The practice of “closing” at the end of a shift is a great way to give immediate feedback to your nurses. Closing also allows for timely, factual information to be exchanged by the people who were involved, and facilitates corrections, clarifications, and learning. The two or three people who worked together during a shift can discuss what went well on the shift and what they would do differently if they had the chance. This gives them an opportunity to recognize, acknowledge, and discuss the day’s events and everyone’s contribution.

The following are some examples of what to say during closing:

• I wish I had realized that your saying “no” to my offer to help actually meant, “I am drowning and have no idea what to even ask for.”
• It would have been more helpful if I had known your patient’s condition had worsened and rendered you unable to take the next admission as soon as it occurred, rather than as the patient was rolling in the door. Had I known earlier, I could have gotten you help, reassigned the admission, and given that nurse a longer “heads-up” period.

• I felt we worked well together, kept each other informed, and tackled that complex case as a team. I hope that I can work with you again tomorrow.

  —Judith “Ski” Lower, RN, MSN, CCRN, CNRN, former nurse manager of the neuroscience critical care unit at Johns Hopkins Hospital in Baltimore

  (June 2009)