Nursing Wit & Wisdom

Inspire and Be Inspired, Nightingales!

Clinical Challenge – Spy Game, Part I

Jul 15, 2013 | Clinical Challenge | 0 comments

Are you a fan of the cable TV show, ‘Psych’?  [I love that show!]  Did you ever see the movie, ‘Spy Game’ with Robert Redford and Brad Pitt?

In each show, there are scenes where the character is trained in reviewing the room and reporting what he saw – without taking a second glance.  Using tools of observation simply from walking into the room and first glance… to review, interpret and report… what he saw.

I find it amazing to listen to all the detail they report!  They describe things I didn’t see even when looking at the TV scene again!

Observation is indeed an advanced skill!

So, how exactly does that help us in Nursing?


Many times, experienced nurses will tell you they picked up clues to changes in patient status’ just by a quick glance when walking by the room, when standing at the door answering a question or doing something else in the room.

How many things can you observe and pay attention to when you are in a patient’s room?

You may be focused on one thing, but your five normal senses along with your Nightingale Spidey sense picks up things around you and interprets them as to “Emergency”, “Urgent”, “Remind Me To Do This”, “Normal” and “Ok, Not Important At This Time”.

How good do you think your observation skills are?

Let’s find out, shall we?

For this Clinical Challenge, you will need:

A colleague, friend, Preceptor, Orientee or other nursing person

A Timer [the one on the wall clock or on your phone will work great]

A pad of paper

Print out this Action Sheet so you can bring the Clinical Challenge with you:

July 2013:  Clinical Challenge: Spy Game, Part I

This Clinical Challenge has 2 opportunities.  We’ll do the first one this month, and save the 2nd one for later!  

1.  THE ROOM REVIEW.  This exercise can be done in any kind of patient’s room or treatment area.  You may think that a patient who is on a ventilator and sedated with multiple pumps, may be the greater challenge.  However, I think that an awake, talking, moving patient with a few family members in the room is actually the greater challenge.

THE STEPS:  This exercise is to be done the first time you walk into your patient’s room or treatment area.  Bring your colleague with you if you can.  Starting when you step into the room… without being obvious… review the room and notice as many things in the room as you can… clinical and non-clinical.  Don’t spend more than 5 minutes gathering observations.  If you are with another colleague set your timer and give each other a secret signal when to stop the observation.  Complete whatever work you need to do in the room and then return to your desk or nurses station.

THE TEST:  When you both return to the Nurses Station, or your desk, take out your paper.  Set your timer again for 5 minutes.  Then you both write as many observations: clinical and non-clinical as you can within the 5 minutes.

THE OBJECTIVE:  What stood out to you as potential problems… at any problem level?  Did any of the observations set off your Nightingale Spidey sense? Why?  Compare your answers with your colleague.  Did you come up with the same observations?  The same number of observations?  The same Nightingale Spidey alert?

So, how did you do?  Which one of you did better?  What would you consider ‘better’?

[Oh, and the one who ‘wins’ buys coffee… continue on please…]

Now, take a moment and discuss with your nursing colleague the 5 Clinical Challenge questions.

  • How did you use it?
  • What did you think?
  • What was the outcome?
  • Will it change your clinical or professional practice?
  • How will it change your clinical or professional practice?

Today IS a great day to learn something new! 



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