Educating and leading nurses through their growth from novice to expert clinicians asks us to remember our own early beginnings and recognize the effort it takes to organize and prioritize care. Signs and symptoms that expert nurses quickly assess may require more time and memorization by novice nurses, so keeping references available for easy access and encouraging each nurse to connect with their unique needs for supporting their work, such as self-made notes and reminders, can be key. We believe keeping communication open and non-judgmental creates room for questions and exploration. It’s tough to be new, and that goes for most things, but being new in a rapidly evolving healthcare climate with high responsibility and accountability is much better supported through teamwork. Taking the time to understand the importance of our work, the tools that we have, and the reasoning behind all that we do, moves quality care forward.
Pause, Reflect, and Plan:
What does the skill-mix look like on my team? How does my leadership influence the outcomes I see? What strategies can I broaden or newly incorporate into my efforts to support novice nurses?
