As a nurse, do you ever have the experience of knowing something’s wrong with a patient before there are undeniably clear clinical signs?

Does the hair on the back of your neck occasionally stand on end? Does a chill run down the side of your body when your gut tells you there’s something’s wrong?

As a nurse, you’ve learned many skills throughout the course of your education. Some are considered ‘hard’ skills (e.g. venipuncture, injections, catheterisation) and others are often characterised as ‘soft’ (e.g. communication, empathy, motivational interviewing). One so-called ‘soft’ skill that can’t really be taught is learning to tune into, listen to and trust your nurse’s intuition.

While some might dismiss this notion, many nurses (and even some doctors) will readily admit that intuition sometimes plays more of a role in our clinical experience than we might otherwise believe in our rational minds.

Your Nurse’s ‘Spidey Sense’

The popular comic book superhero Spider-Man has an internal radar that he often refers to as his ‘Spidey Sense’. While his strength and agility are certainly central to his crime-fighting prowess, that keen intuitive sense rings alarm bells in his head that alert him to dangerous or urgent situations requiring his immediate attention.

In your role as a nurse, there are likely more moments than you consciously realise where your own Spidey Sense kicks in. Do you sometimes ignore or dismiss it?

Nurses and other healthcare professionals are taught a rational, left-brained way of thinking and evaluating situations, and this education serves nurses and their colleagues well. In that case, it’s quite fair to ask where nurses (and patients) would be without the learned skill of critical thinking that becomes sharper and even keener with time.

On the other hand, nurses who take the opportunity to develop the right side of their brain also bring a great deal to the table. The right hemisphere is generally associated with creativity, intuitive knowledge, and the less rational, more intuitive side of the human psyche. Most of us would agree that nurses certainly do more than simply task-based interventions based on orders from doctors and advanced practice nurses.

Nurses’ Spidey Sense can be a very powerful asset in the nursing toolbox if we choose to both develop this skill and respond to its call.

The Case for Intuition

A number of studies have been conducted on nurses’ intuition; however, some scholars have concluded that more quantitative inquiry is needed in order for the research to be considered robust (Hassani, Abdi and Jalali 2012). A literature review of 144 articles on nursing intuition by Hassani, Abdi and Jalali (2012); recommends more rigorous research, however, the sheer number of published works on the subject underscores the relative value of nurse intuition.

In ‘The Fifth Vital Sign? Nurse Worry Predicts Inpatient Deterioration Within 24 Hours’, a quantitative study published in August of 2019, the authors used an objective scoring system to measure actual clinical outcomes based on nurses’ subjective feelings of worry.

Using a five-point score known as the Worry Factor (WF), Romero-Brufau et al. (2019) recorded nurses’ perception of patient deterioration at the start of their shift.

In total, the study recorded 31 159 shifts for 3185 unique patients during 3551 hospitalisations. The nurses indicated 492 potential deterioration events, 77% of which were confirmed as true deterioration events by reviewers. The study also noted that nurses with more than a year of experience had a higher accuracy rate (Romero-Brufau et al. 2019).

While further research was recommended, the authors concluded that nurses’ pattern recognition and sense of worry can, in fact, assist in the detection of patient deterioration (Romero-Brufau et al. 2019).

Learning to Trust and Listen

Finding a way to trust your intuition takes time, practice and patience. You won’t always be right, but learning how to listen deeply to your inner voice may be key to deciphering the meaning of your Spidey Sense. Some strategies for strengthening your nursing intuition include:

Practising meditation and mindfulness. Silence, introspection and the ability to be still and listen to what’s happening inside of you can strengthen your trust in the ‘still small voice’ within you.
Journaling can be a method for tapping into your unconscious by writing without censorship or judgment.
Some experts suggest that making increased use of your right brain by engaging in creative activities (drawing, painting etc.) allows you to trust the more flexible mind states that are based less on data and observation and rely more on outside-the-box thinking.
Learning to listen to somatic reactions to situations (sudden bodily sensations that tell you something is wrong).
Trusting your sudden insights, even if they seem to come from ‘nowhere’.
Working with a counsellor, healer or teacher who understands the power of the unconscious and can help you develop your intuitive ‘superpower’.

Be Your Own Superhero

Both qualitative and quantitative research suggests that nurses’ intuition is not just a fantasy. Nurses are highly trained clinicians who often have a strong intuitive sense, and that intuition can be leveraged to the advantage of nurses, teamwork and patient outcomes.

If you have a strong nurse Spidey Sense or would like to develop it, there are plenty of books and other resources for working with and trusting your intuitive powers.

Nurses are superheroes simply by dint of their amazing contributions to healthcare delivery and patient care around the world. Now you can be an extra powerful nurse superhero by trusting and working with the intuition that resides deep within you.

References

Hassani, P, Abdi, A & Jalali, R 2012, ‘State of Science, “Intuition in Nursing Practice”: A Systematic Review Study’, J Clin Diagn Res., vol. 10 no. 2, viewed 4 August 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800548/
Romero-Brufau, S, Gaines, K, Nicolas, C T, Johnson, M G, Hickman, J & Huddleston, J M 2019, ‘The Fifth Vital Sign? Nurse Worry Predicts Inpatient Deterioration Within 24 Hours’, JAMIA Open, vol. 2 no. 4, viewed 4 August 2020, https://academic.oup.com/jamiaopen/article/2/4/465/5555857

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