1. Drake, Kirsten DNP, RN, OCN, NEA-BC

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Q My boss tells me that I need to be better about situational awareness. What does this mean as a nurse leader?

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For decades, the military has strongly focused on situational awareness as it relates to combat. Situational awareness also comes into play in situations when one's own personal safety is at risk. (Imagine being faced with a grizzly bear.) Now, this isn't to say that nurse leaders are going to combat or facing a grizzly bear, but situational awareness-the detailed assessment of the environment around you and your response/reaction to it-is a skill we can use in our practice. Let's take a closer look at how you can grow with situational awareness.


There's a vast amount of information about situational awareness, so we'll narrow it down to a few key points. Start by knowing yourself. You may ask: What does this have to do with situational awareness? Evaluating your strengths, challenges (weaknesses), and natural leadership tendencies will help you understand how you tend to respond to situations. Leaders with high emotional intelligence who can recognize their own and other's emotions exhibit stronger situational awareness.


The first, and possibly the most important, key to situational awareness is observation. A leader must observe for normalcy, as well as conditions that don't seem quite right in the environment. Being cognizant of context allows you to know what's currently happening.1 You may need to stop what you're doing and/or thinking to assess what's going around you. Try an exercise in which you're observing a setting where you have no authority or decision-making power.


For instance, go with someone to a restaurant and ask for a table where you can see most of the dining area. As you walk in, observe and assess the number of staff working on the floor, the patrons eating there, and the layout of the restaurant. When you get to your table, sit with your back to the restaurant and have the person you came with ask you questions about the setting. Ask them to make the questions as detailed as possible, such as "What was the older couple eating at the first table we passed?" Appraise how many questions you can correctly answer. Attempt this in various setting until you consistently get correct answers.


The next part of situational awareness is reviewing the circumstance, looking at what happened, and assessing what could happen. This information is the basis for your reaction to and management of the situation. Consider performing an after-action review, which focuses on what actually occurred after outcomes can't be changed instead of intended results.2 This practice is frequently a team activity that can provide you with insightful information about how your team works and help you learn from being transparent about your actions, as well as those of your team members.


Finally, remember that your decision and actions have consequences, and failure to act is an action itself. The outcomes of your decisions can influence how well a unit functions. Negative consequences tend to result from poor communication and being distracted. Leaders who involve staff members in the decision-making process have a better level of accountability with their team. Trend the unit's outcomes based on how the decision was executed. This will provide you with information on successes and failures, in addition to improving your self-awareness in the process.




1. Baldoni J. Situational awareness 101. [Context Link]


2. Mind Tools. After action review (AAR) process: learning from your actions sooner rather than later. [Context Link]