Why nurses don't want to talk to a ward psychologist? - page 6

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   Irish_Mist
    Nope, nope, nope.

    I don't want my employer having any kind of leverage over me.
  2. by   Gods_nurse
    Quote from BCgradnurse
    No way. I keep my work and personal life separate, and if I need psychological help I would go elsewhere. Like it or not, these is still a lot of stigma attached to mental health issues.
    A LOT of stigma. In fact, I think nurses are the worst at it!!
  3. by   Gods_nurse
    Quote from Here.I.Stand
    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!
    How do you do that and remain sane???
  4. by   nursemike
    I think it is highly commendable of the OP to offer this service, but I'm not surprised not many take advantage of it. I was very open with my coworkers when I started taking an antidepressant, but then, nearly every time I have a conversation, people feel a strange need to bring up Three Mile Island (TMI). For the life of me, I don't know why they're so obsessed about it...

    Of course, depression (more dysthymia, in my case) doesn't carry quite the same stigma of some disturbances. But I was surprised as I learned how many of my coworkers were taking some sort of psych meds, and even moreso what some of them were for. Someone whose composure I had always admired (and still do) confiding needing anxiety meds from time to time. Genuinely fun people also on antidepressants. I sometimes joke that the Earth itself is bipolar--but so are a surprising number of its inhabitants. Now, I'm extremely lucky to work in a culture that's about as supportive as anyone could hope. When I was a brand new nurse, I'm sure not everyone was personally committed seeing me succeed, but most were, and none wanted to see me fail. Coming back after a lengthy medical leave, EVERYONE was supportive, and even now I get asked about twice a shift if I'm okay (sometimes I just need to sit a minute or two, but I'm okay enough.

    Thing is, I'm a guy, and while most of my coworkers are gals, they are also guys. Nurses are strong, because they have to be, and strong people tend not to admit readily to any sort of weakness. We might open up to a very close friend, maybe request prayers on Facebook, but to have it known we were seeking the help of a psychologist, or even a chaplain--well, that can seem a little weaker than we'd like to admit. I'm sorry so many responders on this thread doubt the confidentiality of their treatment--I don't. Snooping into someone's psych chart is a whole level of difficulty beyond looking up whether they have herpes. Still, sharing isn't easy for people who pride themselves on their independence.

    It's awesome that you offer this resource. After a beloved colleague of ours died suddenly and tragically, our management and our chaplains did their best to offer similar support. I don't think most of my peers appreciated it as much as I did, mostly because it didn't "work." Same with debriefing after a particularly hard code. We feel terrible before counseling, and we feel terrible after, and not everyone has accumulated enough life-experience to recognize the difference.

    ETA: Please do keep offering. The difference you could make to even one person, someday, seems worth it. And just knowing you're there means more than you might think.
  5. by   Kooky Korky
    Quote from seaofclouds21
    I agree with Scottishape. If I wanted/needed to speak with someone, I would seek someone outside of my employer (preferably in a different health care system).
    Of course, the employer can see your medical records since it is paying for your insurance, if yo use
    employer-paid insurance.
  6. by   nursemike
    Quote from Kooky Korky
    Of course, the employer can see your medical records since it is paying for your insurance, if yo use
    employer-paid insurance.
    Your employer and insurer can see billing info. If they're looking at your chart, it's a Federal crime.
  7. by   NunNurseCat
    Quote from nursemike
    Your employer and insurer can see billing info. If they're looking at your chart, it's a Federal crime.
    Well, it depends really. If charts are shared across a health system, and I am a patient within that health system, then someone can see my chart.
  8. by   nursemike
    Quote from NunNurseCat
    Well, it depends really. If charts are shared across a health system, and I am a patient within that health system, then someone can see my chart.
    If the CEO of your system looks at your chart s/he can be sentenced to six years in Federal prison. I'm pretty sure your PCP needs your permission to access your psychiatric chart. If you're saying someone CAN see your chart, that's probably true, but without a legitimate medical need to know, they'd be risking a lot, and it wouldn't be easy for a nosy co-worker to get into your psych records, even if they were willing to risk it.
  9. by   manjar
    There is a lot to think about after reading all the replies.
    I will try to comment and answer most of your posts.

    First, I have to say that generally my help with caring for families in distress was very well accepted by nurses and doctors on the ward.
    As I mentioned before, group settings didn't seem to invite nurses. What happened was, we gradually developed a trusting relationship with some nurses and when I think about it a lot of interventions was made through casual conversations - individual or in small groups. Sometimes they even want an advice about personal issues. But most of the times I am actually there to listen. It is obviously not surprising that some of you also proposed this kind of approach.

