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Expert spotlight: Guide new grads through bad patient outcomes

Nurse Leader Weekly, July 28, 2008

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This week, learn how to help your new graduate nurses deal with bad patient outcomes with expert advice from Shelley Cohen, RN, BSN, CEN.

Q: How can I coach my new graduates through bad patient outcomes?

A: Among the many challenges new graduates will face-and obstacles to the development of their critical thinking-are the patients in their care who have bad outcomes and the providers who are unwilling to collaborate with them. The first year after graduation is a time for education, and care must be taken so that new graduates are not frightened to make a decision or feel constantly indecisive in the care they provide.

• Allow them to grieve through their error or omission. Whether patients are in their care for one hour or one week, in their minds, they are still "my patient."
• Provide them with more than one opportunity to sit with supportive mentors or preceptors to review the scenario that led to the patient outcome.
• Make sure you are the person who debriefs the nurse. Don't expose them to the nurse who says, "I told you this would happen if you let the new grads in here."
• If they are not willing to take responsibility or accountability for something they did or did not do for the patient, recognize this as a patient safety warning. These nurses will require further assessment of their critical-thinking capabilities and ongoing involvement with the nurse manager.

Editor's note: Do you have a question for our experts? Email your queries to editor kmucci@hcpro.com and see your name in print next week! In the meantime, head over to our Web site and view a growing collection of advice from our experts.

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