Advocate for Yourself...NOT Just For Patients

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    Find out why it is important for nurses to advocate for themselves just as much as they do for their patients.

    Advocate for Yourself...NOT Just For Patients

    We have all heard the numerous adjectives used to describe nurses: selfless, nurturing, strong, kind, compassionate, and the list goes on. We dedicate our lives to helping others. We put our family second to put those in need first. We are real life superheroes. We are the real MVPs. This all great to hear and most would even say that it comes with the territory but at the end of the day who advocates for us while we are advocating for others?

    The major problem is that most nurses don’t like asking for what they want or need. We do such a good job speaking on behalf of our patients but fall short when it comes to ourselves. It’s almost as if we have been programmed to defer our desires for the betterment of mankind. Haven’t had a raise in 3 years?
    Well at least I have a job. Taking care of six patients when the maximum is supposed to be 4? This is just how it goes. Being treated unfairly by coworkers/manager? I don’t want to make it a bigger problem. If you haven’t said these things then you surely know someone who has. Therein lies the problem.

    One word that I wish were used to describe nurses more often is assertive. I wish that we were known to go after what we wanted and needed. If we were being honest with each other we would admit that nursing (especially floor nursing) is brutal. Often working 12 hours without a break (or what truly qualifies as one), barely using the bathroom, and hardly able to let “outsiders” know that we’re alive. Why is this the case? Because we’re nurses and we’re strong and also because it’s always been done this way (I hate those words). I remember being a floor nurse and returning to work after vacation to find out that the director of nursing held a meeting to find out what could be done to improve our floor. When I found out the suggestions that were given I was saddened to learn that no one really addressed the deep issues that were going on. The consensus was that nothing would change…and they pretty much fulfilled their own prophecy. I firmly believe that nothing changes if nothing changes. We shouldn’t be afraid to speak up about what matters and to continue to speak up until something is done.

    One thing that I learned from working at a V. A. hospital is that sometimes you have to be your own cheerleader. At the V.A. hospital that I worked for (I’m pretty sure it’s universal) when it came time for annual
    reviews you had to prove why you deserved a raise. You were required to toot your own horn. How loud and strong you tooted was often the difference in pay between the nurses at the bottom and those at the top. You had to list all the great things that you had done, learned, and were part of to justify your increase. The nurses that weren’t able to do this had salaries that reflected this fact. At that time I learned how important it is to let your managers and colleagues know your value (within reason and when appropriate). This can help you get a raise, get on certain committees, get a promotion/new job, and/or be seen as knowledgeable.

    My point of all of this is just to say that perception is reality and
    oftentimes you have to bring people into your reality in order for them to truly understand. If we seem satisfied with subpar conditions then we can expect them to continue. If we are able to care for 6 patients per nurse without major problems then welcome to the new normal. If you’ve been making $40,000 for the past 3 years without a raise then you’re part of the problem. Managers often sit in an office tucked away from the chaos and don’t know or choose not to know about the real life of a floor nurse. If you aren’t happy and you aren’t trying to change things then you can only blame yourself. We breakdown our bodies to save others and we should at the very least be content with our working conditions and situations. If things aren’t safe if you don’t feel valued, if changes need to be made then you need to be the squeaky wheel. Pat yourself on the back, toot your own horn, and speak up for your colleagues and yourself. Small changes often make a big difference and can help move our profession forward. After all, nothing changes if nothing changes.

    What have you done to advocate for yourself? How did you get over feeling uncomfortable about speaking up? How did things change at your job?
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    8 Comments

  3. by   macawake
    The major problem is that most nurses don’t like asking for what they want or need. We do such a good job speaking on behalf of our patients but fall short when it comes to ourselves. It’s almost as if we have been programmed to defer our desires for the betterment of mankind. Haven’t had a raise in 3 years?Well at least I have a job. Taking care of six patients when the maximum is supposed to be 4? This is just how it goes.
    One word that I wish were used to describe nurses more often is assertive. I wish that we were known to go after what we wanted and needed. If we were being honest with each other we would admit that nursing (especially floor nursing) is brutal. Often working 12 hours without a break (or what truly qualifies as one), barely using the bathroom, and hardly able to let “outsiders” know that we’re alive. Why is this the case? Because we’re nurses and we’re strong and also because it’s always been done this way (I hate those words).
    OP, your post describes my greatest nursing-related peeve. The attitude that I've bolded in the above quotes actually make me angry. I genuinely despise that defeatist victim cape that some of my colleagues seemingly proudly wrap themselves in. The stressors that so many other nurses seem to find challenging (such as patients, patient's families, (wilfully) clueless or uncaring management) don't faze me, but nurses who won't stand up for themselves and demand a safe and reasonable workload and working conditions, do.

    The consensus was that nothing would change…and they pretty much fulfilled their own prophecy. I firmly believe that nothing changes if nothing changes. We shouldn’t be afraid to speak up about what matters and to continue to speak up until something is done.
    I completely agree. It is a self-fulfilling prophecy. Of course things won't change if no one is prepared to actually demand change. I've mentioned this in other posts. Management will choose the path of least resistence. The pressure that first-line managers are under from their superiors is likely a lot greater than the meek, half-hearted pressure floor nurses apply. When that is the situation nurses will be ignored, and we're stuck with the status quo.

    If you aren’t happy and you aren’t trying to change things then you can only blame yourself.
    I agree 100% with this. I realize that I'm probably ruffling a fair amount of feathers by saying this, but I'm absolutely convinced that your statement is accurate.

