Why nurses don't want to talk to a ward psychologist?

[manjar]

Hello,

Since I often seek and get good information at this forum I had an idea I can ask you for help with my current issue.

I am a psychologist working in a pediatric ICU. I am there mostly for parents and older children. But I am also supposed to be available for supporting staff with their professional or personal issues.

Head nurse asked me to prepare a talk about the importance of talking to someone and receiving help after a mistake while giving medications to a patient. This I can handle. I can talk about the importance of talk support or therapy. But I am having troubles with the other part which is the fact that nurses rarely seek psychological help or advice. Head nurse encouraged me to talk about reasons for that. I do have my explanations but I would be really happy to hear what you think about that.

So, to summarize: if you had an option to speak to a psychologist, working at your ward about your work or personal issues - would you do it? Why yes and why no?

Regards,

Manja

[Julius Seizure]

We also tried group settings for mentioned topics, we ensured it was in their work time and nurses could pick which other members they want in their group.

When you say that you made sure it was in their work time, I am not sure what you mean? Do you mean that during the nurse's 12 hour shift, they can meet with you on their lunch break? Schedule a time at 2pm? Do you schedule a group meeting a 2:00pm for everyone to come to?

I can imagine that if its during lunch, nobody wants to give up their 30 minutes of escape from thinking about the hospital (if they even get that). If its at some other time in the shift, do they really feel like they have time to step away? I can't imaging feeling like I had time to just go chat with a psychologist in the middle of my work day.

[MelEpiRN]

I know many would disagree with me, (which would make me happy, to be honest) but I think it's also a culture of the current workforce. I organize educational opportunities (many offer CE credit) as part of my job as well as community outreach programs and I get almost zero participation. The only time people show up is if you make it super-mandatory (uh-huh, I said it- mandatory doesn't mean diddly anymore) and pay them. You'd think nurses would want to learn, keep up to date with new info, etc, but in my experience people just want to come in, do the job they're [under]paid for, and go home. No extra, even if it helps them.

[BeckyESRN]

That actually sounds really helpful! However, we work during work time. I cannot recall a single shift during my time at the hospital where I had more than a couple of minutes to attend even an in-service on new equipment, let alone a have a sit down meeting. If this is happening on days off, but being paid, it's a hard sell because most people don't want to be at work more than required. When we had in-services or short classes that we had to attend, the managers would over staff, so that we could rotate in groups.

The information that you're offering sounds necessary and it would be a great opportunity, but fitting that into a work day is going to be a challenge. Maybe start off with some flyers with some info about your topics and when you'll be available. Coverage needs to be provided for the nurses that want to attend. It sounds like you'd be a great resource to have!

[Julius Seizure]

I know many would disagree with me, (which would make me happy, to be honest) but I think it's also a culture of the current workforce. I organize educational opportunities (many offer CE credit) as part of my job as well as community outreach programs and I get almost zero participation. The only time people show up is if you make it super-mandatory (uh-huh, I said it- mandatory doesn't mean diddly anymore) and pay them. You'd think nurses would want to learn, keep up to date with new info, etc, but in my experience people just want to come in, do the job they're [under]paid for, and go home. No extra, even if it helps them.

I think this change is related to the change in company culture where the employee became just another number, not a valued person. If you don't feel like your company values you and you aren't going to be rewarded for excelling (like you said, underpaid), why try to excel? Personal satisfaction isn't found at the workplace.

[JKL33]

You'd think nurses would want to learn, keep up to date with new info, etc, but in my experience people just want to come in, do the job they're [under]paid for, and go home. No extra, even if it helps them.

What I would think :).....

Is that once in awhile someone would ask what nurses want to learn about. Maybe you are allowed to do that, if so thank you, and that's wonderful.

I accept my responsibility to learn about both things the hospital needs me to know and things I want/need to know that are more patient-condition-related. I'm not "upset" by your statement but it's a tad harsh/inaccurate given that educational offerings for nurses are very often someone else's pet project/idea. And...that's fine too, they just may not get a lot of interest. I spend personal time learning about the things I encounter that I want to know more about, because I enjoy it and I'm just curious and I do think it is part of my responsibility.

Edit/PS: The most recent mandatory educational offering I attended involved being read a collection of facts/slides that staff educators had pulled from the interwebs; ALL of it was common knowledge to bedside nurses in my department, and NOT common knowledge to the people "teaching" us.

[JKL33]

Regarding the original topic, I echo J. Seizure.

Maybe you should seek to simply develop trusted and friendly relationships with staff on the ward and offer care over time? Just sort of "become" someone, over time, whom they will approach casually with issues that crop up. I think your position (at least as far as the staff is concerned) would be better utilized as simply a resource present on the ward whom anyone can casually and informally interact with - - not as someone with whom staff makes an appointment and goes to for "therapy."

Now that I'm thinking about it that might be a very helpful thing.

[chacha82, ADN, BSN]

But I am having troubles with the other part which is the fact that nurses rarely seek psychological help or advice.

