Maybe I'm not cut out to be a nurse?

  1. I just got off shift and I've been yelled at again. And, as usual, the person who yelled at me was not a patient, but a coworker. I am frequently the target of bullying -- I've been told I'm too nice. Tonight I got yelled at by a surgeon for reading back a telephone order, and then I got yelled at during report at the end of my shift for relating that a patient with osteomyelitis who is set to be discharged in a few days is now popping up with a fever and a MEWS score of 3. Apparently she didn't think this was information worthy of her time. She's a known bully and I was warned about her more than once.

    But the real issue is how I feel now. I just don't think I'll ever be the type of person to get yelled at like that and have it just "roll off my back." It's been 5 years since I passed my boards, and my skin ain't gettin' any thicker. Maybe I'm just not cut out to be a nurse? I've worked in rural hospitals where the need for nurses is high and an experienced nurse can act basically any way she chooses. How do you all deal with this issue of nurse/doctor bullying? Of being yelled at regularly and learning not to care. I get this sick feeling in my tum just thinking about it. I appreciate any coping advice you might have, or even just to know I'm not alone in this.
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  2. 12 Comments

  3. by   meanmaryjean
    Your repeated use of the term 'yelled at' makes it hard to know exactly what is happening. Are these people literally raising their voices and YELLING at you? What are they saying exactly?

    Because in my experience, many people interpret being challenged or asked to clarify as 'being yelled at'. I get it. It puts you on the defensive- and it feels like when you get yelled at. And that emotional response makes it hard to process what is happening and formulate a response.
  4. by   JKL33
    I have dealt with a little of what you describe, but not much. I do think it has to do with how one presents him/herself to some extent (and that's not to say that the rudeness is okay, either way).

    I am concise when speaking with peers or providers. Cadence and tone of voice are professional/business. I used to write out my part of the conversation/report when I was new (I know you're not new), this helped me gain confidence with these types of interactions.

    You say people have told you you're too nice. It's unfortunate that we tend to conflate lack-of-assertiveness with "niceness." It makes it seem like there isn't a middle ground, but that's incorrect. There certainly IS a middle ground. I call it pleasantly assertive. It's not martyrdom and it's not aggressiveness. It's right in the middle. People that are called "too nice" aren't being helped by being repeatedly called that - - and sometimes it's not even "niceness" anyway but rather fear/timidity/lack of self-esteem.

    This is one of those growth opportunities. These bothersome experiences happen in nursing, but they happen out in the every-day world, too. You sound like you are tired of it. The only solution is to change the part of it that YOU can change. You can't change them, you can only adjust yourself. People who let these things "roll off" aren't really not noticing them, we're just choosing not to let them control us/our emotions. It takes a lot of work for some of us. You can do it too.
  5. by   WonderLinds
    This is so helpful. Thank you! I'm going to be more intentional about my body language and tone of voice when I speak to my colleagues and make sure I'm sending the right message.
  6. by   WonderLinds
    You're right. The nurse didn't literally shout at me. She did raise her voice, but I wouldn't say shout necessarily. She was angry with me for reporting my concerns about new fever in the patient, and said "It's too early in the morning for this ****." And "Honey, don't talk to ME about fevers" whatever that means. He was an osteomyelitis patient about to be d/ced home in a few days. He's literally had six weeks of antibiotics -- shouldn't new onset fever and tachycardia with sweats and chills be given in report? I don't get it.
    The surgeon raised his voice also, but not shouted per se. I was reading back an order over the telephone and he told me I could "Put whatever the hell you want!"
    Last edit by WonderLinds on Aug 25 : Reason: more detail
  7. by   JKL33
    Sounds like your co-worker woke up on the wrong side of the bed. DEFINITELY let that go. Poof. Gone. She can bellyache into the atmosphere all she wants and it has nothing to do with you. Don't absorb it. Continue on with a business-like report. Everyone knows who people like this are - - they're only kidding themselves if they think they are making others (such as yourself) look bad with their protestations and grumbling. They are making themselves look foolish.