    What have you done to advocate for yourself? How did you get over feeling uncomfortable about speaking up? How did things change at your job?
    I honestly think that I benefit from the fact that nursing wasn't my first career. Nursing hasn't shaped/molded me. I will never know for sure, but I suspect that I might have had a different attitude if I had started nursing in my early twenties and never worked for any significant amount of time in a completely different milieu. When I started nursing it was after a decade in law enforcement. That's a job which allows you to develop and perfect your ability to be assertive. It honestly never entered my mind that anyone would have the expectation that I go an entire shift without bathroom and meal breaks. In ten years of nursing, I think I've missed my lunch break less than ten times. Unless someone is actively trying to die, I will eat. Period.

    I don't see myself as a superhero and I don't aspire to be one. I definitely aim for kind and compassionate but I will never be selfless, and that is by design. By making sure that I get the breaks I need, I know that I'll be a more effective nurse for my patients than I would be if I didn't take responsibility for my own health.

    A while back a new poster who was about to start nursing school asked for advice on how to avoid making mistakes in her new career. I offered some advice and one of the points that I made sure to include was to get plenty of exercise and to make time for hobbies and spending time with friends and family. I do regard this as being directly correlated with patient safety. It is my conviction that by taking good care of ourselves, we strengthen our ability to take care of others.

    So what have I done to advocate for myself? I think the main thing really is the fact that I just act like it's the most natural thing in the world that I take regular breaks. I just do it. No one has ever questioned it. When I've precepted students or mentored new employees, I've done my best to shape them according to my own philosophy We're professionals, not martyrs.

    If the workload is unreasonable I will bring it to the attention of the appropriate manager. If it hasn't been corrected within a reasonable amount of time (what constitutes a "reasonable" amount of time, depends on what the issue at hand is), I start writing incident reports that outlines the risks I've identified. That risk could be concern any number of things, for example; patient safety, staff safety or a risk involving equipment, policies etc. I don't mind being a royal pain in the behind if it's for a worthy cause.
  4. by   canoehead
    Self sacrifice is engrained in our culture. Every year, along with license renewal the board asks nurses in my area if they would be willing to volunteer to work in case of disaster. Well, sure I'll help in a disaster, but I certainly wont VOLUNTEER my professional skills. If I leave my home and go to a place that's only got the basics, that's my gift to the citizens that need help. But be damn sure that I will get paid by the government or hospital- they make millions from us little people.
  5. by   allstressedout1
    People where I work are scared speak up. It you speak up you might just lose your job. If you speak up you might get treated worse than you already are. You get made to feel like you are in the wrong.
  6. by   Lane Therrell FNP, MSN, RN, HTCP
    I love this topic. Self-care is beyond important for us as nurses, and it's something we can role-model and teach our patients as well. I use 'the airplane example" all the time with my patients and with my nursing students: It is vital to life that when you're on an airplane and the oxygen mask comes down, that you put your own mask on first before you help the person sitting next to you. When you apply this principle to every aspect of life including your nursing practice, your effectiveness goes up and so does your own personal quality of life.
  7. by   Lane Therrell FNP, MSN, RN, HTCP
    YESSS! Individuals taking responsibility for their own health.... it is a subject near and dear to my heart. It's difficult because it requires awareness, commitment, setting boundaries, and loving yourself. In Western society, we have given our innate individual healing power away to the medical professionals. Interestingly, one of the fundamental principles in Healing Touch (and other forms of energy healing), which many nurses find difficult to master, is this: You're not giving your energy away to the patient you are working on, you are harnessing higher vibrations to help the patient entrain to them so they can self-heal. In my ideal world, beginning Healing Touch would be taught to all first year nursing students. I recommend HT techniques to people from all walks of life all the time for self care.
  8. by   Here.I.Stand
    I would "love" macawke's post if AN had a love button. :in love: I rarely skip my meal break. If it gets interrupted for any reason, I note "no lunch" on my timesheet -- the US DOL says to be a bona fide unpaid meal break, it must be uninterrupted (and I believe away from the work area.)

    The last time I didn't get a break, still having charting to do I decided to take a paid 15 minute after reporting off, and before finishing my documentation. I figure since missing those regularly, the hospital owes me that much.

    Immediately life-threatening situations are one thing, but routine call bells, questions from the MD, phone calls etc are quite another. If I need to pee or get a drink, non-urgent things can wait two minutes.

    I don't understand the "didn't have time to pee" mentality. For me anyway, I've delivered five babies.
    It is physically impossible to hold it for 8-12 hours...am I supposed to use incontinence products so I can avoid the BR? Oh heck no!! I get it, we're busy. I have worked a floor that had many fresh traches and lumbar drains, I've worked SNF, I've worked LTACH with five pts on ventilators, I've worked SICU and CVICU. Nobody has ever died because they were placed on hold, or waiting two more minutes for pain meds. For the love of all that is holy, go to the BR!
  9. by   operations
    This is something I'm actually incredibley good at doing and very poor at conveying how to do. Sometimes I want to tell colleagues to ask for more and speak up for themselves but not really sure how to convey that properly. It starts within yourself, understand that you have expectations, and recognize that others assume you have those expectations. Therefore asking for not only what you NEED but what you WANT is not something you should ever hold back on. No one is going to just hand you things, so if you are quiet and passive you'll be miserable. You have to ask for it.
  10. by   aflahe00
    We are basically told by administrators that we are running some kind of hotel. Patient satisfaction is most important. You want to assert yourself but at the same time you also want to remain employed in your own terms.

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