GNIE: Anecdotal notes = Get out of jail, free pass

I hope my previous blog entry about failing at clinical does not scare my GNIE-related readers unnecessarily.

If anything, here is a secret that I want to share. Those who have played Monopoly before would know of the "Get out of jail, free" cards. Well, when it comes to GNIE clinical, the anecdotal notes is our "Get out of jail, free" pass. 

Given that it is inevitable that we will make mistakes at clinical, what matters then is what we do when we make a mistake.

• If we become aware of our own mistake made while at clinical, we can save the situation by reporting the situation immediately to the CI, the staff nurse and other relevant personnel. Do it with an appropriate attitude (i.e. state the facts, don't push the blame away, accept our part in causing the problem). Then discuss with the CI interventions to correct the impact of the mistake and follow-up on them. Finally, chart the incident accordingly in the nursing notes, and incident report if required.
• If we only become aware of our mistake when prompted by the CI, admit to our mistake immediately with an appropriate attitude and take appropriate actions (see above).
• If we only become aware of our mistake during post-conference discussions, then admit to our mistake immediately with an appropriate attitude (see above).

In all of the above situations, take note of the mistakes made, the corrective actions taken if any, and any ideas on how to avoid a repeat in future. Document all of that into the anecdotal notes under the Responsibility and Accountability section (note: link has been disabled). By doing so, we can turn a "negative" (i.e. mistake made) into a "positive" (i.e. we are responsible and accountable for our mistakes made).

You can see from examples from my anecdotal notes that I have used the above successfully. As far as I know, some other classmates have also used this approach successfully. To quote a classmate of mine, "For any mistake that I've made, big or small mistake, I will document it in my anecdotal notes. Then she is ok." [That is, the CI is ok with the student's competency.]

That said, the anecdotal notes are not a free pass to keep repeating the same mistakes. It will not work if we declare our plans to avoid re-occurence but do not follow up on it. We owe it to ourselves and our patients to pull up our socks and ensure that we improve.