Becoming more assertive

muffie, RN · Dec 7, 2006

NO is the greatest 2 letter word i have ever learned

we are all works in progress

practice practice practice

IaCountryGirl · Dec 7, 2006

As the other person said, practice using the word no. And don't give specific reasons as to why you can't. It's none of the other person's business truthfully.

When you say no then give a reason as to why you can't, you give the other person the opportunity to come up with ways to get around your reason, thus hounding you until you finally give in.

Practice on people now. Eventually the guilt will go away. A lot of the kids I work with want me to cover their shift on my day off (i only get two per week) because they have some sudden drama. But those same kids always have some sort of drama and besides that, they are always complaining they have to work and want to leave early. Sometimes I feel bad if one of them might miss a band performance but I know THEY brought it on themselves so why should it be my duty to help them out? They will never learn that way.

OTOH, I have covered shifts for people when I really did not want to but knew it was the right thing to do because of their circumstances. And they have helped me out in the past.

Daytonite, BSN, RN · Dec 7, 2006

hi, dorselm! well, i was kind of like you, and kind of not like you. i came from a home where my mother was a very strict disciplinarian. we towed the line or got "the belt". consequently, around others i didn't know i was very quiet and anyone who was an authority figure could just walk all over me. with my younger brothers or sisters, however, lookout! once i got a little authority and confidence myself i became a lot like my mother, something i learned very quickly wasn't going to be tolerated in any workplace. it was a very rude awakening and a long road of education for me. i had to take a class in communication skills as part of the required curriculum for my bsn when i went back to school. we were taught principles of assertiveness in the class as well as had a weekly lab where we acted out scenarios and practiced these skills on each other. i also over the course of my career have taken several classes in how to handle difficult people, which is where assertiveness skills are often used. the best practice i got, however, was working in nursing homes and having to deal with all kinds of problems with nursing assistants, now called cnas. i had to deal with any number of them that were insubordinate, mouthy, nasty, outright bold and any number of bad behaviors that had to be confronted and discipline applied. after being walked all over a couple of times i started looking back through all the written materials i had accumulated on the subject over the years. i took one problem person at a time and practiced in my mind the assertive phrase i would say to them the next time they gave me grief--and they usually did. the first time i confronted someone, it was hard. my heart rate probably jumped to 150. i'm sure my words didn't sound real clear--at least not to me. but, the person responded the way all my written materials said they would. i just continued doing this. after awhile it gets easier because you don't get the emotional reaction within yourself that you did the first time. that emotional response you get at first is a real killer. but, like any other skill, the more you practice and get mastery over it, the better you get at it. now, i can concentrate a lot more on my facial expressions and the tone of my voice because i know the words that i need to say to someone when confronting them. it also helps when you develop more confidence in your other nursing skills and knowledge. nothing deflates your ego faster than someone who can cut you to the heart by taking an unfair stab at you by bringing up any lack of knowledge or experience that you might have. dirty pool on their part, but it works.

what i'm telling you is that it is a learned skill. like any learned skill it takes practice. you'll mess up a few times when you first attempt it. the important thing, however, is that you get back up and do it again and again until you get it right. what makes this skill so difficult is that there is emotional involvement. after all, you don't want to hurt the other person any more than you have to. but, you know what i've learned over the years? those who you often need to confront about their behavior usually don't give a horse's patoot about your feelings to begin with. now, that doesn't mean you have carte blanche to dig in and turn the screws on them, but just keep that in mind as you contemplate making that first assertive remark to them in as respectful a tone of voice as you can make it. they wouldn't have been tromping all over you in the first place if they cared about your feelings, would they?

i've never had any other nurses trying to push off work on me that i can remember. i'd be the first one saying, "you're not splitting the work fairly!" have you been reading some of the forums where people are discussing this? i've had nurses who's patient's lights were always going off or their iv pumps alarming and they were no where to be found. that drove me nuts because i'd be running around answering lights and fixing iv pump problems because i couldn't stand the noise. what really irked me about that is that it wasn't going on with my patients so i couldn't go off somewhere and leave my patients problems for them to deal with!

New2ED · Jan 11, 2008

I think I have the same problem! It is even worse when you are in a new environment, out of your comfort zone and you are trying to prove yourself to everyone around that you are a good nurse and you know what you are doing. I often have say yes to things when I know I don't have the time for them and then I get stressed out trying to meet a deadline. Saying No sounds so easy but it is truely the hardest thing to say! I love working with people that are team players and if I say "NO" then how do I fit in to that equation?