I don't mean to be disrespectful, but how would you know that people are not seeking psychological help? Perhaps these employees are not seeking it from you but elsewhere if it is needed. Additionally, if you are talking to the head nurse about employees seeking/not seeking advice on the unit, I would be spooked, personally.

[Ruby Vee, BSN]

Nurses aren't going to seek psychological help from a colleague -- just not done. No one wants their peers -- or their boss -- to know that they think they need some psychological help. You would be a valuable resource in the aftermath of a code or a sentinel event if you were available to debrief the group after the event. And you'd be a valuable resource in dealing with certain patients and family members. But not your colleagues. I'm amazed that anyone ever thought that would be a good idea!

[Orion81RN]

I see my own personal psychiatrist and counselor, with NO ONE at my place of work kmknowing. Unfortunately, there is still such a stigma to mental health care (though I believe EVERYONE would benefit from talk therapy.)

I recently had a colleague tell me about another nurse who "was crazy and had to be on meds." Meanwhile, I'm listening to her with my Celexa and Xanax running through my veins keeping me a functional member of society. Ugh the stigma. And, no. I wouldn't trust talking to the hospital psychiatrist. I see HIPAA broken all the time.

[KatieMI, BSN, MSN, RN]

1). Re. everybody being excited about psychologist available: something tells me that it was a cool idea which stemmed directly from administration and no one ever asked bedside nurses if THEY would want it. Although, if someone did ask them, they surely said "yessirma'am" because that's what they always do for every new "initiative" which is put upon them.

2). As you can see now, nursing is a very secretive and very concervative profession. Nurses are trained, from the day #1 in school, that they are a kind of guardian angels hovering over everybody and everything 24/7 to "ensure safety". This obsession with "protection" and "safety" rather easily goes at unhealthy level, ensuring resistance to change - any change, just for the sake of perceived risk, however minor and unrealistic it might really be. This is a well-known phenomenon and there is impressive amount of research dedicated specifically to studying it and the multiple, pretty equally ineffective ways supposed to help in overcoming it.

As it was said here by many posters, nurses are also fighting powerful stigmas - every day and every minute of their working time. Dealing with "difficult" families, terminal disease in pediatics, communicating with physicians, etc., are sure to be hot topics among them - you can observe it on this forum as well. But among nurses to express dislike of caring for human beings everyone else avoids - drug addicts, criminals and abusers of all sorts, etc., and to demonstrate natural disgust in any form toward them - can be thought only in form of pure anonimity, like we do it here on this free online message board, hiding behind out nicknames. It is unimaginable to see nurses, in the presence of their colleagues, openly and honestly discussing their feelings toward patients, physicians, family members, even their own bosses, because it attaches a stigma which disrupts their image of unconditional care and dedication - and also because, as it was said, they trust absolutely nobody and nothing.

3). "During their worktime" the nurses may not have a moment to pee 12+ hours in a row. They value their 30 min breaks - when and where they can have them - as ultimately precious commodity. Many of them have second and third jobs ans busy lives otherwise, so they might not at all feel like attending some sort of support group when they are off.

I do not want to say that the idea of bringing clinical psychologist on floor was the bad one from the beginning. Nurses might deeply appreciate your work with families, especially if you take the load of speaking with "difficult" ones off their shoulders. But they for all likeness won't tell you - because they will have to either openly tell you how they quietly hate even to see that Ms. Johnson with her multiple issues, or expect this question from you. Both situations will make them extremely uncomfortable. You'll have to break the ice and gain the trust of staff nurses before they will tell you anything at all. And just forget about "groups" and "consults" on workplace - that won't happen, ever.

I highly advise you to familiarise yourself with the phenomenon of "nursing culture" and read this forum, especially topics marked as "vent". After doing that you might better understand why we're doing what we're doing.

[Rnis, BSN, DNP, APRN, NP]

I don't I would ever feel comfortable participating in that type or relationship. even with work related stuff.....I would only share stuff I would be comfortable mgt knowing. interesting concept though.....

On a more general discussion I have pondered for years that I could probably benefit from counseling regarding a high stress long term issue in my life..... can't bring myself to set it up. Too busy and too aware of how much goes into the medical chart....don't really want my business out there for every future nurse, provider, MA to snoop in when I go to the dr in the future. It's not even a 'secret' issue I'm pretty open about it.....I just like to be in control of what is shared and when it is shared.

[canoehead, BSN, RN]

I would thank my lucky stars for a psychologist on the unit to give extra support to families, or help us care plan and stay consistent. I would never divulge my own issues to someone at work. Ever. I've seen and personally experienced informal breaches of confidentiality that affected nurses' career. Just a small example...if the manager refers a nurse to talk to you about a difficult case, she does, and the manager follows up, asking you if the meeting occurred. You say yes, but have a concerned look vrs a bright chipper look. Now the manager wants to talk to the nurse, and there's not really the option of telling your boss to mind her own business. Things could get messy.