Why nurses don't want to talk to a ward psychologist? - page 5

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... Read More

  1. by   JinnSchlajfertig
    I say this as a nurse and someone who will soon be starting my first psych ARNP job who also has a degree in Occupational Health Nursing who us very into employee mental health issues.
    Ditto what others have said. We have CISM which is a peer-run program, that responds to critical incidents. It is geared towards the correctional officers who are accustomed to accessing that service. But I don't think nurses use it that much, but it's confidential, so who knows. Maybe if a nurse was on the CISM team...
    Which brings me to the OP comment about nurses getting support from psych after a med error.
    I would never go to psych for support after a med error. I had a med error, was mortified, and other nurses stepped up to help me frame the experience in a healthy way. Just knowing that other nurses (who I looked up to for being highly competent) had similar experiences helped me to get through it. A psychologist doesn't pass hundreds of meds every day and can't know the pressure that brings and the visceral, gut-churning horror that a med error evokes. So unless the OPs med error recovery program has nursing input, I doubt people will access it. Maybe a better route would be to set up a peer support program. Or training for managers to help staff nurses through common issues like that.
  2. by   mariahlily
    Has anyone said they trust their employer yet?

    I like my current job. My coworkers and charge nurses are all kind. The nurse managers are supportive

    However, my first real nursing job was a train wreck. That particular institution did a whole song and dance number about how they wanted to lift us up and support us when we made mistakes--they didn't want to punish us.

    That's what they told us during orientation and staff meetings. But the culture was very much one of thinning the herds. Even minor mistakes on my part (like accidentally putting my initials on the wrong space on a form) were framed as a "lack of critical thinking skills." When one of my nicer, most helpful coworkers was such suddenly fired, and no one else showed any emotion about her departure, I knew to watch my back. Actions speak louder than words

    If your institution is trying to verbally reassure the nurses that they can talk to you with impunity, they need to show their trustworthiness first. Managers and charge nurses have opportunities every single day to show the nurses that they're on their side. They need to do it, and keep doing it to gain their staff's trust

    Btw why is it that you trust this place? I have to wonder why they specifically want nurses to talk about "mistakes"

    There are a 101 ways to get stressed out at work: bullying, patient deaths, exhaustion, anxiety, grief.

    but if management is only expressing interest in getting nurses to open up about medical errors, it's a sign that this is out of interest for the institution, not the employees
  3. by   3ringnursing
    I think bottom line is people will only open up to those they perceive care about them as a person. Good intentions just aren't enough - because most humans have become jaded and suspicious, and not without cause.

    Perhaps it's an evolutionary behavior that has kept our species alive over the millennia? Our trusting ancestors were eaten by sabertooth tigers, and other predators leaving only the more paranoid, sceptical and misanthropical bipedal homo sapiens to breed? Whatever it is, it is an almost visceral response that seems to be shared by the masses.

    Guard thy arse.
  4. by   JKL33
    Quote from mariahlily
    Btw why is it that you trust this place? I have to wonder why they specifically want nurses to talk about "mistakes"

    There are a 101 ways to get stressed out at work: bullying, patient deaths, exhaustion, anxiety, grief.

    but if management is only expressing interest in getting nurses to open up about medical errors, it's a sign that this is out of interest for the institution, not the employees
    I thought the same thing. "Gee, that's kind of an odd stressor to hone in on when there are things like angry/stressed/demanding parents...." - - which is a far more frequent stressor (by orders of magnitude) than medication errors for any given nurse individually.
  5. by   Green Tea, RN
    When I was working on med-surg for my first nursing job, a nurse educator came to see me after my shift frequently as part of my residency program. She was not a psychologist, but I can kind of relate her to you.
    I honestly didn't like that she came in after my 12 hour shift. Every time, I was exhausted mentally and physically and just wanted to go home and rest. Because of that, I tried to finish every session with her as short as possible. I tried not to bring up any issues or concerns from my side. I acted like everything was fine in front of her.
    At one time I was very tired during a session with her and without thinking much I blurted out that having seven patients was too much. She then quickly change the subject. Since that time, I became not to want to see her much more.
    I think, in general, nurses are aware why nursing is mentally and physically exhausting. The reason is obvious. And often times, the solution is not a therapy.
  6. by   elijahvegas
    nope. the basic idea comes from something i learned from dealing with women--family and romantic relationships.

    when people complain, they dont want advice, 99% they just need someone to listen to them vent.

    so if i need to vent, i dont really need to do it to someone who will understand every aspect of what im complaining about. i just need someone to hear me and tell me things will be okay. and thats what a support system is for. friends, family, some random at a bar even.

    id rather not have someone from my place of employment know that im bad at my job haha
  7. by   PANYNP
    Our hospital's team of psych clinical liaison (psych CL) nurses, whose primary role is to tend to hospitalized inpatients related to emotional and spiritual concerns, also is available to groups of staff for critical incident stress debriefing, such as following a "bad" code, or issues with abusive patients or families.

