1. Claucherty, Christina BSN, RN, CNML

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Intuition: An immediate apprehension or cognition without evident rational thought and inference

Although there have been many memorable moments in my 30 years of nursing, I can identify an experience early on that not only greatly impacted my career, but also affected how I continue to practice, always paying close attention to my intuition and encouraging my colleagues to do so as well.

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In the early 1990s, with only a few years of nursing experience under my belt, I was working evenings on a busy inpatient oncology unit. Nursing report at that time was spent listening to the previously tape-recorded report, drinking coffee and conversing with coworkers as you prepared for your shift. On this particular day, the nurse reporting off to me was discussing a recently admitted patient with abdominal pain who, due to high census, was placed on our oncology unit as she waited for a visit from the consulting physician. Even though much time has passed since then, I vividly recall walking down the hall hearing a woman crying, realizing this was the patient assigned to me.


As I walked into the room and took in the scene before me, I saw a woman writhing on the bed in obvious distress, with a young man worriedly pacing at the bedside who I soon learned was her husband. Her parents were also close by, walking in the hospital corridors, obviously distressed by witnessing their daughter in such severe discomfort. I remember completing my assessment, looking into the patient's eyes, and knowing with all I had in me that she wasn't exaggerating this pain. She wasn't seeking attention by being excessively demonstrative. Above all, I knew my intuition was telling me that something was seriously wrong.


Operating on what I can only assume was pure adrenaline, I strode to the nurses' station to call the consulting physician who had been notified earlier in the day and was planning to come see the patient once his office hours were over. I should mention that this physician had a reputation for being prickly, overly demanding, and intimidating to nursing staff. I knew this, yet I insisted that his nurse put him on the phone. As I waited, I was peripherally aware of my supervisor's presence as she looked up from what she was doing, quietly listening but never interfering as the scene unfolded. The physician briskly asked me for my report and, to his credit, gave me his full attention as I relayed my assessment. I finished my report by boldly yet respectfully suggesting that if he couldn't come to the hospital immediately, we would need to consult another physician. After my strong declaration, he proceeded to order stat abdominal X-rays and stated that he would leave for the hospital immediately.


Everything happened quickly after that. The patient and her family were whisked away to radiology and never returned to our unit. I discovered later that evening the patient had undergone emergency surgery for a severe bowel obstruction. For a brief moment, I remember feeling relieved and confident in the care I provided then proceeded to carry on per usual for the remainder of my shift.


The next day, I was once again sitting in the report room with coworkers when a nurse came into the room and told me someone was there to see me. As I walked out of the report room to the nurses' station, there stood that same husband with a large, bright, beautiful bouquet of flowers. With tears in his eyes he expressed with utmost sincerity, "I can never thank you enough for listening to us, acting so quickly, and advocating so strongly for my wife." As he handed me the flowers, it was then I truly realized the impact I had on this patient and her family while "just doing my job" as so many nurses do every single day.


Gut feeling: An instinctive feeling, as opposed to an opinion based on facts

Many years later, I'm an older and much more experienced nurse. I've added education, stories, and relationships to my portfolio. There have been moments of great successes, failures, frustrations, and triumphs along the way, yet this day on the oncology unit caring for a patient for a very short period of time is imprinted in my memory as truly defining how I not only respect my inner voice, but also how I assist others to do so as well.


As a nurse manager, when a nurse comes to me and states, "I can't put my finger on it, but something with this patient just isn't right" or "I have a bad feeling" or even "I just don't know why I feel this way," I'm on high alert, encouraging the nurse to express his or her thoughts and always listen to and trust his or her inner voice. Together we address the situation, never backing down until interventions are taken for the patient and the nurse feels that he or she has answers, support, and guidance throughout.


In nursing, especially in this high-tech world of patient care where we're surrounded by computer programs and the best monitoring equipment money can buy, it's imperative that we teach and encourage our colleagues to stand by their convictions, use that intuition, listen to those voices, and never ignore those "gut feelings."


I marvel to this day when I think of that shy, naive young nurse I was and the strength and conviction in my voice as I advocated for my patient. This will forever be one of my best days and one of the best moments in my nursing career. As I coach and teach others, I use this experience-whether consciously or subconsciously-to assist nurses in believing in themselves, their underlying thoughts and feelings, and confidently asking those tough questions as they seek out what machines may not.