    Physicians - when you call them, concisely tell them why you are calling, including any pertinent facts. Know ahead of time what outcome you might anticipate. Is there a particular med order you are expecting, or a change in care order? At the end of presenting your problem, you can say something like, "how would you like to handle this?" or "would you like to treat this?" They need to answer appropriately. I never huff and puff no matter what they do. I will not let them get a rise out of me. If a physician said something to me like "put whatever the hell you want", I chuckle and use my friendly voice and say, "If I were allowed to do that I wouldn't have called you! What order would you like?" OR this:

    Me: "Let me repeat that back: You would like Lasix 40 (four zero) mg IV push to be given now?"

    Doc - "Write whatever the hell you want!!!!"

    Me: "Yes or no. Lasix 40 mg IV push to be given now."

    ***

    Carry yourself with dignity. Work at a brisk pace, keep your chin up, make good eye-contact, smile and say hello to others as you pass in the hall. Start to develop a pleasant and humble self-confidence. Recognize the good that you do and let it be an encouragement.

    Recognize that others' difficulties (and maladaptive behaviors) exist on a separate plane from your emotions.

    That's about all I've got...
    Last edit by JKL33 on Aug 25
  8. by   caffeinatednurse
    The person above me posted some very good advice for both situations.

    I would also add that you're going to encounter all sorts of personalities in nursing - some very good, helpful, and kind. And some not so good - the types that you find yourself thinking, "Why did he/she even go into nursing?" I encountered one particular nurse that liked to talk over me during report - literally, I was trying to tell her about my patients, but she would progressively get louder and louder until she WAS yelling at me. I would stop talking until she was finished, and then continue on with report as if nothing had happened. It drove her nuts, that she couldn't get a reaction out of me. Eventually, she learned that she couldn't talk to me that way, and that I was going to get through my report no matter how loudly she talked over me.

    At my last workplace, I had several on-call providers become snappy, condescending, and even hang up on me. I wasn't calling for just anything, either - I was calling because I had concerning X-ray results from radiology, or new onset crackles bilaterally, or purulent drainage coming from a surgical wound. You get the picture. One evening, I had a provider snap at me over the phone, and then hang up. Guess what? I called her back and finished giving her my assessment. I also politely reminded her that I could simply wait a few hours and then address it with another on-call provider. When I was finished, she gave me new orders and encouraged me to call back if I had any questions or concerns. I never had a problem with her after that. You often end up teaching people how to treat you.
  9. by   WonderLinds
    This is so true! I wanted to give an update on the amazing shift I had tonight and how all of your advice helped me! I really appreciate the help
  10. by   Guy in Babyland
    I have had a few doctors (before getting into nursing) that do a "backbone" check. They will yell at you for doing or not doing something. If you come back with a logical reason for your action, you earn their respect and they treat you much better.

    When the surgeon yelled about you reading back his order, you need to stand up to him. "I am required to readback your order, per policy, to ensure that I heard the order correctly. If you have a problem with it, take it up with administration."
  11. by   raindrops1234
    Quote from WonderLinds
    You're right. The nurse didn't literally shout at me. She did raise her voice, but I wouldn't say shout necessarily. She was angry with me for reporting my concerns about new fever in the patient, and said "It's too early in the morning for this ****." And "Honey, don't talk to ME about fevers" whatever that means. He was an osteomyelitis patient about to be d/ced home in a few days. He's literally had six weeks of antibiotics -- shouldn't new onset fever and tachycardia with sweats and chills be given in report? I don't get it.
    The surgeon raised his voice also, but not shouted per se. I was reading back an order over the telephone and he told me I could "Put whatever the hell you want!"

    I think you were in the right for reporting that. Honestly, it sounds like she was having a bad day so I wouldn't take it personally. And some people are just silly- oh it's too early for people to be sick in the hospital this morning? No. Haha. I was at work last week, doing research on my patients shortly after 0700. Nurse comes in and all I hear is "f*** that, f*****, I can't believe I have to give chemo first day back from holiday." I didn't say anything, just kept hunched over, but seriously?! You work on a oncology floor-what do you expect to be doing at work?!?!?!

