How To Recover From Near Rock Bottom...

[Snowana]

Hey allnurses world...wonder if anyone had sage advice...

I'm in a career slump. I have a history of adult critical care for 10 years, and had a chance to switch to peds critical care a couple of years ago. I love the new challenge of working with children, but it seems that for the most part, the parents of the children don't like me. I've been working with my manager to improve this via a performance improvement plan. I have been successful enough to be taken off of it nearly a year ago, and I thought things were ok. Well, I have had 2 double whammies in the past month:

First, I have been called in to the office again to discuss my interpersonal skills with the parents. My manager told me that she was not going to put me on a plan or write me up, but rather asked me I felt peds was the right place for me.

Second, due to low census, I have floated back to my old adult unit a few times. My manager called me to set up an appointment to discuss floating to my old unit...they apparently don't want me to come back! And I have absolutely no idea what I could have done to warrant that!

Critical care...up until these two events...has been my passion! I can't imagine doing anything else...ED, PACU, IV Therapy, teaching, clinic work...none of that interests me. I do feel my manager is one of the few decent ones that does want to see me succeed, however my confidence and self esteem is at an absolute low that I know it will affect my performance. The anxiety of being under the microscope is going to adversely affect me. I know scared parents is a weakness I need to work on, but if another unit is seeing something in me that is a red flag to them as well...it's clear I have some personal growth to contend with. But, can I do that and keep a job that I am afraid I may get fired from? I work in a no-cause state, non-union hospital.

How do I attempt to look for another job when my old unit (that I left on good terms with) does not want me to float there, and my current unit may very well put me back on a PIP and start that process of a termination? What do I say to potential new employers?

Any advice would be appreciated...I am having trouble sleeping at night and very upset by all of this. I know that a lot of this needs to come through working on myself...but that may not be enough. Any advice with how to deal with the interviews and HR of a different hospital system would appreciated!

Thanks!!

[Irish_Mist, BSN, RN]

@Irish_Mist: Parents have said that I come off as condescending. I particularly struggle with the parents that are barely adults themselves and don't have any coping skills with dealing with a screaming toddler that can't eat until their high-flow NC is low enough. I've never been told that in adults, and I can count on 1 hand how many times I was fired by families in 10 years. In peds...it's far higher than 1 hand

I am a very serious and analytical introvert...I know that in terms of my skills and competency, I am a great and safe nurse, but the "social work" part does need improvement. I've trying to figure out what would be good options to fix this...perhaps Toastmasters, reading the right books, asking my manager for a mentor to hear how I interact with these parents and give me pointers on how to fix things...

Do you have any colleagues in the PICU that you would consider a friend? Someone you could ask for some feedback on how to deal with these types of parents? Perhaps ask one of these colleagues to mentor you.

Remember, you are seeing parents at their absolute worst in this type of setting. No one is prepared to have their child in the intensive care unit. I hate to say this but if you have had multiple complaints of parents saying you are condescending, chances are, you probably are coming off that way.

Do you have any children? Put yourself in their shoes and ask yourself how you would want your parent's nurse to speak to you. You can't change how the parents behave nor can you change your personality. You can change your response. Focus on your tone of voice/body language, make eye contact, smile periodically. I'm sure you'll see a difference.

There is nothing wrong with being analytical and introverted. My father is like this and he also is misunderstood by people sometimes. Not everyone can or wants to be extroverted. It's okay to be yourself but also work on things you can do better.

[Wuzzie]

Most hospitals have classes on communication skills. It might be good for you to take one for many different reasons. First, you might gain insight into what the issue is and how to fix it. Second, it really looks good to management when you independently take these steps. Third, it might slow the free-fall to termination giving you a chance to look for a unit that is a better fit rather than desperately searching for anything to pay the bills.

[Penelope_Pitstop, BSN, RN]

I could have written a very similar post two years ago. I'm not going to get into my entire story because A) this isn't the place and B) it's triggering for me but it's eerily similar.

What I did was leave the hospital entirely. I'd only ever worked in the hospital until that time (9 years as an RN) but I ended up doing community mental health for a while. The pay and hours were actually worse because it was a salaried position but it got me back to myself and kept me away from the place that nearly did me in (yes, I recognize that a lot of that "doing in" was me). I do want to go back to the hospital some day, I think. Right now I do home health which isn't my dream job but the hours and pay are better than community mental health. According to my husband (I have terrible insight into my own functioning sometimes) I am the best I've been in terms of MY mental health in four years.

Sometimes ya need to get out of your perceived comfort zone before it changes to an all-out COMBAT zone. I would end my employment there on MY terms vs. THEIR terms, ya know?