In regard to dorselm I have found with the older nurses that are out to eat the younger ones, when you say no to them or stand your ground, you have proved yourself worthy in their eyes. If you show that you can be walked all over and talked down to then hang on for the long bumpy road!

aquarius1 · Jan 11, 2008

hello dorselm,

I can personally relate to your situation. Like you, I also find it hard to say NO, most of the time I would normally say Yes to this and Yes to that....coz I'd like to help and it gives me a good feeling. But lately, some people have taken advantage of my kindness and generosity, to the extent of making me feel as if they " own " me, as if I'm a robot under their control....so I thought why should I let these people continually treat me like this? I am a professional nurse, and I am where i am now not becoz of them nor their help but becoz I have studied and worked hard for this....I am no one's servant except for the patients.....since then I have learnt to say NO specially to people whom I know would only take advantage of it. Just say NO when you mean to say NO, it doesn't mean you're gonna be a nasty person, you're just being yourself and being wise. You can do it....

Alternator81 · Jan 11, 2008

Don't worry about the nurses-- they will just ignore you! Worry about your fellow students... nursing students are the most assertive, pushy, over-bearing, and competitive people on earth!

vashtee, RN · Jan 11, 2008

Don't worry about the nurses-- they will just ignore you! Worry about your fellow students... nursing students are the most assertive, pushy, over-bearing, and competitive people on earth!

Whoa! You sound very hostile. The students where I go in no way match your description.

Alternator81 · Jan 11, 2008

Whoa! You sound very hostile. The students where I go in no way match your description.

I'm really not hostile. It's true for my program. Group work is like The Apprentice .

llg, PhD, RN · Jan 11, 2008

For people who have trouble being assertive, think about it this way ...

When you DON'T stand up and be a strong advocate for what is right, you are putting your desire for emotional comfort and an easy life above the needs of the patient. That's being self-centered. If you really are as caring and compassionate as you say you are, you will dig down and find the strength to put your self-consciousness and anxiety aside and do what needs to be done to help the patients.

Now ... that perspective may sound a little harsh, but it contains a lot of truth. Most people are afraid to speak up because they are afraid that they will suffer some negative consequences if they do. They put their own self-interest ahead of what is best for the patients. That's not caring and compassionate: that's selfish.

As a nurse, you will have work to do -- work that is in the best interest of the patient. You'll need to do what you need to do to get it done and not worry about how you will look doing it ... or whether someone else will get offended by it, etc. Focus on the what the patients need and not your own self-consiousness. If you can do that, you'll probably be just fine.

New2ED · Jan 11, 2008

I am no one's servant except for the patients.........Aquarius1

Maybe I have a slanted view on this one but servant is not the word I think of when I describe my job. Patient advocate would be more like it. I think to often, administration especially, would like to think of nurses as servants but we are their to protect people and save lives, not fluff sheets and get beverages. Most of the people that go overboard with requests are the ones that have family members in the room who are completely competent or can do it for themselves! Don't get me wrong, I will do what it takes to get the job done and for the most part go above and beyond but I am no servant!

phoenixfire · Jan 12, 2008

My point of view on this subject is a tad different than the other posters. I think that it takes all kinds of special people to become nurses, and while you should never allow yourself to be trampled on, that quiet nature of yours may be your salvation later on.

I'm the opposite type of person: I take charge without thinking, do what needs to be done without asking or being asked, and have rarely had a problem standing up for myself or anyone else who I felt deserved it. My problem is that sometimes I can be a wee bit over the top. For example, one of my best friends is moving this weekend, and I've organized her kitchen, set up her bathroom, directed furniture, made half a dozen phone calls, and helped get her kids set up in school. Now, some people might say that I'm overstepping my bounds, but I think I'm just being helpful. Because my friend is so easy going (nothing upsets that woman!) she just sits back and lets me do my thing, because she's known me for years, and she understands that this is just how I am, and that I really am just trying to help.

What I'm getting at is that it takes all different types of personalities to make a work environment function, so while you are practicing being more assertive on your patient's behalf, don't try to change yourself for the sake of anyone else. You are who you are, and you will find a way that works for you. Whether its a sweet smile while you say "I'm really busy right now, perhaps later", or "I'll think about it and let you know", be who you are, and let the rest of the people around you deal with things their way.