The ability to challenge practice – how can you achieve it?

#hellomynameis Hannah, and I am a third year student nurse.

Those of you who know me will fully understand when I say that my brain-to-mouth signal can sometimes be a little faulty. In other words, I have no filter – so it will probably come as no surprise that questioning practice (both good and bad) comes as second nature to me.

Asking questions about good practice is a great way of picking up new approaches for the care that you deliver – different techniques, a choice of words, or a method to de-escalate an agitated patient. You can adopt these approaches for your own practice, and learn from those with a broader experience!

Disclaimer: Before I get myself into trouble, what I am about to say does not mean ‘go and tell every nurse or doctor that you are right and they are wrong’. From my experiences, bad practice in Children’s Nursing is quite rare (forgetting your stickers does count though!)

However, I am sure at times you have thought ‘Hmm, I’m not so sure about that’. The question is, did you say it out loud or did you just think ‘they know best’? Limited experience is, of course, a good reason to stand back and keep quiet, but you have recent training, a new outlook and fresh ideas…so why not share them? Sharing your ideas, and questioning practice may feel beyond our boundaries as student nurses, but they are in fact completely within it!

Throughout my training, I have regularly asked questions such as “Why codeine?”, “Why use this dressing?” or “Don’t you think you should go somewhere a little more private?”. Expressing my (professional) curiosity is not something I consider difficult. However, I understand that for some people it doesn’t come so easily. SO, I am going to give you a little bit of encouragement.

I have to be honest, challenging a professional’s use of words, actions, or the legibility of their documentation can sometimes come ‘at your own risk’- but it should be a challenge to be accepted! One thing I have learnt is that challenging practice (when appropriate and professional) and sharing your opinion only earns you more respect. Maybe at first you get the ‘who is this student?’ stare,  but challenging and questioning the practice around me has provided me with so many opportunities to learn. Healthcare professionals see that you are willing to be an advocate, they recognise your ability to identify risks, and if questioned, your ability to act upon them. This has only ever earned me more trust as a student nurse, and with that, more responsibility. If your question is out of idle curiosity, do not be afraid to ask it! We are all working within this profession with the same intentions…to provide the best possible care for our patients. So why not ensure that this is what they are receiving?

During simulation, we are advised to approach certain aspects of practice with “I see you are doing this, but I have been taught to do that this way”. As a general rule, this really does work! Healthcare professionals are often very receptive to new and updated techniques. It does not matter how experienced you are, how many hospital corners you have folded or which university year you are in, learning from one another is SO important.

However, if what you are witnessing falls into the ‘Hmm, I’m not so sure’ box, you do have a couple of options;

  • You can speak to your mentor, raise your concerns and hopefully this will provide you with reassurance.
  • Contact your Practice Educator – they are usually available to speak to students throughout the day and will be able to provide you with some advice and support
  • Or, if you do not feel comfortable with either of those options, contact the University (Practice Liaison Tutor) and talk through your concerns with them.

Before you take my advice and start questioning every professional in sight, understand that there is ALWAYS an appropriate time to ask those questions, and with that, an inappropriate time. If you ask a question and do not receive an immediate response, wait a little bit…the chances are they really did hear you the first time (speaking from experience here!) But when the time is right ask that question, question the practice, and believe that your voice is as valid as anybody’s.

Just be ready to stand behind your mentor as a shield if the person you’re questioning looks angry (I’m joking – you’ve got this!)

Author: Hannah Saunders, Year 3 Student

Disclaimer: This blog contains personal opinions of students only and does not necessarily represent the views of the Children’s Nursing team, School of Health Sciences or the University of Surrey.

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