"Grow a thicker skin!"

cmo421 · Oct 24, 2007

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.

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.

nursemike, ASN, RN · Oct 24, 2007

I think you had a big part of it with "fake it till you make it." But I do think there may be active ways to get there, too. I think confidence is a big part of the solution, and part of developing confidence might be lightening up on the self-criticism. It's the nature of the business that you will make occassional errors, and while you certainly don't want to be nonchalant, you have to realize that it isn't because you are stupid, or even careless. You would never have gotten this far if you didn't have a lot going for you, and it's probably healthy to remind yourself just how far you've come. Pat yourself on the back at every opportunity. The better your image of yourself, the less the opinions of others will matter.

I think self-evaluation is important, but as necessary as it is to be honest with yourself about your shortcomings, it's just as necessary to be fair. If someone else did the same thing, would you ream them over it, or gently point out the mistake and help them find ways to avoid it in the future? I also think you have to evaluate the criticism you receive from others: first, is it valid? second, are they saying this to help you improve, or just looking to tear you down? In some cases, you may decide that the criticism is valid, but the delivery isn't. So use the useful part, and just blow off the rest. (Ultimately, you'd want to be able to stand up for yourself, but until you get that thicker skin, it might be prudent to avoid anything that might seem defensive. A simple, "Thanks, I'll keep that in mind." ought to suffice, and sends a better message to others--and yourself--than, "Oh, gosh, I'm sorry..."

If you look at my profile, I have just a little more experience than you do--two years and a bit, to be precise. So I can definitely relate. If your experience goes the way mine has, you should soon, if you haven't already, start encountering people newer than you who are looking to you for guidance. Scary, huh? But if you've made it through your first year, you've done something--something big--that they haven't, and here's your chance to help them along. Not long ago, I showed someone how to start an NG. It was, like, my fifth NG, and I'm far from an expert, but it was her first, and I think the experience was of benefit to us both.

Finally, a little anger can be a great motivator. I don't mean lashing out, but a little bit of inward "I'll show them!" can be constructive, if you're careful about it. Determined is good. Reckless is bad. But I'm sure you know that.

allnurses Guide · Oct 24, 2007

You are me when I was in my 20's and I still, at times, let things bother me to an extent where I tear up or actually cry. It drove me crazy when I was your age . . my face would turn red, my eyes would start tearing up. It felt unprofessional. (It isn't!).

I think the answer is simply "time".

Quit beating yourself up. :icon_hug: You are normal.

steph

Alex_RN2b09 · Oct 24, 2007

The words "grow a thicker skin" are misleading, and makes me think of reptiles. Your situation sounds very similar to mine, and it has nothing to do with your dermis. :-) You need confidence, pride in your work and self esteem. Your confidence will allow you to work under pressure from others without fearing mistakes or angering them. The pride you take in your work and confidence will provide what you need to defend your decisions without getting upset. Self esteem is part of all of the above, it will give you the best thing of all. The ability to take criticism be it postive or negative and to walk with your head held high, and become a better nurse because of it.

Again you may ask what will give me these seeming difficult things to obtain?

As people have said above it's largely baised on experience, but a postive additude with a willingness to learn and grow can make it go a bit faster. :-)

llg, PhD, RN · Oct 24, 2007

If it is really a problem in your life, maybe it is worth investing in some counseling -- to help you identify WHY you can not handle criticism in a healthy way. For example, does it trigger some tremendous self-doubt that you have? If so, maybe you have some issues with self-concept that a counselor could help you resolve. Do you have a need for everyone to praise you or like you all the time? Once again, a counselor could help you explore that and help you cope with the fact that you will never please everyone all of the time.

If you don't have any big issues to deal with ... and the issue is simply that you don't like to be criticised, then there is probably not much more than can be done to help you other than to say "learn to live with it" because it is unrealistic to expect everyone to give you positive feedback all the time. Sometimes, we all have to receive negative feedback in order to know that we need to make some changes in ourselves.

So ... why do you think your skin is so thin? Is it worth seeking counseling over?

RheatherN, ASN, RN, EMT-P · Oct 24, 2007

There are certain things that really get to me, like when we get "grilled" from the instructor in clinicals. if i dont know something i feel i am being personally attacked sometimes. If i have a really bad day, i have been known to cry after leaving the site in my car, on the way home. but i think all this comes with school. its not unusual at all, just because you are not "tough as nails", doesnt mean anything. it will come in time, be strong, use allnurses.com to vent. hell, email me!!! i would love to talk! trust me we all have our days!!!

-H-

i bet you anything even the strongest nurse cries on a bad day! And dammit if they dont! they are lying to ya! lol

chris_at_lucas_RN, RN · Oct 24, 2007

Your description of that inward pain when failing to meet your own standards or when someone is angry with you is so me!

What is currently working very well for me are two new-ish behaviors.

When I make an error I say to myself (or to someone else, if it turns out I get "caught" not being perfect) "I am a work in progress."

And when I receive criticism (or what I perceive is criticism), I quickly and warmly say "thank you, I appreciate all the help I can get." If I do it fast enough, I can keep the feelings from getting too hurt.

Kind of like the "act as if" in one of the earlier posts. Yeah, like that.

Good thread, thanks for starting it!

TraumaGirl1018 · Oct 24, 2007

I can totally relate to you! Being a new nurse is tough enough, without the un-constructive critism and all the talking behind everyone's back. I guess I dont have much advice, just wanted to let you know you arent alone.

And if anyone has advice on growing thick skin, please share!!

Alex_RN2b09 · Oct 24, 2007

I love allnurses! *hugs!* You guys make me feel almost normal.

oramar · Oct 24, 2007

I got to tell you that you have a lot of company on that one. As soon as you beat it let me know so I can too.

rn/writer, RN · Oct 24, 2007

You may always take things more to heart than the average bear, but I do have some observations and suggestions.

You might have two different problems that will be more difficult to manage while they are intertwined. The confidence issue that others mentioned is very likely involved here. They gave you good information about building your skills, learning to let yourself off the hook, and relying on a "tincture of time" to give you some healing in this area.

The second problem is a little trickier in that it tends to hide behind the first, leading you to think that it's the lack of confidence when it is something else altogether. That something else is a conditioned response to embarrassment. People who have this strong reaction tend to intensify its effects simply because they dread it so much and feel so helpless to control it. People who have panic attacks often find that their ultimate fear isn't connected to any particular trigger (crowds, heights, elevators, etc.) so much as it is a fear of having the attack itself. In other words, they fear their panic more than they do their circumstances. On a less disruptive scale, you could be going through something similar, feeling so embarrassed about being embarrassed that you would like to just drop through the floor and disappear.

I call this a conditioned response because (if this is at all applicable to you) 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.

I'm going to stop here and wait to hear whether or not you think there is any merit to these ideas as they relate to you. If you do, there are some steps you can take to separate the two elements--uncomfortable input and intense reaction--so that you will be less vulnerable. That alone can increase conficence.

If you don't think this applies, then maybe working on the confidence alone will be enough for you.

Either way, I wish you well in your quest.