Nursing: Taking Back Our Power

A few months ago, I wrote an article on allnurses about dealing with annoying co-workers. During the time I wrote that article I was mired in negativity about my nursing career in general. I would wager a bet that every nurse has been there at least one time in their nursing career. Nurses Announcements Archive Article

Updated:  

I am not a positive person by nature. Unlike naturally positive people, I have to work at it. I want to be positive. I feel better when I am positive, but sometimes the negative bug bites me and won't let go. I am a voracious reader of psychology and "self-help" books and articles. They give me insight into the human psyche and help me understand my trigger points.

One of my trigger points is feeling a loss of control. I am no dummy. I know that a higher power is really in control of my life, but He sometimes lets me think that he is in control just so he can have a good laugh. Anyway...When I am feeling overwhelmed and under-appreciated at work, I feel a loss of control. I like the illusion that I have a handle on things. When I lose my grip, I tend to get morose and negative.

A fellow Allnurser called me on some things I said in the aforementioned article (thanks, Interleukin) and I have been thinking of what he said ever since. I am glad he commented because it made me clear my head and regroup.

I want to share with you the things I learned on this little journey of reflection. In nursing school, what we are lead to believe is that we will "practice nursing". I don't know about you, but I don't practice nursing...I do nursing, for 12 hours straight, often with no breaks.

For some reason, doctors, patients, and administration seem to hold nurses to a higher standard than others. By this, I mean that they seem to think that nurses should tolerate the abuse dished out on a regular basis. They should gulp it down and say "Thank you, sir, can I have some more?". Well, guess what? This nurse has had enough. I am not going to take it anymore. From now on, I am standing my ground. I am taking back my power.

According to Dictionary.com, the term "abuse" means to a. to use wrongly or improperly, b. to treat in a harmful, injurious or offensive way, c. to speak insultingly, harshly and unjustly to or about, and d. bad or improper treatment. Do any of these definitions describe your work environment?

Nurses are feeling demoralized, frustrated, discouraged and repressed. Rules and policies put in place by administrators who have never set foot on a nursing floor are the norms. They have a very unrealistic view of the process of nursing as a whole. By their choice, they have put blinders on, plugging away for the almighty dollar, while their nursing staff, the CORE of the hospital, takes the brunt of patient dissatisfaction. Most nurses are compassionate, caring people. One reason they decided to be a nurse was to be on the front lines of patient care. Yet, every day, nurses leave the nursing profession citing overwhelming stress and emotional fatigue.

We try to be patient advocates. We try to set limits with difficult patients and demanding families, but the administration does not back us up. Instead, when complaints arise, it is often the nurse that the blame falls back on. As nurses, our plates are full, but each week seems to bring more and more responsibility and paperwork. The more we do, the more we are expected to do.

Co-workers and doctors often add to our stress level. As more nurses become disillusioned with nursing, it shows. We become disgruntled, short-tempered and discouraged. Once the morale of the unit starts to suffer, it is very difficult to correct. Dealing with doctors who are less than cordial often causes unrelenting stress. I have seen nurses cursed, backed in a corner, called names and screamed at in front of their peers. All in the name of health care. Not once, have I heard a physician called down for this type of behavior. Why do we tolerate this?

One reason may be because we feel that, as professionals, it would rock the boat if we complain or stand our ground. We are afraid of being labeled "troublemakers". Well, I have decided that from now on, I will not allow myself to be talked to or treated in a rude or obnoxious manner. I will stand up to the person who is verbally abusing me. I deserve to be treated with dignity and respect.

Administrators, doctors, and peers are not the only ones who can dish out abuse. The people we are paid to take care of, our patients, are often the worst offenders. For whatever reason, patients, and often times, their family members, can be verbally and physically abusive. Demented patients have an out. They are confused. But patients who are not confused should not be allowed to physically assault health care staff, nor should they use threatening language. Yet, again, it is tolerated.

