Think about a recent situation in nursing that you recognized as needing to change in some way and share your reflection with others in the discussion board. Did you take action to change the situation? If not, why not?
If so consider the following:
Who did you connect with in some way to create change?
What were the barriers that you faced in making the change?
What facilitated getting something done?
Looking back, what would you do differently next time around?
The Clinical Nurse Educator: I collaborated with the educator to research and identify a suitable, validated non-verbal pain scale that was easy to implement and aligned with hospital standards. We chose the Behavioral Pain Scale (BPS) as it was simple and well-supported by evidence.
A Few Experienced Nurses: I spoke with several senior nurses on the unit to get their feedback and to help me present the idea. Their input was vital for anticipating potential pushback and ensuring the new tool was practical for daily workflow.
The main barrier I faced was resistance to change from some staff members. They felt that their current methods were sufficient and that a new tool would add unnecessary paperwork and complexity to their already busy routines. There was a perception that it was "just another thing to chart."
What facilitated getting the change done was a data-driven approach. I was able to show the nurse manager and the team a small chart review I conducted, which demonstrated the inconsistency in pain documentation for non-verbal patients. By presenting the problem with objective data, rather than just anecdotal observations, it became a clear patient safety and quality issue, not just a personal preference. The nurse manager then championed the change, and the educator created a concise, in-service training session that was mandatory for all staff. This direct, hands-on training helped overcome the fear of a steep learning curve.
If I were to do this differently, I would have involved a larger group of nurses in the initial research and selection of the non-verbal pain scale. I brought the solution to them after the fact, which made them feel less included in the decision-making process. Next time, I would form a small quality improvement task force with a few key nurses from the beginning. This collaborative approach would have given them a sense of ownership over the project, likely reducing initial resistance and making the implementation smoother. It would have also allowed me to better understand their workflow constraints from the start, enabling us to choose or adapt a tool that was an even better fit for their specific needs.
A recent situation I recognized as needing change involved the inconsistent use of pain assessment tools for non-verbal patients in a post-surgical unit. The unit had a standardized numeric pain scale (NRS) that was effective for most patients, but for those who were sedated, had a cognitive impairment, or were otherwise unable to communicate verbally, nurses were often using their own subjective observations rather than a validated non-verbal tool. This led to a lack of objective documentation and, in some cases, delayed or inadequate pain management.
I did take action to change the situation. I believed that this was a significant issue affecting patient comfort and quality of care.
I connected with several key individuals to create change:
The Nurse Manager: I first approached the nurse manager to express my concern and to get her support. Her buy-in was crucial for any policy change.