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“You start with the guidelines and theory that you know, and you build on that through your experience, but then there’s the human factor,” said Deborah Thames, RN, BSN, CCRN-CSC, a nurse scholar in the cardiovascular intensive care unit at Emory University Hospital in Atlanta.Protocols may work 99 percent of the time, but when they don’t work for the hundredth patient, nurses must adapt to accommodate subtle or not-so-subtle changes, she said.That comes with experience.“I had a 6-month-old patient who had just had heart surgery.
A parent is with the child every day and is the best source for baseline changes.
Knowing when to listen comes with time and experience.
Critical thinking and writing are skills that are not easy to acquire.
You use your education, but then you begin to see things over the years. You have to care and be totally attuned to your patients and their families, so that you can be their advocate.“We’re called on a stroke alert when a patient who is in the hospital for other issues starts to present symptoms of a stroke.