As nurses, we need to take back our power. We need to start saying "No" to abuse, "No" to unsafe nursing ratios. We need to document and fill out incident reports on every incident that makes us uncomfortable. That seems like a ton of extra paperwork, but it must be done. If you are a supervisor, you need to support your staff, plain and simple. Your staff will respect you for it. Do not allow patients and their families to mistreat you. Let them know that their behavior is unacceptable. If they take it to administration, deal with it by handing management a letter detailing your side of the story (keep a copy for yourself). There are two sides to every story. More often than not, nurses are not allowed to share their point of view. Same with doctors. Stand your ground.

Nurses need to support their fellow nurses. Let them know that you've got their back. Encourage them. Lift them up. Acknowledge their positive attributes.

In 2007, a bill was placed before Congress. It is called the Registered Nurses Safe Staffing Act of 2007. Basically, if it passes, it would make it a law that hospitals would have to have safe staffing ratios or face big fines. Other nursing issues are also discussed in this bill. The American Nurses Association (ANA) supports this bill. If you are concerned about the future of nursing, write your congressman and ask for their vote on this issue.

One more thing: Stay Strong! ?

Thanks for posting that there was a second version - I just ordered it! :)

Specializes in Med-Surg, HH, Tele, Geriatrics, Psych.

I just ordered some books similiar to this off Amazon. This one is going on my wish list too. Thanks for the link.

Specializes in med/surg, TELE,CM, clinica[ documentation.

Thank you so much for your article. I agree that we must take back our power. No, we should not be abused by any one. Not long after I transferred from post partum to my present med/surg position, I had a really nasty run in with a doctor. He was known for his nastiness and for eating nurses for breakfast. My patient, a sweet gentleman of 68 was having urology problems. I was fresh off of an ALL FEMALE unit and hadn't dealt with male plumbing in over a year! Dr.X goes into the room and starts yelling so loud that you could hear him at the other end ot he hall: " What the **** is this, look at this foley, who is his nurse, get in here now"? (I hadn't even seen the patient yet, I had just gotten report). I went into the room and announced myself as his nurse. Then Dr.X, says' What are you some kind of idiot, can't you see that this foley is almost out, what is wrong with you"? I let him rant and rave a bit more. I then replied, well Dr.X, I see why you are so very upset and I am Mr.Y's nurse, but I just got out of report and I am a fairly new nurse, and just transferred from post partum and I would be very glad to help you fix the problem-please tell me how I can help you? He was speechless. Then he said, please remove his foley and monitor his I&O's and I will be back this afternoon to place a new foley or start him on a CBI, by the way, than you nurse. Dr.X, came back at 4pm to put in a new foley, he kindly asked me to assist him, he went and got all of the supplies while I stayed with the patient and he thanked me again when he was throught. After he left the floor everyone asked me what I did to Dr.X? I told them that I was honest and told him the truth. After the incident he had alot more respect for the nurses on my floor--he retired at the end of 2007.

I really do believe that we have to start to document exceptions to assignments, lack of resources etc. We must protect our licenses! The hospital I work for is seeking the Baldridge award----they covet it so badly-we had a visit but didn't get it--we are trying again. We have patients who come to the hospital and think they are at a hotel. The families just make everything worse. For a long time I had trouble setting limits but I am leraning to do so and to be nice about it and if I have to be strict I am. Above all, My allegiance is to my patients needs not the family--the family can go to the cafeteria.

Thanks again for a terriffic article.:D:bow:

Specializes in ICU, Telemetry, neuro,research.

i commend you on tapping in to your strength. yes, unions, in theory, help. in the school system down here, where i was before i became a nurse, they are benign and useless. there is a hospital on this campus that has a union and the nurses are, in general, more content. but nothing is perfect. it should not take a union to make working conditions condusive to happiness and success for the staff and patients. but, that is in a perfect world. the question is, do we make do with the status quo or do we take the chance to be an agent of change. that is rarely an easy path. perhaps, if we can gather our coworkers who have the same beliefs as we do. strength in numbers would make our message more effective. but, the reality is that the only thing that moves organizations large and small, (with some few exceptions: ge, disney, toyota,etc), is the bottom line. so, if we were to threaten the bottom line, i am not talking about a drastic step like a walk out or the like, just something that would not give them an option but to pay attention to us, what then? perhaps i am just dreaming. we are losing nurses right and left and while there are waiting lists at most institutions of higher learning, if we do not do something to improve the working enviornment and mindset of the medical establishment, then those young minds will run screaming away just like we feel like doing sometimes.