    And as for the surgeon yelling at you-I always repeat back telephone orders....unless it is something like just tylenol. But I am a new nurse and it's my license on the line if I don't get the orders correct so.....I ask them to slow it down for my if I don't understand what they are saying. I am usually very open with being a newer nurse and I am always very friendly so normally the doctor's aren't too bothered by taking the extra time.

    I hope things get better for you! There is a lot of good advice here!
  12. by   morganm_0819
    Quote from JKL33
    I have dealt with a little of what you describe, but not much. I do think it has to do with how one presents him/herself to some extent (and that's not to say that the rudeness is okay, either way).

    I am concise when speaking with peers or providers. Cadence and tone of voice are professional/business. I used to write out my part of the conversation/report when I was new (I know you're not new), this helped me gain confidence with these types of interactions.

    You say people have told you you're too nice. It's unfortunate that we tend to conflate lack-of-assertiveness with "niceness." It makes it seem like there isn't a middle ground, but that's incorrect. There certainly IS a middle ground. I call it pleasantly assertive. It's not martyrdom and it's not aggressiveness. It's right in the middle. People that are called "too nice" aren't being helped by being repeatedly called that - - and sometimes it's not even "niceness" anyway but rather fear/timidity/lack of self-esteem.

    This is one of those growth opportunities. These bothersome experiences happen in nursing, but they happen out in the every-day world, too. You sound like you are tired of it. The only solution is to change the part of it that YOU can change. You can't change them, you can only adjust yourself. People who let these things "roll off" aren't really not noticing them, we're just choosing not to let them control us/our emotions. It takes a lot of work for some of us. You can do it too.
    I agree with this whole heartedly and it is something I myself am working on. 2.5 years of being a nurse and I am either too timid at times, which causes me to bottle things uo until I snap, or just find myself miserable at work. Thank you for posting this response, its something I needed to see.
  13. by   RNNPICU
    OP.
    I think the nurse who responded as they did especially with the "it's too early..." Maybe they were wanting to have a smooth shift and now with a fever,e tc they are thinking it is going to be a busy shift. Maybe with her response for the don't talk to ME about fevers, there is probably a back story or something else unrelated to your report.

    For the MD, I would just repeat the order and ask Yes or No. thank you.
  14. by   ILUVERNSG
    Great advice! OP: please consider doing some assertiveness training.
    Quote from JKL33
    Sounds like your co-worker woke up on the wrong side of the bed. DEFINITELY let that go. Poof. Gone. She can bellyache into the atmosphere all she wants and it has nothing to do with you. Don't absorb it. Continue on with a business-like report. Everyone knows who people like this are - - they're only kidding themselves if they think they are making others (such as yourself) look bad with their protestations and grumbling. They are making themselves look foolish.

    Physicians - when you call them, concisely tell them why you are calling, including any pertinent facts. Know ahead of time what outcome you might anticipate. Is there a particular med order you are expecting, or a change in care order? At the end of presenting your problem, you can say something like, "how would you like to handle this?" or "would you like to treat this?" They need to answer appropriately. I never huff and puff no matter what they do. I will not let them get a rise out of me. If a physician said something to me like "put whatever the hell you want", I chuckle and use my friendly voice and say, "If I were allowed to do that I wouldn't have called you! What order would you like?" OR this:

    Me: "Let me repeat that back: You would like Lasix 40 (four zero) mg IV push to be given now?"

    Doc - "Write whatever the hell you want!!!!"

    Me: "Yes or no. Lasix 40 mg IV push to be given now."

    ***

    Carry yourself with dignity. Work at a brisk pace, keep your chin up, make good eye-contact, smile and say hello to others as you pass in the hall. Start to develop a pleasant and humble self-confidence. Recognize the good that you do and let it be an encouragement.

    Recognize that others' difficulties (and maladaptive behaviors) exist on a separate plane from your emotions.

    That's about all I've got...

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