I have encountered the use of the statement "How do you know, if you simply do not know?" a multitude of times during my nursing career. I have said it over and over to new staff that begin to work in the neurosciences. It can be pertaining to an important aspect of a neuro assessment or a certain way of communication that will benefit not only the deliverer of the message but also the development of new individual knowledge. There are so many examples. I have also been in situations when I have asked for grace to bestow that it is okay for me to be the one to ask simply "How do I know if I don't know?".

I have had several recent patient and family reactions in which I wanted to be able to reach into my pocket and pull out a "get out of jail" card regarding it being okay to not know. As I reflect over this, the words "If you are another person that is going to come in and patronize me for something that is already done, I am not interested." come to mind.

I go in blindly when I am asked to see patients and families for clinical consultation and support from the clinical nurse specialist role. Over the years, it has served me well. I have to allow myself the time to be present with them to hear their story. Discussions can then happen regarding moving forward in establishment of trust and confidence.

It is important to recognize that there are skills outside the specialty focus of neuro medical-surgical nursing-for example, external ventricular drain management during magnetic resonance imaging and deep sedation assessment-and when I have come across these topics recently, I reach out to colleagues or the AANN NeuroNetwork. The responses have been timely, insightful, and evidence based. Sometimes, it has opened up the opportunity for those who know the answers to open up a dialogue, and they feel free to address a "simply do not know" question in return.

I have discovered that there is no way one person can know all the answers. Our organization provides us with the tools and connections that we need in this specialty field. The friendships and connections last a lifetime, and the knowledge remains fresh and relative to our specialty. I look forward to not knowing, yet learning, for many years to come.