How do you develop thick skin?

  1. This is a question for all. I've been told many times that you need to have thick skin to work in the OR and you can't take things personal.
    Ok so i was wondering how do you develop thick skin and how do you learn to not take things so personal? I'm already nervous as a new grad, new RN but i notice i get really nervous when someone snaps or yells at me. Because i'm not on my own yet i don't feel as stressed, but i know once i'm on my own and a surgeon or someone is yelling at me i'm afraid i'm going to go blank or freeze up or maybe break down and cry later on. I'm afraid i'm going to be too sensitive and take things too personal and go home crying after every shift. I know its inevitable and that i will have to deal with surgeons yelling, throwing fits and taking it out on nurses but i'm afraid i won't handle it well. I'm the type who normally doesn't talk back or give attitude. I believe in not feeding more fuel to the fire, just let it burn out on its own. I just hope that i won't be taken advantage of or walked all over having this philosophy. I had a nurse yell at me today for being in the way and now i don't even want to look or talk to her anymore. She's a dominant type who i thought was nice but now i see her in a different light. She's on my witch list now and someone i hope won't precept me. Would this be considered taking it personal?
    I would love to hear any tips, advice, words of wisdom, your experiences and what type of personality do you have. Please share. Thanks

    IsseyM
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  2. 34 Comments

  3. by   cardsRN
    don't work in the OR, but here's my take. long ago i decided that work was just that. work. it is not my life. i can be friendly and get along with everyone, sure, but i am not looking to make any lifelong friends there ( i have my real life for that). that helps in not minding when someone doesn't like you for some reason or thinks they are better than you/you're an idiot because you're new... etc. after awhile i began not to even notice the drama that occured around me. i didn't even know if someone didn't like me for whatever reason. i just do my job and remain out of the little gossip fuled back biting loop. may sound isolated, but it has saved me from stressing about being miss popularity. the nurse who snapped at you for being in the way- next time you work with her look her in the eye, be friendly and act like nothing happened. i bet she will too.
  4. by   IsseyM
    Thank you for sharing CardsRN. As i was reading your post, i realized i was like you with previous jobs (non-nursing). I went to work, did what i was supposed to do, stayed away from drama and went home. I didn't pay attention to those who didn't like me for whatever reason and ignored the ones who thought they were better than everyone else. I don't ever remember getting my feelings hurt or go home crying. Maybe i'm worrying more than i should. I think i'm just freaking out because i've never had a career with so much responsibility, so much information to process and memorize, etc etc. Its stressful as a new RN and you can't help but think the worst. Again thank you for sharing.
  5. by   TracyB,RN
    Aaahhhh, fooey on mean people... We all start somewhere. First off, you need to be confident. ACT confident, even when you're not. That will come with time.
    You are NEVER going to make everyone happy or like you, for reasons that may or may not be valid.
    Once you start to believe that your not-so-kind co-workers are just that, "co-workers" things will probably lighten up a little bit. Plus, it seems like the OR has a pretty high turnover rate & people that are experienced probably are just getting frustrated with training, training, training, to have people leave.

    One little hint that I have found to be the most beneficial when dealing with "attitudes".... be HONEST if you don't understand something. Pretending to get it when you don't can potentially negate any positive progress you have made in someone's eyes. They will wonder if you can ever be trusted. Plus, not being honest when you don't understand can be detrimental to the safety & well-being of your priority in the room... THE PATIENT.

    When you hear gossip, keep your mouth shut...no need to repeat it. If someone is ******** about something/someone to you, there is no need to talk about it.

    You say you got yelled at for being in the way.... When you are with a new person or in a new procedure... be honest, say you're not familiar with the procedure, prep, or whatever & ask your preceptor for the day "what can I do to help" & then do it. So much of OR work is based on getting the patient in & out, sometimes it's hard to take the few extra seconds to explain in detail what's happening when the surgeon is screaming at you.... Make a list of questions you have throughout the day & GET THEM ANSWERED. Each day is a learning experience & you are never going to please everyone everyday. You'll drive yourself crazy trying to do that.

    Do you have a clinical educator that can work with you? Take advantage of that. Ask to go in a lighter case, or a somewhat slower room where the circulator will have time during the case to answer your questions.
    I have learned from experience, that setting a goal for the day, telling the person you are working with your goal for the day, you will have a better chance of achieving that goal & start becoming more confident in yourself.

    The person you talk about in your OP was probably just as stressed.... could have been the day's cases, the surgeon, a bad night sleep. People are going to be crabby somedays....brush it off. I'd just about bet my right arm that it wasn't meant to be directed AT you & more directed at her frustration of trying to get the case going.

    Hope this helps a bit...
  6. by   jade-athyst
    I'm glad you posted this. I'm also a new grad and am having trouble developing "thick skin". My preceptor actually told me I needed to the other day. And I actually have cried on my way home, probably more nights than not. I even cried out on the floor one day (my preceptor was snapping at me that I was progressing too slow, on a day when I was extremely anxious and overwhelmed anyways.) I think I handled it well though. I calmly went into one of the private staff bathrooms, let some tears fall, took some deep breaths and got back to my patients. I wish I could figure out a way to keep from crying in the first place though.
  7. by   IsseyM
    GREAT TIPs TracyB!!! Very useful. I'm trying to look and act confident, its pretty tough though. I feel so lost and useless, more like i'm getting in everyone's way. Yes we do have a clinical educator. She is doing our AORN's Peri-Op 101 class. We don't have a choice on what cases we go into, whether they be easy or hard. She wants us to do all the specialties, so we can get a wide variety of experiences. Each of us in class are assigned to a specialty for 1 week to 4 weeks. EX. Neurology 4 weeks, Ortho-3 weeks, Ambulatory 1 week, etc etc. After we complete all our specialties she expects us to be on our own, but they will give us until next year of September if necessary. Actually the nurse who yelled at me was not in a room with a case. She was in the ladies room (LOL) and unfortunately i was in her way. Yes i do think she was stressed but i also think she was in a hurry to get out of there, who knows. All i know is she could of asked me politely but she had to be rude about it. I guess her parents didn't teach her manners. Oh well. I know i can't please everyone and that is not my job. Though it seems like at my hospital everyone is there to please the surgeons more than the patients. Again thank you TracyB, i will definately put your tips to use.

