How do you develop a thick skin?

  1. I know that it's important to have a "thick skin" as a nurse, but I just don't. I tend to be pretty sensitive when people are outright disrespectful to me. Not so much the people I'm caring for. More so peers and superiors. This is something I know I'm going to have to work on, I just don't know how.

    Today was a real eye-opener for me. My professor was very rude to me for no reason. I mean just downright mean. I won't go into details, but I wasn't the only one who thought he crossed the line. It wasn't because I did anything stupid or anything. The only thing I can figure is that he was just in a bad mood.

    Anyway, I was able to stay composed long enough to get to the bathroom - where I balled my eyes out. Now I'm afraid that I'm too emotional for nursing. I know it's a tough profession. How can I develop a thicker skin?
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  2. 15 Comments

  3. by   nptobee
    belabelisa, I too am very sensitive. You are sooo right that you have to develop a thick skin in nursing. I trying to do that right now. I've been a nurse since February, the way other nurses, and docs can treat you is so sad. It may not be the best advice, but I find it's better for me to get angry instead of getting sad. Too much sadness hurts my soul. The other day I was in a procedure with a doc and he told me to move, and banged on the stretcher. Move! like I wasn't going fast enough. It was my first week on my own and I was trying. Anyway I politely said, Dr. -- I'm moving as fast as I can, and looked him in the eyes. I wanted to burst into tears but saying that soothed me.

    Try not to take it personally, most times you'll find that the offender treats everyone that way. Maybe they are just miserable. I'm working everyday to stop swimming in emotion and feeling.
    I'd like to hear how others are doing it too.
  4. by   belabelisa
    nptpbee, thank you so much for your post. It's good to know that I'm not alone in my sensitivity. I understand exactly what you mean when you say that it hurts your soul. That's the way I feel. It's so much more than being offended or upset... my soul actually hurts when things like this happen. I just don't understand why people have to treat other people the way they do. It makes me so sad for humanity... does that sound silly? Anyway, it's ironic because my sensitivity is what lead me to a caring profession in the first place and now I feel like I have to overcome it. My good friend brought up a good point today. She said that it's my sensitivity that will make me a good nurse because I am able to empathize with other people and I truly care for others. So, I guess we don't really want to overcome the sensitivity completely.

    I'd actually be okay with feeling hurt, as long as I could keep the tears in. I'm am so afraid that I'm going to cry in response to a mean comment by a doc or something. What a great way to lose respect. I don't worry about how I'll react to mean patients. I've been in situations in the past where I had to care for disrespectful and mean people. In those situations I can accept that they are just at a certain point in their lives and it's my job to care about them regardless. I just have a very hard time with mean peers and superiors.
    So, I guess I just need to think of how I can react to those situations. Maybe I could focus on saying one brief, strong comment and leaving it at that. I like your response to the doctor who rudely told you to move. You made a simple, strong comment and ended it there.

    Anyone else have any ideas? I'd love to hear them. Clinicals are starting soon and I'm sure I'll encounter many opportunities to practice my reaction then!
    Last edit by belabelisa on Oct 13, '05
  5. by   MIA-RN1
    I don't know what to say to help but if it makes you feel better I cry at the drop of a hat. Seriously. At work a coworker told me someone had told her that I said some nasty stuff--all lies--and before I could even think straight enough to realize that it was all lies, I just sobbed and sobbed like a baby, in front of my coworker and new boss. I felt so hurt and betrayed I guess.

    I had a patient who was admitted into ER and she had cancer and was just wonderful with this glowing fighting spirit and I cried when we talked. Not a lot, but a bit teary. Because I thought she was beautiful.

    I even got wobbly in class today, watching a video of a birth.

    My kids have found me reading a great book and crying all during the good parts.

    I don't even go to movies that could ever possibly have love stories with happy endings, weddings, or intense emotional scenes.

    I can only wonder what will happen when I am out there next year and a doc talks rudely to me. Ah well, you are certainly not alone.
  6. by   JenNJFLCA
    I am slowly growing a backbone as I go through the program. For me, assertiveness won't be there till the confidence is. That's the way I am and I can't change overnight. It has been a very slow, frustrating process. You just have to keep your chin up and not care what other people say or do.
  7. by   bluesky
    Well, I have been a nurse for about 1 1/2 yrs now and when I started off I was really quite sensitive. In fact, I am sure there are posts on this very forum that I composed along those lines when I was back in school.

    The truth is that negative feedback will always hurt but as time goes on, each sting is a little less unbearable and doesn't last as long.

