Told to have tougher skin!

Nurses General Nursing

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I was told be several people on a previous post that I need to have tougher skin in the workplace. Is this something you have always had (for those of u who have it) or something you acquired due to working in the healthcare field. I agree I do and I need to know what I can do to toughen up the skin.

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to me, it means you need more self-confidence. If you are good at what you do, or even are trying to the best of your ability then that is all you can do. Other people are occasionally harsh but if you are okay with yourself then you can forgive them for trying hard in a high stress environment. Alternatively people can be mean but again if your okay with yourself you brush them off knowing your doing what you can. easier said than done.

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Specializes in Cardiac, ER.

I have had to acquire tough skin. I am a very non confrontational person by nature. I was raised in a family that didn't yell and scream at each other. I am surrounded by kind, gentle people in my private life. I had to learn to stick up for myself and do what I think is best even if it isn't popular or might even seem unkind from others eyes.

I think working triage has forced me into this frame of mind. "I do understand that all the noise in the waiting room is making your headache worse, but I don't have a room to put you in yet". "I do understand that your child has a fever and is cranky and uncomfortable in the waiting room, and yes you have been here longer than others but I have to send the chest pains and stokes ahead of you".

"Yes, I understand that you haven't eaten all day,.but I can't bring you a tray until all of your labs and xrays are complete and we know why you are having abd pain". "Yes, I understand that starting an IV on your 3yr old is painful and scary to him, but you told me that he has been vomiting for 2 days and hasn't peed in over 12 hours,.he needs this IV". "Yes doctor,..I understand that you ordered the UA in room 3 over an hour ago,..the pt has been unable to void and you would like an in/out cath for the UA,...I have been starting the Nitro drip in Rm 10 and will get the cath as soon as I can".

I have had to learn that what is a priority to my pts, the docs, radiology etc might not be my priority. I have to make my decisions based on my knowledge of the situation and prioritize accordingly.

Hang in there,...it gets better.

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Specializes in ICU, ER, EP,.

tough skin doesn't happen because you wish it. I wish I never had acquired it, but my home life would suffer and be a mess if I didn't toughen up and seperate the two.

You have to go through each experience... live through it and find a way to be whole, in your whole life. It doesn't simply happen.

You have to code a 32 year old H1N1 that dies with her 4 year old at bedside... trach and peg a 102 year old who's family wants the social security pay check... code a 18 yr. old multiple gunshot wound victim... only to save him and have him a quad for the rest of his life at family demands...teach the 85 year old grandma that her heart attack will leave her a cardiac cripple and unable to breathe just doing her favorite cooking... the 45 year old that needed a heart transplant that dibbled in drugs again will now die... off the transplant list.

The frequent flyer that you bond with that you swear you got through that shows up with a blood sugar of 700, a PH of 6.9... and he codes and dies at 23.... the 45 year old MI that didn't have health insurance and waited at home for days.. and now needs a transplant and won't get one without insurance.

Grandma that doesn't understand 60 years of cooking on fat back and bacon is causing her CHF and pats your hand kindly and tells you..."it's the way its' always been".

I've obviously gone too far, remembering so many people that have touched me. My point is.. 15 years in it still hurts, sure my skin is hard if a doc tries to take me on... a co-worker gets snarky... but there will ALWAYS be patients that get through that skin and touch your soul.

Thats why we're here, it's hard. when it isn't ... time to go. My skin is dragon hide tough, but the people I care for always penetrate it. That is the difference. Never stop caring.. but leave it at the door so you have the strength to care again.

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Wow, zoo keeper. What a way to explain the need for tough skin. You have a way with words, and your stories truly touched me. I always worry (as a nurse to be) about letting things at work- stay at work. Thank you for your insight.

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Specializes in Emergency Dept. Trauma. Pediatrics.

I have some pretty tough skin, at least on the outside where anyone is concerned, but I wouldn't recommend the way I got it. I am better at having a tough skin when it comes to confrontation and negativity. When it comes to "sad" things, I am not as good.

