The event in
question occurred during the handover phase of a nursing experience. Handovers
are a critical element of nursing practice. If information is missed or
transferred incorrectly, the lives of patients can be placed at risk. However,
time and space pressures often mean that handovers have to be completed quickly
or in busy environments. For this reason, routine and protocol are highly
important. In this instance a situation arose where the handover was completed
incorrectly. The ward had long-term clients, the majority of whom had
conditions that were unchanged. Nobody had had any procedures or surgeries, and
there were no changes to medication. The nurse who was finishing her shift was
in a rush to leave and avoid the heavy traffic on the roads. Therefore, in
order to save time she said “you know everybody here, nothing’s changed since
yesterday.” This was her handover, and she left immediately afterwards. In
response to this, the student nurse carried out her shift as usual, and later
spoke with a mentor. The mentor and the student discussed the various options
that the student nurse could have taken, and reflected on the experience.

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The initial
feelings were surprise, shock, embarrassment, and finally insecurity. Student
nurses are taught to follow procedures, and are also taught the high value of
those procedures (Chang and Daly, 2012). Whilst instinct and gut feelings are
useful, this is a profession that requires structure (Daly, Speedy, and
Jackson, 2009). Therefore, when somebody with higher levels of experience
breaks procedure it can be a surprising and uncomfortable experience. The
feelings of insecurity came from being left with patients who had not had a
proper handover. Although “nothing had changed” from the previous day, this was
still a large amount of information to consider. Several of the patients had
complex cases that involved comorbidities, and there were lots of risks of
sudden changes in people’s conditions. In addition to this, two of the clients
had allergies that increased the complexities of their care. To be left in a
position of responsibility without full knowledge of the intricacies of the
various patients was a particularly vulnerable scenario. After speaking to the
mentor, the feeling was one of relief. It was apparent that carrying on with
the shift as if the handover had been successful was not the correct course of
action to have taken. Therefore, there was also the feeling of having learned
valuable information.


The experience
revealed that a nurse must always be prepared for surprises and departures from
the norm. This was both a positive and a negative experience. The negativity
stemmed from losing confidence in a colleague, and from seeing that procedures
that are taught as being immovable are not always followed. This is a normal
reaction, according to Rn (2001). On the other hand, the positivity stemmed
from being able to learn from a new experience and to meet new challenges. The
reality is that not all nurses will follow procedure correctly (Gerrish, 2000;
Duchscher, 2009; and Funnell and Koutoukidis, 2008). This is something for
which there are formal responses that can be made by superiors and other
colleagues, and which a new nurse needs to become used to. In this instance,
the mentor explained that there were several courses of action that could have
been taken. The student nurse could have continued with the shift without
making any comment. Alternatively, the student nurse could have stopped the
colleague before she departed and asked for a more thorough handover. After the
colleague had left, the best course of action would have been to have alerted a
superior to the situation. This would have ensured that full support was given.
Learning this was a positive experience.


There is
much to be made of this experience beyond the basic acquisition of procedural
information. Involved in this situation were physical and emotional responses,
and all are an important part of the learning process (Zielinski, 2012). As a
student nurse, repeating procedures accurately is very important. During the
training phase there is a large amount of information to gather, process, and
learn (Zielinski, 2012). This information can have serious implications for a
client’s health, so the stakes are very high in comparison to some other
professions. For this reason, a considerable portion of the nursing training
process is practical (Duchscher, 2009). By doing tasks practically, a nurse
learns in several different ways, particularly engaging visual and kinetic
learning practices (Gerrish, 2000; Chang and Daly, 2012). For this reason, it
is particularly important that the training phase of nursing is a period where
accurate procedure is followed. On the other hand, not all practical experiences
in the nursing profession are carried out perfectly. Some people are
unprofessional about their work, and some unexpected experiences arise even
when everyone works to the best of their ability. In the nursing environment
this can be very unsettling (Gerrish, 2000), but nevertheless requires an
analytical and measured response (Chang and Daly, 2012). Being able to think on
ones feet is a necessary part of the nursing experience. This handover provided
a very good example of a situation where there were multiple courses of action
to be considered and chosen. Therefore, it provided a good example of the need
for critically reflective practice. One of the most valuable aspects, however,
was learning about the personal emotional response to the situation (Zielinski,
2012). The feeling of insecurity was particularly problematic, as it threatened
to distract from other professional duties. It was interesting to note that it
was hard to concentrate on other nursing functions, such as taking blood pressure
readings, due to worrying about whether anything important had been missed.
Knowing that insecurity is the expected personal response in this situation is
an important lesson to learn, as there are various exercises that can be
carried out to overcome that potential problem. Finally, the importance of
having the support of a mentor was revealed during this experience. Until this
time, the mentor had seemed like someone who was there to help with practical
problems such as worrying about carrying out some of the more complicated
procedures. This was the first situation that had arisen where the
professionalism of a colleague was called into question, and where the
potential courses of action were slightly embarrassing to undertake.
Recognising that a mentor is able to give advice about how to respond
emotionally to moral situations was a valuable lesson.


It is clear
that the course of action that was selected was not the best one. Seeking help
immediately would have been more appropriate. It was fortunate that on this
occasion there were no problems; however, the situation could have been very
different and there could have been serious consequences. Therefore, the
student nurse should have either prevented the colleague from leaving, or
should have sought advice. However, the choice to have a meeting with the
mentor was the correct one. This highlighted the importance of meeting with the
mentor more frequently, and being more communicative with people in general. If
one feels comfortable talking to colleagues and asking advice, one is more
likely to learn from other people’s experiences.

Action Plan

An action plan is designed to answer the question: if the situation
rose again, what would you do? The answer to this is quite clear. Firstly, it
is important to have the confidence to say to a colleague that you do not have
enough information. In this instance, saying “please stay and repeat the
handover” would have saved many problems and would have reduced the risks
considerably. Therefore, if this situation happened again the first course of
action would be for the student nurse to outline the problem to the colleague
clearly in the hope of repeating the procedure correctly. If this failed, the
next course of action would be to contact a superior and explain the situation.
If a colleague is satisfied with undertaking a handover in this manner on one
occasion, it is possible that it is a frequent occurrence. This potentially
puts lives at risk. Therefore, it is important that a manager is made aware. By
alerting a superior, a more junior nurse will also be able to have the support
that he or she needs to work safely. 


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