    I truly don't think there is anything wrong with taking to head nurse about this. We don't talk about concrete peoples' troubles. She is worried about overloaded nurses, nurses leaving and poor peer relations in some cases. In this light we think together about what can we do to make these issues better.

    Maybe there was a misunderstanding somewhere between all the posts. Talking to a psychologist after making a mistake is not a priority. But it is an option. The purpose is to relieve burden after a bad experience and to help bringing focus to future work.

    As for looking into personal files. In our hospital we all know that everything you look up is recorded.

    One of you asked if I go to a colleague psychologist talking about troubles I have at work. By all means, yes! Of course that is the first thing I do. That is before I go to my supervision session with another psychologist. Talking about issues which are hard for us is something that is highly recommended for keeping sanity in stressful work environments especially. Talking about difficulties is a good thing, helping to process what we experienced. Troubles which stay inside won't go away by themselves usually. They will build up and make us more an more vulnerable to stress. The first and most important step is admitting it is hard. I often encourage nurses and doctors to vent in whatever way they want. I do this having in mind that their venting will make it less possible they will behave inappropriate or even unprofessional with patients and their families. This is also the way to try prevent staff from burning out.

    I am really thankful for all your thoughts. But everything I read also worries me. I wonder how it is to work everyday in a place where there is so much mistrust and caution in interpersonal relationships. I am aware of mental health related stigma. But reading all this confirmed what I again almost forgot. A load of stigma is in the health system itself. I see that there is also a lot of misconceptions about what exactly a psychologist does and how he does it.

    Fear of losing a job is of course devastating. I live and work in a European country where maybe things aren't so harsh about this issue. I guess work culture is somewhat different here. It is not very likely to lose a job after making an honest mistake or having mental health troubles.

    So, to summarize .. I believe that some of the reasons you brought up are true in my case. Nurses don't want to seem weak. They don't want to spend extra time at work. They often have other ways of managing stress and vent. On the other hand those who have interest do contact me and share their troubles with me but in casual conversations. Maybe the core of my problem is the fact I want to make the best out of my resources and make my work more structured which is quite impossible in ED. I guess this is something I should stop worrying about.
    That said I will keep offering help, I will be present at the ward and try not to get frustrated if nurses don't use it as often as I think they could. To be honest I am less worried about nurses who work at the ward for longer time. But new, mostly very young nurses often leave the unit very quickly. They might have a bad experience and I believe they could be better taken care for in terms of coping with working in highly stressful ward.

    I can't tell you how precious this discussion is for me. My talk is next week and I definitely got additional inside by talking to you all.
    I do hope for all health workers to receive as much support they need and deserve. Only healthy people can really take care for the sick or injured.

    I am sure I will be seeking information advice and opinions on this site in the future.

    By the way, I love the joke about the Earth being bipolar

    Regards to all,
    Manja
  10. by   NunNurseCat
    I appreciate your efforts Manja, and yes please keep going. I will reconsider my own preconceptions on this subject. My fear has less to do with you, or any other psychologist for that matter, and more to do with who has access to the information. Out of curiosity what sort of records do you keep regarding encounters with employees, and who has access to them for legitimate purposes?
  11. by   pinkiepieRN
    I'm sorry if I missed this somewhere, but what is your *ROLE* as a psychologist on the unit? Is it to counsel staff or act as a clinical liaison between staff, patients and families? I guess it could be both but I'm wondering if you're trying to step out of your scope by being "helpful".

    Also, nurses are more likely to talk amongst themselves and commiserate about a common issue, looking for suggest or venting than they would to a psychologist, an outsider, a "non-bedside" clinical staff.
  12. by   JKL33
    Quote from manjar
    I am really thankful for all your thoughts. But everything I read also worries me. I wonder how it is to work everyday in a place where there is so much mistrust and caution in interpersonal relationships. I am aware of mental health related stigma. But reading all this confirmed what I again almost forgot. A load of stigma is in the health system itself. I see that there is also a lot of misconceptions about what exactly a psychologist does and how he does it.

    Fear of losing a job is of course devastating. I live and work in a European country where maybe things aren't so harsh about this issue. I guess work culture is somewhat different here. It is not very likely to lose a job after making an honest mistake or having mental health troubles.

    ........

    Regards to all,
    Manja
    Manja, it is clear that you have a genuine interest in this and concern for helping others. Thank you for sharing here.

    I just wanted to come back and let you know that I don't really think nurses in general have an issue with the idea of talking about their experiences or struggles. In the US our misgivings are probably almost solely related to the problem of "The Business of Healthcare" which is what our healthcare system is. Nothing is sacred if it affects the bottom line too much.

    Good luck with your presentation. I appreciate the way you have interacted here.

    Take care ~
  13. by   Axgrinder
    This:


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