I will say though, holding on to things will not do any good. Sometimes people like you, sometimes they don't. Some people sugar coat things, some don't. In the end I would rather have someone brutally honest than not honest. All you can do if you are being a little sensitive is brush it off. Take every experience and learn from it. If you need to come here and vent, than do so, or to family or friends or whoever you feel comfortable with. Don't bottle things up but don't let negativity consume you.

There is a learning experience in every situation. Try to remember that everyone is different, they view things differently, they communicate differently, and they might mean things differently, don't take it all to heart.

That's all I got, I am not that good with motivational speaking LOL

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Specializes in Family Nurse Practitioner.
to me, it means you need more self-confidence. If you are good at what you do, or even are trying to the best of your ability then that is all you can do. Other people are occasionally harsh but if you are okay with yourself then you can forgive them for trying hard in a high stress environment. Alternatively people can be mean but again if your okay with yourself you brush them off knowing your doing what you can. easier said than done.

Very well put!

For example whenever I start a new job I just tell myself that there will be one or two who are not going to be friendly or helpful. It isn't about me it just is the way things roll. Even though I don't think it is particularily nice I ignore them or even help them and within a few months we are good. One has even become a dear work friend. My guess is that she gets insecure when someone new comes poking around as if they are judging her, in any event it wasn't about me and I wasn't about to own it.

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I think what makes me me is my heart. I care about people. However, I don't care what other employees or people think of me as a person meaning I have tough skin when it comes to gossip.

I know my problem will be having tough skin around patients or families. I've gotten better through volunteering since I meet people battling death, however, I am not where I need to be. I get teary eyed and just look up to let me eyes dry. And if anyone sees it I blame it on my dry contacts. lol. But, you still need to be compassionate. We are all human. I think sometimes nurses and doctors are too tough and sometimes patients and families just want to see the human side of them. I know the nurses and doctors see it all the time, but they don't want to feel like just another patient. Would you?

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Specializes in Nursing Professional Development.

There is no magic formula. Resillience only develops as we go through hardships in life. We develop it as we endure the trials and tribulations that we encounter ... by not giving up and running away ... by getting up and trying again ... putting one foot in front of the other and moving forward each moment at a time.

It developes over time, not all at once. Just keep going and keep trying. Try to forgive those who need forgiven ... tolerate those who need to be tolerated ... and learn from each experience along the way.

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Specializes in Hospice, corrections, psychiatry, rehab, LTC.

It's an acquired skill. We naturally care what people think about us and our abilities. Sooner or later, you come to the realization that there are more important things to be concerned with, particularly if the perceptions are not reality (for instance, I would be a lot more concerned if the perception was that I was continually screwing up, and I actually was). You cannot control what other people think. The serenity prayer comes to mind in situations like these.

It may be a matter of deciding what to pay attention to and what to ignore, rather than becoming tough.

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Specializes in Pediatrics, Newborn Nursery, Post Partum.

Hi guys, I definitely think that a tougher skin comes with experience. Knowing when its appropriate to say something or not and to who is the main thing. Yes there will always be co-workers that you will not get along with or doctors that you just can't seem like or stand by that matter. But the main thing or concern will always be your patients. Always remember that you are your Patients advocate and if that means at times questioning an order or decision or going in after the fact and making sure that the patient understood or doesn't need anything else. I have been told many of times that I have overstepped my bounds, but not once have I regretted it. I been forced to apologize to doctors, but not for my actions but for what they though I had done. Just always keep in mind that you are there for the patient! And just like another nurse stated learn and take to heart the Serenity Prayer.

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i will agree, that if you have a non-confrontational/timid personality, then yes, thick skin is learned acquired.

but if you have a naturally big mouth like moi, easy-peasy...no problem with my 'sharing concerns'.

if you remind yourself that your professional designation is lpn/rn, and NOT doormat, you will learn what is worth speaking up for, versus what to blow off.

more than thick skin, everyone needs to pick their battles wisely.

leslie

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