I'll never forget the time when, as a new critical care nurse, I was publicly chastised after report by a more experienced nurse because she'd discovered that one of my agitated ICU patients had managed to remove his elastic compression stockings. She found them down around his ankles and assumed I'd carelessly left him in a state of disarray, which she reminded me was not the culture of our unit. If she'd asked me how it had happened in a nonjudgmental way, we could've had a far better and much more informed conversation.
Given the opportunity, I would have related that due to a sick call-out and short staffing, I'd been assigned a highly critical patient who required a 1:1 nurse-to-patient ratio, in addition to the stable but agitated patient. I did my best to manage this challenging pair for a 12-hour night shift-and did so without incident until the last hour, when the critical patient deteriorated and required a full resuscitation with CPR. The good news is that this patient survived; the bad news is that I couldn't keep the other man's elastic stockings on his legs while I was trying to save my critical patient's life. I also didn't eat or take a bathroom break for 12 hours.
Rather than leaving work feeling tired but elated about saving my critical patient, I felt completely defeated by my coworker's rebuke. Years and multiple patients later, I still recall this terrible interaction.
Knowledge is tied to the quality of the questions we ask. Inquiry is an art. That means avoiding the temptation to prejudge a situation and craft a story that's off-base before getting the facts. Don't assume-ask the person to share exactly what happened and provide perspective on it. Actively listen. Be mindful of body language. The resulting conversation should be collegial and professional, not an interrogation with rapid-fire, close-ended questions. Also consider the longer-term relationship that you want to have with the individual at the end of the interaction.
No one wants to be unfairly judged or denied a chance to tell his or her side of the story. Cultivating the art of inquiry engenders higher-quality problem solving, mentoring, and professional development opportunities. Most important, it may eliminate a very real cause of preventable nursing stress and moral distress. Let's show our care for each other by taking care how we ask questions!
Until next time,
Linda Laskowski-Jones, MS, APRN, ACNS-BC, CEN, FAWM, FAAN
Editor-in-Chief, Nursing2017 Vice President: Emergency & Trauma Services Christiana Care Health System, Wilmington, Del.