Quite simply, it is NEVER ACCEPTABLE for anyone in any rank or position to corner a person, shake their finger in someone's face, curse, etc. NEVER. This is when a nurse states simply and directly as they walk away, "If this is going to continue, I am calling security" -- and BE PREPARED TO DO IT.

Of course, this is not possible in a small facility. However, most hospitals these days have security, and that is why they are there.

Whether one is male or female, new or experienced nurse, patient or doctor does not matter. NO ONE has the right to abuse. Period.

We as women especially tend to think we should bend over backward as we are being verbally pummeled. NO WAY. No doctor would take it. Why should a nurse?

Indeed, documentation is KEY. Always keep record of the facts. Do not point back, do not yell back, but by all means state clearly what will happen next if it continues. And be prepared to FOLLOW THROUGH.

Hi there. I just wanted to share something I found very interesting. I did my critical care semester at a teaching facility in the Dallas/Fort Worth area that has what I think is a unique policy regarding physician abuse directed at nurses. It's called a "code white". When a code white is called, all the available nurses in the area come and surround the doctor! What a novel idea! Presenting a united front when calling physician's on this type of behavior is fabulous! I don't know the exact numbers, but I know the code white doesn't happen very often. My guess is because dr's don't want to be confronted this way. I am very lucky, in the ER where I work, our docs are the best. They know the nurses are the backbone of the ER and they treat us with respect and we are allowed considerable more autonomy than other areas of the hospital because of all of our protocols in place. Hang in there. Nursing is a calling. My best advice is if you aren't happy in your workplace, seek out other opportunities. I am continually amazed at all of the different areas of nursing that exist. One of the things I love about nursing is if you don't like this area, there are a million and one others you can try! Take care!:nurse:

I loved your article! I'm new to this forum and I'm thrilled to find others who share my point of view.

The point you brought up about not being in control is a key point. With regard to nursing, there are so many factors that the nurse has no control over. I'm not just talking about unforseen medical emergencies!!!

I'm talking about things like the RATE at which she gets new patients (E.R. admits/post-op/direct admits). On our floor, we no sooner discharge a patient and the CN is on the line telling us we are getting a new patient and "report" is holding on line 2. I mean this happens within a couple minutes of discharge every day!

Also, "the late-in-the shift admits" are another thing we don't have control over. Notoriously, on our floor, you are wrapping up your shift and preparing report/kardexes/chart checks for the next shift while medicating patients and performing other duties AND, sure enough, the admit you just got report on shows up and all the hard work you did to get yourself out on time (all day long) is for nothing because now you're getting off late no matter what!

Not only do we need more realistic staffing ratios, but we need to have rules in place that provide for a more humane WORK PACE. Barring "medical emergency-related transfers" there should be some rule in place where there is a mandatory 10 to 15 minute time frame BETWEEN patient admits! Also, barring emergent reasons, there should be no patient admits between the hours of 18:00 and 20:00 and 06:00 and 08:00. Those hours should be reserved for sacred "catch up" time for the staff.

I would love to see a future in nursing where nurses fight for THESE rights TOO!!!