    That's my truth, at least.
    Last edit by bluesky on Oct 12, '05
  8. by   Race Mom
    I am not a nurse yet, but you already said something that could hit a nerve... Just say "humanity" and shake your head, in a disappointing way. That would make me think twice, but I'm extremely sensitive too! I also don't know if it is crossing any lines, but my rebuttal would be...THEY crossed the line, I just responded to it in a simple, non threatening manner.
    I need sleep!!!
    Lisa
  9. by   MissJoRN
    I tend to stand there only half listening saying "la-la-la-la" to myself, say something annoyingly calm (but still maybe a little meek) "OK, I'll remember that, my IV needs to be hung now", then cry in a stairwell if necessary. (hopefully you're on a high floor so you're least likely to have passers-by) Once I shared a crying step with a resident, LOL. I rarely did make it to crying, just the "la-la" phase. It's hard for me because I tend to be very defensive and want to explain what I did, why I did it, why I don't understand it was wrong, or who told me I shoul do it. So I often tend to say something very weak instead to stay out of more trouble! OR is nice because we have masks and once you master keeping your eyes neutral (they can say a lot!) you can stick your tongue out at people! What's fun is that very often if you remain very calm (la-la-la), the person yelling at you looks like an idiot... you'll be surprised at who will point this out to you, LOL. It looks like you're taking the high road, when really, you're just working to hold back the tears
  10. by   snowfreeze
    I have been a caring and sensitive nurse for 12 years now. I still cry, I am a patient advocate but don't get personally involved with patients and families. The thick skin theory is maybe more knowledge in what is end of life issues and what is acute and critical issues. Everyone dies eventually, letting go after a brief period is harder than letting go after a long downslide in health. I am always a patient advocate.
  11. by   llg
    As an experienced nurse who has worked with a lot of "thinned skinned" newbies ... my suggestion is to focus on the patient's needs.

    There is nothing wrong with having feelings, being empathetic, shedding a few tears, etc. However, it becomes a problem if it interfers with your ability to provide care for the patient and/or disrupts the care provided by others. If you "fall apart emotionally" you are not able to help the patient and may become a burden to your already overworked colleagues.

    When you feel yourself starting to get very emotional about something, take a deep breath and assess the situation. Focus on what the patient needs and/or what will help the situation. Focus on serving the patient's needs and/or on a strategy for dealing with the difficult interpersonal situation (or whatever). Have you feelings, acknowledge them ... but stay focused on acting in a way that will be of use. That is what you are there for.

    Ignoring your true, spontaneous feelings usually isn't a good idea ... nor is always getting angry ... or always ignoring the negative ... or always making a joke of it ... or always anything. Each situation is different and you need to develop a variety of responses to suit the different types of situations. But one thing is almost always true: you (and your patients) will almost always be better-served if you focus you mind on meeting the needs of the patient. In the short-term "heat of the moment" that's a practical strategy that will help you through a difficult event.

    Another tip is that most emotional situations are easier to resolve if you can find a way to diffuse the strong emotion rather than escalate it. By focusing on problem-solving (and/or tasks to complete), you can often steer your attention away from the strong emotions that are impairing your ability to think and act at your best. Once your emotional self is no longer "running out of control," you will be better-able to find an appropriate way to express those emotions and resolve the situation.

    llg
    Last edit by llg on Oct 13, '05
  12. by   Sheri257
    One of my instructors was giving me such a hard time, I was going to go to the head of the nursing school. But I figured I better talk to her first. When I confronted the instructor, she said she was just "joking." I said it didn't look that way to me and that I didn't appreciate it.

    She hasn't bothered me since. People only treat you badly if you let them. Standing up for yourself is the best way. Just because we're students doesn't mean we have to take bad treatment. And I'm one of those people who just can't tolerate bad behavior.

    A lot of people are scared to talk to instructors about these things, but it really is the best way to resolve the situation. That's what worked for me.

  13. by   Newbie Nurse SMP
    Oh Gosh... You all are scaring me! I am just in A&P 1 now and won't be starting clinicals until next year, but I am as sensitive as they come! I cry at the drop of a hat. And I didn't even think that I would have to deal with people being nasty on top of dealing with the fact of trying to learn Nursing. I seriously can't even get a bad look without getting upset.

    I don't know what I am going to do once it is my turn to do the clinicals.!!
  14. by   belabelisa
    These suggestions are wonderful. Thank you all so much. MissJoRN, I love the "la, la, la" idea and I will seriously try sticking out my tongue with a mask on one of these days! :chuckle

    Llg - your input is very helpful. I think it will REALLY help if I make it a point in tough situations to think about my #1 priority (the patient) and to focus on problem solving.

    I hate it that sensitivity is seen as a weakness. I hate it that tears are seen as a weakness, while anger is often accepted and even seen as a strong expression. It's funny that many people who talk about others being "emotional" are very emotional themselves - they just express the emotion in other ways (i.e. anger, stress, etc). I'm not ashamed of my tendency to get teary. I don't think that my tears are inappropriate or that crying is a sign of weakness. However, I realize that I exist in a society that does. If I don't want people to see me as weak and "emotional", I will have to suppress my normal reaction to being hurt. I hate it, but that's just the way it is.

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