One thing I always tell my students is that they are at their very best when they are studying. As students, they are learning and practicing the highest standards. They are exploring and investigating the evidence and they are open to change. They are building knowledge, and discovering new ways to become the best nurse they can be. While they might not yet have the benefit of years of experience, they most certainly have a wide outlook on the latest knowledge.
It isn't easy being a student though. Lack of experience makes it difficult to contextualise learning, and the very nature of medicine as an ever-evolving field means that there are rarely definitive guidelines to follow. Students must test and explore ways to implement evidence-based practice, while also ensuring that their nursing is individualised to their patients, clients, and practices. It is not uncommon to have students saying that their workplace is doing things differently to the way they have been taught. When they question their workplaces about it, the answer they receive often reveals a reluctance to change, or perceived challenges with finding the time to learn a new way. This is often the most frustrating thing for students who want to practice what they are learning, but it is the first lesson in teamwork, and challenges in implementing evidence-based practice.
Learning and adapting to realities of practice is an important step for students as they must learn to work as a team. Once a student graduates, they will continue applying what they know and will begin developing their own preferences and habits. Routines take over and they will evolve habits based on daily experiences. The benefits of experience can give confidence, but that is not always a good thing. I like to tell my students that once they graduate, it is all downhill from there. Once we are working long days, it is much harder to find the time to explore new evidence. Confidence in our jobs can make us default to what has worked before, or make us cut corners. It can make us believe someone else's suggestions, and go with what is easiest, rather than what is based in evidence. It is a challenge we all face when we stop studying every day.
So, how do we avoid going downhill too fast? We do that by maintaining personal standards, and a culture of continuous improvement.
Maintaining currency involves exploration, investigation, and a willingness to be open to change. It also involves establishing an environment where new information is manageable, and easy to access. Sharing of information is important as it helps to develop a culture of continuous improvement among colleagues which, is probably the single biggest factor for success in establishing robust evidence-based standards in clinical practice.
Developing personal standards of practice is important to maintain high standards of patient care. These are the standards that are never compromised even when there are time or peer pressures. No matter how busy or distracted I am, I always stick to my standards, every single time, as I know that compromising could have life or death consequences for my patient.
These two values of personal standards and continuous improvement are the most important contributions I can make to my students and even for seasoned colleagues, coming back to these values helps ensure we are establishing the most effective healthcare teams, and a stronger and more effective community.