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'How do you get better at thinking on your feet?'


Can you advise this student nurse?

“I am a student nurse in my second year and have done well on all of my written exams so far. Maths and anatomy are fine for me, but I get flustered and anxious when handling patients and dealing with problems that arise in my placement. 

“If those problems were written on a test, I would be fine, but I am always too nervous and unsure to make the decisions in real life. I’m afraid that I’m not cut out to be a nurse and that I won’t be able to do anything without my mentor assuring me that I’m doing something correctly.

“If it’s just on paper, it isn’t too scary, but making decisions that affect patients – actual people – is terrifying. I don’t know if I can do this.

“I’d appreciate any advice for getting better at thinking on my feet while on the job or for having more confidence when working with real patients.”

Please use the comments section below to share your advice


Readers' comments (2)

  • Hi.

    This is exactly why we invest three years in training you and a preceptorship period too! That’s not to say you won’t have times of uncertainty after qualifying, we all still do even 15 years later. Even consultants need to call each other for help (although they call it a referral!).

    Your approach to your problem is commendable. You have recognised and reflected on it. On reaching your limit you have asked for help. These are arguably more important than the technical skills you are concerned with, as they ensure your practice will constantly improve and keep patients safe in the future.

    My advice for improving your ability to apply your knowledge to patients is to change your language. Instead of asking your mentor if what you are about to do is okay, state your assessment of the situation and what you INTEND to do about it. If your mentor does not correct you, you know you are right. Example: “Mr Bloggs is bedbound at the moment having suffered a stroke and I’m concerned about his pressure areas. His waterlow is 25. I intend to order him an alternating mattress.” Mentor: “Nice one thanks”.

    Another technique is rehearsal/visualisation. When you are learning something at home, imagine a situation where you could need to implement it and work through the situation in your head. Do this a few times and when it happens for real you will be better prepared.

    Finally remember when you are not sure it is ALWAYS acceptable to ask for help and reassurance. Start with your assessment and recommendation and accept modifications from your colleague, as opposed to just asking what to do. Make sure that you ‘do the doing’. Another year of implementing care and you honestly will be fine.

    Good luck!

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  • Trust in yourself. I always start every shift by seeing all of my patients, then you have a guideline as to how they were at the beginning of your shift and if there are any problems at that point you can get straight on the case of resolving them .
    Ask for help if you need it.. We all need help at times and a good team know they have to draw on each other..
    Try to think forward. If you have time on a shift to sort something out for the next shift or the next day, do it . This will help you gain confidence and give others extra time if a patient needs extra support.
    You do not have to do everything. You are handing over anything you have not managed to do to the next shift. Do not be bullied into feeling that this is not ok .

    Take your breaks. Do not get into the habit of not eating and drinking at work. . Even 5 minutes with a cup of tea in the staff room will allow you some head time .

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