"Grow a thicker skin!"

Nurses General Nursing

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Hey, y'all. I'm hoping you wise nurses can help me out with an ongoing question I've got.

So all my life, since I was little, I've been really sensitive. I take criticism very deeply, and get (inwardly) very upset when I screw up or when others are angry with me. Everyone says, over and over, that nursing requires a thick skin. When I ask how to develop one, I get told "you just have to not let things bother you so much." Um, okay. HOW??? Is there a trick? Is there no trick, and it will come with time and it's just a "fake it till you make it" kind of thing? Maybe I just have the emotional IQ of a radish or Asperger's syndrome or something, but this advice literally does not make sense to me.

I'd love so much to transfer to the OR, but until I can stop turning red and choking when the fellow is snotty to me, I don't think I should.

Thanks for any help you can offer.

Specializes in NICU.

Wow, Miranda. Just ... wow. That's pretty on the money, I think. I do have panic attacks, although I've gotten them down mostly to anxiety attacks these days! :clown: And then yeah, it's like a compounding problem. Mistake ---> fear ---> fear of panic attack and then embarassment that you a) made a mistake and b) are too "weak" to handle it. The same when you*haven't* made a mistake and you get sniped at anyway, athough then you get that flash of anger that (at least in my case) keeps the tears down. If you have tips, I'd love it, and from what it sounds like, there are plenty of people in my boat. Thanks for all the responses, you guys! Both the advice and the support are awesome.

I will say that I told an attending (!) the other day to please give me a moment to think and I'd solve the problem (it was a thing with tangled lines). But he was a junior, covering attending who I'm not particularly scared of. Oh well, baaaaby steps! Now on to the attendings who scare me so much I literally get nauseated! :monkeydance:

Specializes in Peds Urology,primary care, hem/onc.

Wow, I was reading this and I was the same way when I was a new nurse (yikes 10 years ago). A lot of this will get better with time and more experiance. As you grow in your career, you will get more confidence in your skills, learn to read people better and learn not to take things personnally. You will also get to know yourself and how you react to things better. I know when I get really angry, I cry. It is not beause I am sad or upset it just happens. I have learned over the years how to breath and make myself relax and talk myself through it so the emotion does not take over. But this has taken me years to be able to do. Whenever I receive criticisim (I still do this) I will give myself a little time for the emotional aspect of it to go away and honestly look at the situation and see if there was merit to what was said. I am lucky that I have a trusted mentor who I can also run things by as well. Most of the time, I ignore they way it was said and learn from what was said. When you work with people for a long time and get to know them, you will learn to read them and their personalties and see that often, they act that way with everyone (not that it makes it right) and it really has nothing to do with you. The chief of our division, who I love, often has a hot temper. A lot of people are intimidated by him. The best advice I ever got when I started working with my group was 99% of the time, if he is upset, it has nothing to do with you and if it does, you will know. I have learned that, although he tries really hard not to, he has an unbelievable amount of stress and sometimes he just has a "moment". He always apologizes later and we get along great. His frustration comes from wanting to do the absolute best for his patients and often not being able to because of the numerous roadblocks we face everyday. What I wish I had been told when I was a new nurse was to focus on patient care, learning everything that you can and be an advocate for your patients. Try to look at every confrontation from both sides, that way you can learn from it. I sometimes think I learn more from the negative interactions I have had in my career over the positive ones. I used to be exactly like the OP when I was younger and in time and practice, I am not like that anymore. A lot of it has to do with confidence in my abilities (that takes time too) and knowing I have the right to stick up for myself. I used to quake with fear when I worked with a doctor/nurse that had a strong personality. Now, these are the people I end up working best with. I have also learned, that during stressful moments, I have ended up inadvertantly intimidating people even though I try very hard not too and I definitely don't mean to. I actually think people with our personalities make better nurses because we are sensitive and caring. We also want to be the best nurse we can be and care that we are doing a good job. It just makes it more difficult for us personally because we often take it too heart a little too much. This is a rambling post but I hope I am getting across what I mean. Good Luck! You are normal and you are going to be just fine! Give yourself a break and keep working hard!

I think that life in general requires a thick skin and that no matter where you are, someone is going to say something that just wrecks your nerves. I'm prenursing and currently work in a public library as the administrative receptionist and some of the crap that gets said to me makes me wonder how they've made it as far as they have b/c sometimes the things that come out of a person's mouth are just plain...well...ignorant.

