President's Column: Cultivating Confidence — What’s the Evidence?

Oct 06, 2020

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Since the start of the pandemic I've struggled a bit with confidence in my ability to use evidence to guide my practice.

Normally, when I do a literature review, I restrict my search to the past five years. Now, from week to week, I'm not so sure I can give the same evidence-based answer. The pandemic has made me redefine what is "current," as an article related to COVID-19 from just three months ago is likely outdated.

A thoughtful editorial in American Journal of Critical Care by Dr. Aluko Hope and Dr. Cindy Munro captured the challenge of discerning what we know and our responsibility to critically appraise evidence amid the fog of the pandemic. How do we move forward during this time of uncertainty?

I think it's about cultivating confidence through our enduring commitment to evidence-based practice.

Confidence reflects a general view of how successful you'll be in accomplishing a goal. The good news is that we have evidence about actions to build and improve confidence, and these actions are a part of everything we do. Here are strategies to cultivate your confidence:

  • Practice (the way to get better at something — do it!)
  • Set and achieve smaller goals in support of a larger purpose
  • Overcome imposter syndrome by banning phrases such as "I'm just a ______"
  • Be willing to say, "I don't know"
  • Step outside your comfort zone and take risks — seek new opportunities
  • Don't go it alone
  • Seek feedback
  • Reflect on previous successes

Acknowledging uncertainty, recommitting to strategies to cultivate confidence, and the words of the poet Maya Angelou give me direction and confidence to move forward:

"Do the best you can until you know better. Then when you know better, do better."

There is another everyday strategy that cultivates confidence: re-engagement in evidence-based practice.

Since the start of the pandemic, many activities related to advancing a culture of inquiry have been set aside. Now is the time to reenergize our engagement in evidence-based practice as it builds confidence and reaffirms our commitment to using the best evidence as we provide care for patients and families.

Another study explored the effects of having evidence-based resources available. The major benefit is an increase in confidence in accessing evidence and an improvement in nurses' ability to understand the evidence. These effects support increased morale and teamwork as groups continue to come together to explore using evidence to drive practice or step forward in evidence-based advocacy. These outcomes — confidence, morale, teamwork and advocacy, as well as improved care — are hallmarks of a healthy work environment.

This study demonstrates the powerful effect of having access to evidence. Now pause and think about all the evidence AACN has provided since the start of the pandemic through our online Coronavirus (COVID-19) Update, newsletters, webinars, social media channels and the AACN journals. These resources help provide the evidence we need to take care of these unique patients and ourselves, and to reinforce the need to critically evaluate evidence. This gives me confidence.

This Is Our Moment to be curious and come together to seek evidence-based answers to advance our practice.

Confidence is about a hopeful future — the expectation of a positive outcome that sparks an action. Being All In lives in this purpose-driven action, which honors our unique expertise, knowledge and wisdom.

Let me know what you are hopeful for and how you are using AACN's resources. Write to me at