I think end of the shift admits is as big a problem as nursing ratio's. I work on a "dump" unit...we get everything!!! And you can bet if its within 30 mins of the end of your shift...the phone is going to ring and an admit is going to happen. I have taken the motto that this is a 24 hr facility and somethings are going to be left for the next person to do. I will gladly stay and do everything an admit requires if its in a reasonable time frame. But I certainly do not expect the nurse that I am relieving to stay over 2 hrs to finish up an admit that popped up at 1430. Nor do I expect any of my co workers to EXPECT me to stay when the admit pops up at 2230! This is part of standing up for ourselves, being respectful of our coworkers and toughing it out .

Specializes in Mixed Level-1 ICU.

Right on, Nitengale166!!!!

Regarding staying over to get things done...(we all have lots of examples, I'm sure, but...)

I'll never understand why the surgical checklist isn't done for a patient that the previous shift KNEW was going to surgery...they took the time to get the consents signed but DID NOT do the surgical checklist???...and PRESTO your shift starts and the transport guerney is there to take the patient...

wait...wait...wait...it gets better, there's no WEIGHT on the chart so the patient needs to be weighed too...and then ALL your patients start calling because they're in pain...AND THE STRESS BUILDS...you guys know the drill

BUT WHY DOES THIS HAPPEN?...IS THE PREVIOUS SHIFT TRYING TO BE MALICIOUS??? I don't believe so...

the only thing I can attribute this to is that the nurse never calls O.R. Holding to find out WHEN the surgery for their patient is scheduled for because the nurse sees that as a low priority...

All shift long, we constantly have to prioritize and that's what I mean by it's a 24/7 job...I don't purposely LOOK for things that fall on my shift to UNLOAD onto the next shift, but we've all had to prioritize and ignore certain tasks and we'll continue to have to do that...

In a perfect world we'd get everything done all the time, but nursing isn't a perfect world!

That's why I am taking steps in my life to create something different...that's why I work two 12-hr. shifts a week (considered part-time) and NOT three anymore...I choose to create a different life for myself!

Specializes in Mixed Level-1 ICU.

".and then ALL your patients start calling because they're in pain...AND THE STRESS BUILDS...you guys know the drill"

The "drill" you speak of is self-perpetuated.

You, the nurse, are in charge. If you rush and you end up screwing something up, they'll come gunnin' for you.

YOU must take charge and, in a priority fashion, complete the tasks...at a safe clip!

If the OR is calling, tell them what YOU need to do. If patients are in pain, get the charge, super or other nurse to handle them, if you need to travel right away.

IN NURSING, YOU CANNOT MAKE UP FOR TIME LOST WITHOUT RISKING AN ERROR.

..."but nursing isn't a perfect world!"

Nursing is unpredictable. And if others with whom you work have yet to understand that, it is because you have not made it clear.

Instead, we continue to try to get more and more done, in the same amount of time and then we watch ourselves run around like the old headless chicken 'cause it ain't possible...and it will only get worse as JHACO mandates a continuing litany of tasks that nursing will rubber stamp..lie it has for 50 years.

We have no voice because vast numbers of us are the suffering selfless silent. And that's at the heart of most all of nursing's complaints.

At least here, on this website, we can talk freely and let others now what' s happening.

Specializes in aged -adolescent.

Interleukin

How would you deal with these two incidents?

1) You are the junior RN on the floor at a school. On Drs clinic morning, one student asks to see the dr about a matter and I have said "Yes, he may". My superior states that he does not need to see the doctor, just give this and that. Two days later working by yourself you are concerned about his illness, symptoms are worse. The hospital keeps him as he has cellulis. For the next week everything you do is wrong.

I tend to err on right side of caution and same week sent another boy to Doctors. He had atypical pneumonia. Admitted to hospital. Another week of so called faults on my part.

situation 2 In our establishment there are both RNs and Endorsed ENs. The senior asks the EENs to attend to an IV injection. This is not considered within their scope of competence being an invasive procedure and so they refuse as they are not permitted to do this.

As an RN I can legally give an IV and know how to although haven't done any for a while. I am refused the option even though I am the Nurse on call. I feel it's insulting. Is this professional jealousy or bullying. Of course If the senior wants me to do something she couldn't be nicer.