Nursing Intuition: How to Trust Your Gut

Chapter 3

Intuition and What it Feels Like.

INTUITION CAN FEEL LIKE a lot of different things all at once. Someone could say something, or you could be assessing your patient and suddenly something hits you that something just feels wrong. It could come over you like a cramp or heaviness like a pit in your stomach. It could feel like someone in your head is yelling at you to look again, reassess, because something feels off. You could just know that the outcome for this patient is not going to be a good one without having a lot of supporting evidence for that conclusion. You may get a flash of a scene in your head of something happening to the patient or it could be that you can smell death. I am not sure if everyone can smell death or just a portion of us.

I used to be a personal support worker in the summers between university semesters. It was in a long-term care home in my hometown. It paid better than my Canadian Tire job and was closer to what my career end goal was – which was to become a nurse. It provided hands-on care to people and gave me a much better understanding of how hard personal support workers and healthcare aids work. I would show up to work, walk through the door and a smell like damp moss mixed and an acrid smell I still cannot describe very well would hit me. All I could think when I smelled that smell was, who died? or who was dying? Nine times out of ten I was right and one of our residents had died the night before. I never considered that it was anything more than a simple smell until I talked to people who were in nursing school and who had yet to work somewhere where death could happen at any given moment. When I mentioned the smell, those people would look at me funny and ask what smell I was talking about. It was not until someone else who had been in those situations would come up behind me and say, "you know, the smell." People would continue to be confused and there was nothing more you could do to explain how it smelled other than it was the smell of death.

I think about the conversations I have had with different nurses through the years and if I ever heard one of them mention that they did not think something was going the right way or they felt off about a patient, I would tend to strike up a conversation with them and ask them the why's.

"Why don't you think this is going the right way?"

"What makes you think something bad is going to happen?"

"What do you think is behind that gut feeling?"

"When that feeling hit, where did you feel it?"

"What did you feel when you got the idea that something was going to happen to the patient?"

"Do you feel it in your gut? Is it a knowing? Or do you picture something happening?"

Turns out everyone is a little bit different in how they feel/experience their own intuition. Most say they feel it as a heaviness in their gut. This is how I feel it. I often wonder if this is because there was such a strong quiet emphasis on following your gut in nursing school. I wonder if, because that was the way I anticipated the feeling to come – when it happened that way, I believed it.

Exercise:

Ask. Ask around how people at work feel about their gut instincts.

Listen. Listen for what those people are saying, noticing what language they are using to describe it.

Learn. Ask and listen and then learn from other experiences.

Be mindful that this may be triggering for some people as this usually brings up feelings of knowing something was going to happen in past situations and someone potentially ignoring those feelings, resulting in the patient having a bad outcome. Watch for guilt, shame and feelings of regret and support your fellow nurse through this! Let them know that they still learned a valuable lesson (however hard) through this experience. Ask them about what they learned and how their practice has changed since this encounter!

You may also start to notice that some nurses (and other medical professionals) are very anxious and overly concerned about specific diagnoses or symptoms, when to you this seems odd or miniscule in detail. I can bet that they have had a previous experience where they missed something, or something happened that has changed their practice and is the sole reason they seem so nervous about this one thing. Mine include charting (because I have been chewed up and spat out by a previous manager for lack of charting when a physical page of my charting went missing and the patient complained about my care afterwards), pancreatitis (see last chapter), bullying (that is damn near another entire book) and ectopic pregnancies (almost had someone bleed out on me and die). These are the things I harp on (and on and on) about because my past experiences have colored and changed the way I practice. I try to share these stories with other nurses so they can learn from my mistakes. Some are eager to listen, some try to listen, and others roll their eyes and walk away. All these reactions are fine because their experience will be different from mine. I choose to try and help people avoid my past pitfalls, whether they listen or not is up to them. I just hope they never end up where I have been when things go south.