1. Schaffner, Marilyn MSN, RN, CGRN

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A nurse assessing a patient with a diagnosis of scleroderma who is scheduled for a GI procedure observes the patient is short of breath and complains of dizziness. Immediate impressions prompt the nurse to further explore the patient's pulmonary history. The nurse senses something is not as it should be and informs the doctor. The patient's procedure is canceled and she is admitted to the hospital for workup to rule out pulmonary hypertension.


A child observes the cocoon of a butterfly and forms immediate impressions that it is simply a blob of dead matter. However, we know this seeming blob of dead matter turns into one of nature's most beautiful insects with a head, thorax, abdomen, two antennae, six legs, a coiled proboscis for drinking flower nectar, and four wings that are usually covered by colored scales (


I recently traveled to the state of Washington on business. While there, I was persuaded to travel to a neighboring town to view a field of tulips. Immediate impressions had me questioning why I would want to take time to visit a mere field where someone had grown tulips. After visiting the tulip fields in Mt. Vernon, Washington, the home of the Skagit County Tulip festival, where over 700 acres are devoted to tulip growing, my impressions shifted immediately. I have never experienced such beauty in my life. The fragrance, the multiple colors of the tulips, and the peace I experienced while walking through the fields was truly a spiritual experience.


Recently, I was in an airport waiting for my connecting flight. The woman sitting next to me was a middle-aged woman who appeared fit with a bright smile and a head of new hair-like fuzz on a peach. My immediate impression was this woman had obviously undergone some treatment that resulted in alopecia, but she looked well, as if the treatment was a success. We began to talk and she told me she was on her way "home" to see her family for the last time as her doctor said her cancer had metastasized and she had less than 3 months to live. Her bright smile turned to tears. As we parted, I could not suppress the urge and gave her a hug that was freely accepted.


This past weekend, I was reacquainted with an old friend. As we had dinner together, I noticed the conversation centered entirely on him. On my way home, I reflected on our evening together. In the last year, my friend had been through a tough divorce. It became clear to me this self-focus was based on his need to build himself up. What I had not seen until too late, behind this shield of a successful professional, was my friend who is still struggling to rebuild his self-esteem and life. Instead of being irritated about his self-centered approach, there were so many things I could have said to help in his healing.


These are all examples of how we form immediate impressions. The literature guiding us on how to make a positive immediate impression is vast. Much of the literature focuses on how to ace an interview including such suggestions as: prepare your outfit in advance; be alert, well-groomed and clean; smile and maintain eye contact; research the facility; arrive on time; maintain good body posture; know what you are talking about; and use your listening skills (Career Center; Gilbert, 2004). On the other hand, very little has been written guiding us on how to avoid skipping to an immediate impression.


Immediate impressions can be good, such as the nurse who quickly assessed the patient's pulmonary problem. However, immediate impressions are often deceptive. As Anais Nin said, it is often the case that "We don't see things as they are, we see things as we are" (Gallagher, 2001, p. 108). For example, no matter what methods are employed, a candidate interviewing for a position may be judged unfairly.


What methods can we employ to prevent us from rushing to judgment? Laura Gassner Otting (2004) gives some recommendations she applies to interviewing and making hiring decisions. I believe these recommendations can be applied more widely in our lives.


1. Take a longer view. We need to suspend immediate impressions until we learn more. I may never have had the experience of seeing the beauty of the tulip fields had I not been willing to learn more.


2. Know how you make decisions. If you react instinctively, you may be more prone to skipping to immediate impressions. The more emotional you are in making decisions the greater difficulty you may have in controlling your impulse to react to immediate impression triggers. One way to guard against this is to be aware of it.


3. Take time to listen. Had I really been listening to my friend, I would not have lost the opportunity to help him heal. However, the opportunity is not completely lost, as I will follow up with a note.


4. Treat everyone equally. When judging one person against the other, ensure you have used the same practice for each. This is particularly important when you are interviewing candidates for a position.



Don't be fooled into trusting your immediate impressions. By learning to control our impulse to form immediate impressions, we may open ourselves to a better understanding of one another and a better appreciation for the beauty around us.




Career Center. Ace the interview. Retrieved July 8, 2004 from


Gallagher, B. J. (2001). Witty words from wise women. Kansas City MO: Andrews McMeel. [Context Link]


Newman, J. (2004). First impressions: How to be a hit, not a miss. Good Housekeeping, 238 (6), 136, 138, 140.


Otting Gassner, L. (2004, January). Don't rush to judgment: Relying on first impressions when assessing a job applicant can lead to a poor hiring decision. Human Resource Magazine. Retrieved July 12, 2004 from[Context Link]