    I don't believe I've heard about individual counseling, though, for all the reasons listed by everyone else.
  8. by   akulahawkRN
    Aside from mandated CISM debriefings, I won't typically talk to a staff psychiatrist or psychologist while at work regarding issues of a personal nature. As others here have stated, we just usually do not have time to do it and I'm no exception to this. For that matter, I won't ask our medical providers about a personal medical issue for the same reason. If there's something that's immediately pressing, I may ask a provider for a recommendation about who to go to for a given issue but that's as far as that goes. For mental health stuff, I'm also like pretty much everyone here. I would choose a mental health professional that's not work-connected because too often word gets around and jobs change. I would normally want a provider (medical or mental health) to be separate (and take several different insurance programs) so that if I had to change jobs, I could generally continue seeing the provider for my health. It makes for better personal privacy and better continuity of care.

    Now if I got sick or injured in some way and I had to go to my hospital's ED, I wouldn't mind as they're really good people and they genuinely care about their co-workers. I would, however, just simply prefer that my work not be my source of primary medical or mental health care.
  9. by   Orion81RN
    Quote from chacha82
    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.
    EXACTLY!! He/She ALREADY gave up too much info even discussing this with the "head nurse." NOT OK
  10. by   Here.I.Stand
    Quote from 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.
    Speaking for myself, it has nothing to do with not wanting to learn or being satisfied with my minimum. It has EVERYTHING to do with having a full SMORGASBORD. (I stopped having a "full plate" years ago.)

    On weekends I am an extremely dedicated and passionate RN.

    During the week I'm a SAHM to five kids. One of my girls has gymnastics 3x a week, and meets a couple times a month. My oldest daughter is more into endurance-type sports and works out 6x a week. My oldest son is into music and has weekly piano and voice lessons; two girls are also in orchestra. My husband is usually at the office until 7 p.m., and overnight for work at least once a month -- typically 2-10 nights. My kids attend four schools, and because they are open enrolled outside the district, I drive them all. And then of course is the small task of feeding and laundry for seven people, and helping with homework prn.

    Feeling frazzled yet?

    My work is a 30-40 minute drive depending on traffic, and weekday parking is $10. So say my take-home pay is $30/hr, minus the $10 and gas.
    Plus, the time and gas incurred by having Grandma babysit the preschooler while I am gone. All things considered, I can't justify the drive for a 1-2 hour inservice when I have access to CEUs from home.

    Community outreach? I don't even have time to shower some days! (Unless I want to be up after midnight.) To assume that everyone's reasoning is apathy, that is a very simplistic assumption. And you know what they say about assuming!
  11. by   Here.I.Stand
    And OP, I'll echo what others have said. I would welcome something like a critical incident debriefing, and I'm sure you are an asset for difficult families....but discussing my professional difficulties with a psychologist? I am pretty busy doing my JOB, and if I do have time, I would much rather take a BREAK. It's like other non-RN professionals in the unit; I don't stop my duties for PT/OTs, chaplains etc to teach me either.
  12. by   SmilingBluEyes
    Take my personal problems to my employer? Never, ever happen. I have had therapy, always at my cost with someone in no way attached or having interests that protect or relate to my employer.
  13. by   NunNurseCat
    I too agree with these unanimous responses. It's a matter of the perceived risks outweighing the benefits. The last thing any of us want to do is bring attention to ourselves for the wrong reasons, and seeing a psychologist at work would be risking exactly that. Add the time cost and the choice becomes clear. Edit: Assessing risk is part of our job, and what we see in this thread is that a group of nurses spread far and wide all ran their own risk analysis and came to the same conclusion regardless of location or employer.
    Last edit by NunNurseCat on Nov 6 : Reason: To edit of course.