The best advice I can give you is to look at each comment and think of it as a "consider the source" type situation. Meaning that if you take a good look at WHO a comment is coming from, most of the time, you'll just brush it off. For example, yesterday I was reprimanded for using a hypen on a document. All I could do is sit there and look at this person and try to hide the incredulous look of shock and the wanting to die of laughter at the ignorance of this lecture. A long time ago, I would have taken this as a personal attack, which you can't do. Like I said, you have to "consider the source," do the best job you can do, and go home.

I hope this helps. :roll

I feel your pain.

What drives me nuts is when you have experience and you change hospitals and the nurses on your new unit act like you are a total idiot if you don't know how to do something. It really makes you feel like ****, but you have to resist the urge to run. They forget that if the tables were turned and they were new they would be just as confused in the hospital you came from.

I think a big part of has to do with separating your professional life from your personal life.

If your S/O yells @ you & calls you name, then yes it is personal & you should take it personally ...

BUT if someone disagrees with you, or yells @ you in a professional environment it is in no way personal. They are upset with the situation & @ most they are upset with the way you handled your job, they do not know you & could in no way be commenting on you as a person. How could they, they don't even KNOW you??

It really works for me & as my husband says "You're brilliant and beautiful, but you can't even SPELL confident" lol , yet clients/patients never get to me ; )

Does that make any sense?

Specializes in step down cardiac.

I always that that after 3 years of nursing that I may have finally developed a somewhat thick skin. Then I started doing travel nursing. This is my first assignment and its terrible. Most of the nurses are very rude and not friendly. They are not understanding at all that Im not totally familiar with their "way "of doing things. I just dont understand why so many nurses are like this, outwardly rude to other nurses. It makes me want to scream sometimes. If you are unhappy with your job, then find a new one! I hate feeling like Im a bad nurse b/c they pick apart every little thing just to make someone upset. ughhhh.....:o

I understand and can relate completely. I just said the other day I am gonna take a course in desensitizing,,,lol Something. My partner always says" Nurses are suppose to be tough!" not me at all. I do not like confrontation, I will never avoid it, but it reduces me to tears 8/10 times. I do not beat myself up when things go wrong, just get too teary eyed when I should not. I can hold my own when someone is fresh or rude. But when someone hurts me,or I am completely overwhelmed, I will hit the bathroom for a good cry and then imerge. :monkeydance::monkeydance::monkeydance:Tis just me,and I can not help it.

Crying is actually pretty useful. It is often more endearing than anger.

Specializes in Jack of all trades, and still learning.

Tears and fears have been my best friends - not! - for a long time. You are not alone.

Counselling is a good idea, as suggested earlier. There may not be a problem as such in your life, but counsellors are good at helping you pinpoint ways of dealing with other ppl proactively. One counsellor showed me how to identify a number of different reasons why a person may be behaving as they are.

Sure, don't expect yourself to be suddenly able to become less "thin skinned". But do something now. As others have said, you are normal. Or else, maybe normality is boring, so most of us choose to be abnormal?:trout:

Specializes in Community, OB, Nursery.

I am with you on that one.

For me, it has been a lot like Miranda said...expecting myself to feel a certain way at a certain time, and it becomes a self-fulfilling prophecy.

What works for me is the following:

1) I remember what I'm good at, because I may not know how to do ABC, but I'm really dang good at QRS that nobody else can do.

2) The people who've sniped at me (justifiably or not), I remind myself that they are just people who put their pants on the same way I do.

3) It does get better with time. People and situations that would have made me fall to pieces a few years ago now make me roll my eyes and keep going. Maybe even laugh.

4) I surround myself with good friends at work.

5) I leave work at work. That will be easier to do as time wears on. If not, it's time to switch jobs.

6) I take 50mg of Zoloft qd. :)

Hope this helps. Hang in there.

Intended to get back here sooner, but our cable (including Roadrunner) was out for a while this evening.

I think. I do have panic attacks, although I've gotten them down mostly to anxiety attacks these days! :clown: And then yeah, it's like a compounding problem. Mistake ---> fear ---> fear of panic attack and then embarassment that you a) made a mistake and b) are too "weak" to handle it. The same when you*haven't* made a mistake and you get sniped at anyway, athough then you get that flash of anger that (at least in my case) keeps the tears down. If you have tips, I'd love it, and from what it sounds like, there are plenty of people in my boat.

your brain has learned to associate being caught off guard by criticism or a strong emotional response from another person with feeling extreme discomfort and a loss of composure on your part. The operative word is "learned." Because the cause (unpleasant input from someone else) has so long been associated with the effect (intense reaction of embarrasment and high emotion) there is the not-too-surprising idea that the two are inextricably linked. Fortunately, that isn't true.

