Self-Advocacy for Students
Every student nurse knows that clinical rotations are a hit or miss experience. There are so many factors that cannot be controlled on a hospital floor - the patient assignment, the nurse you are shadowing. You can go a whole day with nothing much happening. Yet, there are still a smug few who always have some riveting story to tell at post conference. Are these people just lucky? I say no. They are excellent self-advocates.
Self-advocacy can be defined as a person's ability to effectively communicate or assert his or her own interests. Building advocacy skills will not only help your education and career. It is also a vital set of skills to use later, when advocating for your patients. In this post, I will describe three skills of self advocacy: confidence, perseverance and follow through.
"But I just started," you say, "How can I have self confidence?"
Excellent point hypothetical reader! We all suck at nursing when we start out. There are other confidences you should practice. Boil it down to this: You belong on the floor of your rotation. If something is happening with your patient, you have a right and a responsibility to be in that room! That is your patient. That is your intervention. Your education is not an imposition on the system, it is designed into the system. Introduce yourself! Make yourself known.
During one of my ER rotations I met with students from another program. We were polite to each other. When patients arrived, they showed their confidence by standing near the door and desperately wishing to participate. I showed my confidence by telling the nurses which procedures I had already practiced on other floors and asking if I could do them. I ended up tailing a woman in labor from the ER to the maternity floor and assisting in natural childbirth. They practiced vitals on a semi-comatose patient with a bruit.
Perseverance, you gotta get some. Staff nurses and preceptors are often overworked and distracted. Some avoid students out of habit. Some don't notice us at all. Perseverance is all about asking; about getting a yes. When your patient is due for a nursing intervention or procedure,this is a big deal. You should be doing it. So ask. Some schools only allow certain procedures to be done by a student nurse with the direct supervision of a preceptor. So include them as part of the process. Pre-research every intervention, then ask if you can do it. Now if your preceptor says no, or if the nurse feels you are out off your depth, don't give up, This is where perseverance comes in. If you get a no, respectfully ask another question.
The next best thing to being able to do a procedure is to assist while your nurse does it. So ask. You might still get a no. Don't give up, that's only strike two. Take another swing. Ask if you can observe, beginning to end. If you still get a no, at least you swung three times. Final note: If you do, in that rare double rainbow, end up ticking someone off. Apologize sincerely and don't ask them again. The problem is not you, so don't beat yourself up.
Follow through is next. Follow through is not about the,"yes" you just got, it's about earning the next one. When you do get a yes for procedure, make it easy for your preceptor and nurse. A procedure isn't just the activities at the bedside, there are little things you can do to help. Offer to set up the room. Be interested in the supply gathering and offer to carry things. When the procedure is finished, make it clear that you will be happy to clean up. Be involved in the charting and minutia. Always, always, say thank you to the nurse and the patients involved. Then, make sure to mention any and and all good mentoring shown by nurses to your preceptor. This will make it easy for those involved to say yes the next time.
If these steps of self-advocacy are applied with sincerity and without attitude. You will begin to build a reputation as "one of the good ones." Keep it up and you might be pleasantly surprised when the nurses begin to trust you; to seek you out for procedures. After all, a trustworthy student nurse means less work for them and better care for their patients.
Good luck out there self advocates. Practice well. If you think clinical is tough, wait till we have to get a job.