How To Recover From Near Rock Bottom...

allnurses Guide · Aug 10, 2017

I don't particularly think that, if you search for a new job, that you need to mention these issues that you are having at work, although some employers do ask on the application, if you've ever been placed on a Performance Improvement Plan. While I certainly do not advocate lying on an application, I'm also not sure how an employer can confirm that information, however you answer that question.

It sounds like you do have some interpersonal issues that you need to work on. I myself have gone from being a nurse that patients really didn't like much at the beginning of my career... To being one that receives a lot of recognition and praise on those survey thingies. :) ... Maybe you have a close friend who you can ask honestly.. "How do I come off, to other people?" "What do people think of me?" Do some self reflection.

Good luck! :)

*note: I don't ever like to tell people not to be themselves, or to care what people think about you... But sometimes in health care, the old "fake it til you make it" cliche is very true.

I'm a pretty introverted person and really don't enjoy talking a whole lot. But, I've become SO skilled at dealing with patients over the years, that when I walk into their room, I suddenly turn into Miss Personality. Weird.

Career Columnist / Author · Aug 11, 2017

Hey allnurses world...wonder if anyone had sage advice...
I love the new challenge of working with children, but it seems that for the most part, the parents of the children don't like me. I've been working with my manager to improve this via a performance improvement plan. I have been successful enough to be taken off of it nearly a year ago, and I thought things were ok. Well, I have had 2 double whammies in the past month:
First, I have been called in to the office again to discuss my interpersonal skills with the parents.
Second, due to low census, I have floated back to my old adult unit a few times. ...they apparently don't want me to come back!
.
How do I attempt to look for another job when my old unit (that I left on good terms with) does not want me to float there, and my current unit may very well put me back on a PIP and start that process of a termination? What do I say to potential new employers?
Thanks!!

You don't say anything to potential new employers. You are a qualified applicant with 12 years experience.

With your background, your resume will undoubtedly land you interviews, and it's important that you prepare for the typical and expected questions:

* What's your greatest weakness?

* Tell us about a time you (fill in the blank: exceeded customer expectations, had a conflict

with your boss, broke a rule)

* Why should we hire you?.......and so on.

* Why are you leaving your current position?

In my book (link below) answers to these questions, including what NOT to say, are all covered along with strategic insider tips. I used to be a hiring manager and I do know what nurse managers are looking for in a candidate :)

Finally, there's a mismatch between how others see you and how you view yourself. That's absolutely fixable, with determination and help.

You are on the brink of self-discovery and personal growth. Start with seeking the feedback of people who know you and care about you. People who will give you insight into how you come across to others.

Actually, starting in a new setting may be a wonderful opportunity for you. Best wishes, my friend.

Snowana · Aug 11, 2017

Wow! I am humbled and appreciative of all the feedback and advice! I'm starting to feel there may be hope!

The history with my old unit was that it was a horrifically toxic place, jam packed with favoritism and lateral violence directly from the manager (she has been fired and unit is on interim manager #2 in 8 months). I irked her the wrong way somehow, and I went from being one of the strongest nurses that was entrusted with the sickest patients to a worthless target over BS reasons literally overnight. She never could write me up because I'm a great nurse that pays attention to detail and really cares for my patients. Instead she made up "concerns" and harassed me, as she did several other great nurses that didn't brown nose. I then became a paranoid wreck over the things she nit-picked over. I floated to peds several times to help care for the older patients, and it went well!! ...until I started with the littles. Now I go back and something I did over there irked a new crew, and I haven't the faintest idea why.

NurseBeth, I didn't see a link to your advice ðŸ˜Š

Thank yiu again everyone! You are the best!

KatieMI, BSN, MSN, RN · Aug 11, 2017

Hi, Katie, do you mind telling me what your "communication quirks" are? My personality is one where I'm very quiet and serious, and when I do speak, I speak analytically about a situation because "small talk" doesn't come naturally to me. Essentially, I just talk when I need to. I know a lot of times it makes people uncomfortable (I've actually had people become very rude to me for no reason at all, despite them being very sweet with everyone else, because I suppose they perceive me as being "cold"). I try to overcompensate by always being really polite, and smiling when I make eye contact with people. I know the smile trick works time-to-time because when I smile, I am being genuine, and I can see the genuine smile that people give me back after initially looking unsure.
Of course, I definitely don't think I'll ever be the "favorite" nurse or CNA because I'm not a talker.. I jokingly get called "robot" by my family lol, so I'm still trying to figure out what area would be best for me. Just wondering if you could elaborate on your own personality a bit.