The first part of your problem, the lack of confidence, will resolve as your skills increase and your comfort level grows. This is especially true if you make a habit of setting concrete and achievable goals and keep track of your successes along the way.

The second part, the extreme embarrassment, requires a different approach. Because this is an emotional response, it will usually not get better on its own. You don't just outgrow an emotion. In fact, left "untreated," it can actually intensify over time until you dread it so much that you start avoiding certain situations. In some cases, the person experiencing this can find their world beginning to shrink.

The steps to making this better consist mostly of getting your head and your heart to speak to one another, telling yourself the truth, making conscious choices about your thoughts and behavior, and finally, desensitizing yourself to potentially hazardous situations so that they no longer pack the wallop they once did.

Your brain has learned to go from zero to sixty once a reaction is triggered. There is no stopping point along the way. There are no degrees of intensity proportionate to the event. It's an all or nothing reaction that can leave you more embarrassed than the original subject matter. And more afraid for next time.

The starting point for changing this is to acknowledge that your response is an over-reaction and a well-worn pattern that has taken on a life of its own. If you can separate the kernel of truth in your response (you were embarrassed or caught off guard or criticized, etc.) from the falsehood of the intensity (I wanted to die, I felt mortified, I wished I could disappear), you will be able, bit by bit, to keep what is real and discard the rest by consciously retraining your emotions so that they no longer run wild.

Think of a big dog, the kind that takes his owner for a walk. The animal is barely restrained by the leash and the human does well to keep her arm in the socket and hold on for the ride. This is a good metaphor for unchecked emotions. We end up getting dragged wherever they take us, and the results can be unsettling, to say the least.

This is the pattern that you have learned to follow, but you can learn something new. I'm a big fan of "The Dog Whisperer" on the National Geographic Channel. The host, Cesar Millan, teaches people how to gain control of their pets, and this is no small feat. In some cases, the dog has been running the household, tyrannizing the owners with its aggressive behavior, biting and barking and running people ragged. In a very short time, Cesar shows the humans how to regain control of their pet and gives them a kind of mastery they never dared to hope for where their animal was concerned. He can usually turn things around on the first day, although many weeks of practice may be required to cement the progress.

If you have never seen this show, I highly recommend it. Even if you don't have a dog, there are so many useful lessons on this show about behavior in general. Cesar often points out how those who behave in unhealthy ways with their dogs carry that over into their relationships with other people. Weak and vulnerable interactions invite misunderstanding and can even lead to abuse.

What you are after is calm, assertive strength that can take criticism and even embarrassment without having an extreme reaction.

Truth #1

The extreme response is a separate entity from the triggering event and your initial reaction. You think it's your natural reaction because it always seems to happen, and up till now you didn't know you had any choice.

Truth #2

You do have a choice. Might take some time to discern it and put it into practice, but you are not chained to having over-reactions for the rest of your life.

Truth #3

Your emotions (the big dog) have been allowed to run away with you and take you places you don't want to go. You can, by an act of your will, take back the control that you have given away and chart a new course.

Truth #4

Normal embarrassment, discomfort, and momentary loss of composure can feel unpleasant, but they are manageable. What you have been dealing with--the over-reaction--is a different animal altogether. In order to isolate and excise the hypersensitivity, you have to distinguish between the normal and the extreme, accepting the one as part of life and rejecting the other as an aberration that keeps you from functioning in a full and healthy manner.

That's enough for now. It's nearly 0400, and this is a lot to take in.

Just know that you can do this. In fact, I think you'll be amazed at what can happen in a fairly short time.

I soooo remember being afraid of criticism.

I still don't *like* receiving it, but my husband gave me the best piece of advice once.

"The sooner people realize that you don't give a sh!t what they think of you, the more they will respect you."

While I am sure that people will have a LOT to say about that advice, it has helped me tremendously. It has helped me to stand up for myself and to not kiss peoples butts. When I sense that someone doesn't like me (and trust me, the line is long), I no longer bend over backwards trying to MAKE them like me. Its a liberating feeling.

I come to work, I do my job, I be myself. My patients love me (well, MOST of them do!) and thats what counts.

Specializes in NICU.

:bowingpur Miranda, you are a wise woman. I'll have to check that show out. :bowingpur

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