[caffeinatednurse, BSN, RN]

It depends on the hospital system, but it seems like a new employer would likely not be privy to the information regarding PIP, unless you tell them, or the nurse managers know each other. Either way, if you leave prior to being terminated, you can tell the new nurse manager that the unit was not a good fit for you, which is not a lie. If you get fired, however, you will have to provide an adequate explanation for that.

Have you talked with your current manager about the problems that you're having? Have you let her know that you really care about your job and that you want to be better in your current role? Ask for her advice regarding the situation. If you still get the feeling that you're headed for another PIP or possible termination, do yourself a favor and begin looking for work elsewhere. With 12 years of critical care experience, there are plenty of employers that would love to have you. Emphasize your experience and minimize whatever difficulties you have in your current role. You should be fine. :)

[ILUVERNSG, MSN, RN]

Observe a nurse who is well liked by patients.

Learn to emulate her style of interaction.

[AmandaTheNurse]

Can you tell me more about the problem your interpersonal skills? How do the parents not like you? Is it that you get angry fast? Or you sound sarcastic or cold to them?

I have a colleague. She has over 30 years of experience. She is someone you seek advice to and count on when you encounter nursing problems at work. However, most of the staff hate her. Why? Because of her trouble in emotional intelligence. The junior nurses and staff from other department couldn't take her because all she did was opened her mouth and scolded and retorted when they made mistakes or things didn't go her way. She created a lot of conflict. She doesn't like sweet talks and she tells you off when she does not like it. She got into trouble a lot because of this. She was fired at one point. Few years later, She tried to come back to the same employer to work but they refused to have her back. After many begging, they decided to give her a chance. Although it is hard to change, she still get into trouble because of her anger and yelling at people at times, but she is definitely much much mellow now. This has created a scar in her heart because she was hurt by the fact that people couldn't see the work she has done to her patients and her doing her job seriously and wholeheartedly but got annoyed because she picked out their incompetencies.

Now I'm not the best either when it comes to communication. I look angry when I'm angry; I look upset and I'm upset; I look happy when I'm happy. Sometimes I say the wrong thing in wrong situation. If someone keeps stepping on my toes, I will make sarcastic remarks or retort if necessary. I hate dealing with parents so I have sworn to myself to never work in peds (because I had a very bad experience when I was junior. The mother just screamed at me not to touch her daughter and wanted a Dr to do it instead). I'm working in an adult ward and so far so good because I have learned to ask my nurse manager to deal with them instead when my first attempt of talking in a civilised way has failed.

You need to first be aware of what your problem is. If you are not sure, try ask your colleagues personally. Be sincere and do not get defensive, then they will tell you honestly. Read some books to improve your communication skills. Learn some tricks to deal with the difficult situations (like me ask my manager to deal it, ask someone else to do the procedure instead if I know the patient or family members are fussy, wear a mask when going into a fussy patient's room.... etc). Find the field that suits your personality the most (like me working my way to become a nurse educator because student nurses LOVE me! I receive the best feedback from them). Listen to feedbacks. It may take some time to figure out, but you WILL figure out eventually.

I hope you find your light soon :) take care!

[Snowana]

Again...wow! I am moved by the comments and support from all you wonderful strangers! Thank you so much! I had no idea there was such amazing support available here! I certainly intend to pay it forward when I stumble across the post of another RN experiencing the hell I am going through right now!

I am meeting my manager tomorrow morning before my shift to discuss what happened on the adult unit. It is a half hour before I am supposed to work, which I am hoping is a good sign. I easily could be making a mountain out of a mole hill out of all this. I am not on a current write up or improvement plan, but being that I work for a non union company that has a history of firing on the spot, depending on what the heck I did...it could end badly.

On a good note, I already have an interview at another hospital system for adults, not pediatrics. I'm in a bit of a pinch...as I stated before, my old unit's ENTIRE leadership has been fired/asked to leave/retired since I left 20 months ago. The issues I had are under the watch of interim manager #2, who does not know me at all. I'm not exactly getting a great reference from them, and I was with them for 10 years! And my current pediatric reference won't be stellar because of my interpersonal issues...oh I hope I just get written up, not fired!

Checked e-mail, and there is an internal full time day shift position open (I'm days)...I can't imagine who else is leaving. I hope I can sleep tonight!

[Snowana]

Thank you. I know that is something I have needed to do, @Iluvernsg. With our low census and inability to get the patients I really need to get experience with (thanks to profound new hire orientation) it has been difficult to do. With my conversation tomorrow, I will ask if it is possible to "buddy up" with someone that is good with that stuff.