Too many of them... enough to say that I speak VERY slowly with quite a heavy accent with British overtones and overall is a quiet, introverted, never-small-talker with some "ICU personality" features thrown there for better mix :rolleyes: I live in placed where xenophobia is pretty common among population and so a few times I'd got "care star notes" worded approximately like this: that nurse was speaking broken English and behaved like a weird foreigner, but once we listened to her it became clear that she was the only one person around who really got what was wrong with my mother and knew what to do" :roflmao:

Irish_Mist, BSN, RN · Aug 11, 2017

I think you need sit down and ask yourself if PICU is where you truly want to be versus adult ICU. If you truly want to remain in the PICU, work on your communication skills. Can you tell us some specific feedback about the parents not liking you? Surely not every parent dislikes you. You cannot please everyone. A few complaints here and there are expected. Are these frequent complaints? If so, it's worth thinking about.

I don't have pediatric experience. I can imagine parents of critically ill children feel a range of emotions from vulnerability, powerlessness, tremendous fear, and countless other emotions I wouldn't wish on my worst enemy. It takes an incredibly empathetic, patient person to balance the needs of their patients with the needs of the parents. Quite frankly, the more I type, I don't know how pediatric nurses do it. I don't think I would have the patience.

Bottom line: Find out where you want to be. If your current manager is willing to work with you, stay (but only if you think it's the right thing to do). If not, moving on for a fresh change of scenery isn't a bad alternative. Maybe read some books about communication techniques, attend some seminars, or something like that. Communication is an art and it CAN be mastered.

BEST OF LUCK TO YOU!!!

Snowana · Aug 11, 2017

@Irish_Mist: Parents have said that I come off as condescending. I particularly struggle with the parents that are barely adults themselves and don't have any coping skills with dealing with a screaming toddler that can't eat until their high-flow NC is low enough. I've never been told that in adults, and I can count on 1 hand how many times I was fired by families in 10 years. In peds...it's far higher than 1 hand

I am a very serious and analytical introvert...I know that in terms of my skills and competency, I am a great and safe nurse, but the "social work" part does need improvement. I've trying to figure out what would be good options to fix this...perhaps Toastmasters, reading the right books, asking my manager for a mentor to hear how I interact with these parents and give me pointers on how to fix things...

Snowana · Aug 11, 2017

@jennylee321: Well, that's sticky. My old unit is a pretty awful place, I'm grateful I survived as long as I did. The three people comprising the management team I had when I left have since been asked to leave or be fired, and the first interim manager lasted a whole 4 months before quitting. They are on interim #2. She does not know me at all. My current manager is willing to share the feedback they have with me. As much as I hate hearing how bad I am, it would be nice to see if their concerns matches my current managers...or if it's contiguous with one of many reasons why I left adults for peds.

Ruby Vee, BSN · Aug 11, 2017

I'm sorry all of this is happening to you, but I'm glad to see you taking accountability and looking to do the work on your communication style and personal growth. Kudos.

I spent two years on a Heme/Onc floor and then when I had to relocate cross country, decided that Heme/BMT would be a interesting, challenging position. Within the first month, I knew I had made a mistake, but I was determined to stick it out. I'm an introvert; small talk comes with much difficulty for me and I was young -- wasn't yet wise enough to realize that I had to change ME since I couldn't change anyone else. Heme/BMT was absolutely the wrong place for me. The patients and their families were pampered there, the nurses saw the psychosocial aspects of care as greater as (or greater than) the physical aspects. I was working straight nights, with 15 patients all needing transfusions of RBCs, WBCs or platelets. Some were changing their blood type and were getting incompatible blood. There was TPN, chemo, and antibiotics -- sometimes three different antibiotics and just one tiny double Hickman to get it all through. Anywhere from 1-5 of the patients on my hall would be in reverse isolation -- gowns, hair covers, shoe covers, masks and gloves to get into and out of every time I went into a room. And add that to the visitors spending the night who expected to demand and receive extra blankets, orange juice, etc. Days had 3 patients at most, evenings had five. I had them all. And usually no one to help except the other RN who had her own 15 patients. I was working hard on getting all of the physical care done correctly and in a timely manner. The psycho-social aspects just flew right by me. The other nurses rotated shifts and had time to develop relationships with patients and their families during daylight hours; I didn't have that.