    IsseyM
  8. by   IsseyM
    Quote from jade-athyst
    I'm glad you posted this. I'm also a new grad and am having trouble developing "thick skin". My preceptor actually told me I needed to the other day. And I actually have cried on my way home, probably more nights than not. I even cried out on the floor one day (my preceptor was snapping at me that I was progressing too slow, on a day when I was extremely anxious and overwhelmed anyways.) I think I handled it well though. I calmly went into one of the private staff bathrooms, let some tears fall, took some deep breaths and got back to my patients. I wish I could figure out a way to keep from crying in the first place though.
    HI Jade. Congrats on being a new grad. Its tough isn't it? We're so used to being students, I know i am. I still feel like a nursing student and sometimes wish i could be...so i can get away with asking dumb questions. (LOL) They always told us in nursing school there are no dumb questions but i don't think so. Seems like when i've asked questions they look at me weird or ask or tell me, "You're supposed to know that already." My brain is fried from studying so much throughout nursing school especially my last semester (that was the hardest semester), then studying for the NCLEX and now studying to become a Peri-Operative Nurse. How in the world can they expect us to retain so much so soon. Its not happenin with me. I learn at my own pace not superman's pace. I wish i could give you advice on how to keep from crying in the first place but i couldn't tell ya. I guess it depends on how sensitive you are, how you were brought up, and how personal you take it. I was brought up with a strict intimidating military father who hardly showed emotion and never affection. I couldn't cry in front of him or my mother or i would definately get it big time, so i think thats one of the reasons i know how to hide my emotions. But i still see myself somewhat sensitive. I notice i'm more sensitive when its almost that time of month. I hate to cry but again its better to let it out than hold it in. Its ok to cry Jade and if you have to do it privately in the bathroom there is nothing wrong with that. Let it all out. Take care Jade and good luck with everything. Keep us updated.

    IsseyM
  9. by   nickola
    I've been doing this a long time, but I remember my days as a new grad. as though it were... 100 yrs ago!! Seriously, I was very sensitive- I was 22, looked alot younger, and felt like I was always defending myself. If a doctor TALKED to me I turned red as a beet- I cried over the littlest things- & I don't know when I developed a tougher skin, but I'd say it was about 2 yrs into it b/f I stopped taking everything personally & began to relax!! I remember the nurses who were less than helpful- and some were downright mean. The OR has alot of strong personalities, as well as the ER- & I'm sure other specialty areas I don't have knowledge of. It gets easier- give it time, learn all you can, and these people won't bother you eventually. Now I'm very comfortable & confident in my skills, & I can do my job w/anyone breathing down my neck- but it takes TIME. It'll happen, trust me. :wink2:
    Last edit by nickola on Sep 27, '06
  10. by   Marie_LPN, RN
    I remember the first time a surgeon started yelling directly at me about a scope that wasn't working right, THEN he started in with the words "stupid" and "incompetant" and i told him the truth "Calling me names and yelling at me lilke a dog is not going to fix that scope, but when you're finished doing that, let me know, till then i'm tuning you out." Now when (if) they rant and whine, i just keep looking at them, and nod my head saying "Finished yet?"

    I also used the phrase "i'm doing the best i can" whenever someone whined they weren't getting what they asked for (DEMANDED) within one second of asking for it. To some, it never occurs to them that it make take a few second to open the package and make sure the strip has turned before handing the item to them.

    As for the other nurses, i refuse to feed in or listen to the gossip. If someone starts talking about someone, if i can, i walk away saying "i don't have time for this." If i can't walk away, i'll say "Not interested, since what "Amy" is up to has nothing to do with Mrs. X, our pt. on this table."

    I typically take my lunch outside to the picnic table (if i get lunch) alone, since the breakroom looks like a scene from the National Enquirer.
    Last edit by Marie_LPN, RN on Sep 28, '06
  11. by   sharann
    I think it's all that formalin they have to handle for specimens. That stuff can do a number on your skin!
    Ok, bad humor I know.
    I would love to know how you OR men and women manage not to pummel some of those surgeons to death with all their shennanigans.
  12. by   ortess1971
    Quote from sharann
    I think it's all that formalin they have to handle for specimens. That stuff can do a number on your skin!
    Ok, bad humor I know.
    I would love to know how you OR men and women manage not to pummel some of those surgeons to death with all their shennanigans.
    Thankfully, not all are like that..and those that are,I have no problem letting them know that it is NOT acceptable to treat me disrespectfully. It helps if your OR has a manager who will stick up for his/her staff, and policies in place for docs who continually act badly..Some places will make them go to anger management etc.
  13. by   elcue
    You simply must NOT permit anyone to yell at you or speak to you disrespectfully. Period. You are an adult in a place of employment, not a delinquent in a corrections facility.
    If someone does, look them straight in the eye and calmly say, "You may not speak to me like that. Let's just start over."
    The days when nurses tolerated such treatment should be long behind us.
  14. by   Marie_LPN, RN
    I would love to know how you OR men and women manage not to pummel some of those surgeons to death with all their shennanigans.
    Just because we haven't, doesn't mean we haven't thought about it (many times lol)

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