Instruct­ing entry-​​level nurs­ing stu­dents def­i­nitely has its chal­lenges. My stu­dents learn early in the semes­ter that my favorite ques­tion is “Why?”

Recently, a stu­dent was car­ing for a patient who was admit­ted with a new solid tumor can­cer diag­no­sis. In review­ing the patient’s lab val­ues, the stu­dent was puz­zled as to why the patient was expe­ri­enc­ing a grade IV neu­trope­nia. When I asked the stu­dent “Why?” she iden­ti­fied that a poten­tial cause could be chemother­apy admin­is­tra­tion but deter­mined that the patient had not received any chemother­apy. Because the patient’s physi­cian was present at the time, the stu­dent approached him—with some trepidation—and inquired why the patient was expe­ri­enc­ing neu­trope­nia. The physi­cian iden­ti­fied this must be lab error and was quite com­pli­men­tary of the student’s analysis.

By encour­ag­ing the stu­dent to approach the physi­cian, her self-​​esteem was ele­vated expo­nen­tially through allow­ing her to rec­og­nize that she could com­mu­ni­cate with physicians.

Susan Mott-​​Coles, RN, MSN, AOCN®, ACNP-​​BC
Fac­ulty
Van­der­bilt Uni­ver­sity School of Nurs­ing
Nashville, TN