There were several complaints that I wasn't "friendly" enough, that they thought I was knowledgable but not caring enough. My manager wasn't willing to work with me, and before I even fully realized what was happening was traded to the ICU. I was embarrassed and ashamed that I hadn't fit in on Heme/BMT, but immediately knew that ICU was a better fit. Psycho-social concerns were addressed only after the patient was stable, and there was no spending the night in the room OR demanding that I cared for the visitors as well as the patient. My new co-workers were great, and one of them is still a close friend today, after years of cross country visits and long phone calls and letters. I fit in there; people liked me, I was happy. I don't know that I could ever have been as happy on that particular Heme/BMT floor -- my manager did me a favor.

You shouldn't have to turn yourself inside out or change your personality to succeed at work. It could be that the particular PICU you're in is just not a good fit for you. The culture of the PICU across town may be a better fit. The parents may be used to the other nurses breaking the rules to do them favors, and if you follow the rules, you're "the bad nurse." (I see it all the time -- someone lets the family crowd 8 people and a bucket of chicken into a double room where one or both patients are NPO. If you stick to the two visitors and no food or drinks rule, they're angry. That's not your fault. The other nurse(s) set you up.)

BUT -- since you've been told that you have problems with your communication style, you are absolutely right to want to work on it. You've gotten some great advice upthread, and I don't know how much I could add to that. Just know that you're not the only one who has ever had the problem, and it is possible to come out the other side and succeed. I hope you do.

allnurses Guide · Aug 11, 2017

Thanks, I do appreciate that. I'm not so sure it will be enough...and how to answer questions in future interviews. Most threads here seem to indicate that once you're on a PIP, there's little chance for recovery despite best efforts...

While it is not true that a employer can't give negative information if asked for a recommendation most won't because they fear litigation. Unless you have done something egregious that caused harm to a patient, chronic tardiness/absenteeism or insubordination they will most like confirm your dates of employment. When in interview you can address a lack of a personal reference by saying that your last position with kids was not a good fit and when you decided that was the case your old position was no longer available so you thought you would try your hand else ware.

Start looking for another job immediately and stay positive. As Katie MI said there's no shame in having difficulty working with the parents of Pediatric patients. I have work pediatric and adolescent Psych for several years and their parents can be fairly challenging. Let's just say in psych the apples don't fall far from the trees. When dealing with parents you almost have to treat parents as patients as well.

Good luck in your quest

Hppy

JKL33 · Aug 11, 2017

There were several complaints that I wasn't "friendly" enough, that they thought I was knowledgable but not caring enough.

Ugh. The bane of many introverted "thinkers."

There is a LOT we can do to amend our body language and communication style in order to show people that we care in a way that they understand. Luckily I've learned this without being forced to. The problem is that we still can't fix others' self esteems, which play a huge part in this (short of a nurse who is just rude).

It hurts me that many people do not see excellent technical and assessment skills and careful mental processing of a patient's condition as "caring".

guest52816 · Aug 11, 2017

@Irish_Mist: Parents have said that I come off as condescending. I particularly struggle with the parents that are barely adults themselves and don't have any coping skills with dealing with a screaming toddler that can't eat until their high-flow NC is low enough. I've never been told that in adults, and I can count on 1 hand how many times I was fired by families in 10 years. In peds...it's far higher than 1 hand
I am a very serious and analytical introvert...I know that in terms of my skills and competency, I am a great and safe nurse, but the "social work" part does need improvement. I've trying to figure out what would be good options to fix this...perhaps Toastmasters, reading the right books, asking my manager for a mentor to hear how I interact with these parents and give me pointers on how to fix things...

Your reply is what I thought when I originally asked this question. And that is because you gave a very analytical response as to why you enjoy working on the unit. It seems to me that you need to learn how to meet your patients parents where they are at.

What do I mean by that? Meeting your patients parents where they are at means sizing up quickly their ability to learn, willingness to learn and then tailoring your communication style to meet that level. It isn't about your level of comfort or expertise.

It can be a difficult thing to do (I speak from experience). I think Toastmaster would be very helpful. You will be expected to give speeches to different types of audiences, and to adapt your style to those audiences. Great experience.

You are obviously an intelligent and competent nurse. But you need to learn how to interact with BOTH of your patients - the actual pediatric patient and their parent.

Good luck.

Workitinurfava, BSN, RN · Aug 11, 2017

Is it possible your are burned out and just don't know it?