Why nurses don't want to talk to a ward psychologist? - page 3

Hello, Since I often seek and get good information at this forum I had an idea I can ask you for help with my current issue. I am a psychologist working in a pediatric ICU. I am there mostly for... Read More

  1. by   BeckyESRN
    That actually sounds really helpful! However, we work during work time. I cannot recall a single shift during my time at the hospital where I had more than a couple of minutes to attend even an in-service on new equipment, let alone a have a sit down meeting. If this is happening on days off, but being paid, it's a hard sell because most people don't want to be at work more than required. When we had in-services or short classes that we had to attend, the managers would over staff, so that we could rotate in groups.

    The information that you're offering sounds necessary and it would be a great opportunity, but fitting that into a work day is going to be a challenge. Maybe start off with some flyers with some info about your topics and when you'll be available. Coverage needs to be provided for the nurses that want to attend. It sounds like you'd be a great resource to have!
  2. by   Julius Seizure
    Quote from MelEpiRN
    I know many would disagree with me, (which would make me happy, to be honest) but I think it's also a culture of the current workforce. I organize educational opportunities (many offer CE credit) as part of my job as well as community outreach programs and I get almost zero participation. The only time people show up is if you make it super-mandatory (uh-huh, I said it- mandatory doesn't mean diddly anymore) and pay them. You'd think nurses would want to learn, keep up to date with new info, etc, but in my experience people just want to come in, do the job they're [under]paid for, and go home. No extra, even if it helps them.
    I think this change is related to the change in company culture where the employee became just another number, not a valued person. If you don't feel like your company values you and you aren't going to be rewarded for excelling (like you said, underpaid), why try to excel? Personal satisfaction isn't found at the workplace.
  3. by   JKL33
    Quote from MelEpiRN
    You'd think nurses would want to learn, keep up to date with new info, etc, but in my experience people just want to come in, do the job they're [under]paid for, and go home. No extra, even if it helps them.
    What I would think .....

    Is that once in awhile someone would ask what nurses want to learn about. Maybe you are allowed to do that, if so thank you, and that's wonderful.

    I accept my responsibility to learn about both things the hospital needs me to know and things I want/need to know that are more patient-condition-related. I'm not "upset" by your statement but it's a tad harsh/inaccurate given that educational offerings for nurses are very often someone else's pet project/idea. And...that's fine too, they just may not get a lot of interest. I spend personal time learning about the things I encounter that I want to know more about, because I enjoy it and I'm just curious and I do think it is part of my responsibility.

    Edit/PS: The most recent mandatory educational offering I attended involved being read a collection of facts/slides that staff educators had pulled from the interwebs; ALL of it was common knowledge to bedside nurses in my department, and NOT common knowledge to the people "teaching" us.
  4. by   JKL33
    Regarding the original topic, I echo J. Seizure.

    Maybe you should seek to simply develop trusted and friendly relationships with staff on the ward and offer care over time? Just sort of "become" someone, over time, whom they will approach casually with issues that crop up. I think your position (at least as far as the staff is concerned) would be better utilized as simply a resource present on the ward whom anyone can casually and informally interact with - - not as someone with whom staff makes an appointment and goes to for "therapy."

    Now that I'm thinking about it that might be a very helpful thing.
  5. by   chacha82
    Quote from manjar
    But I am having troubles with the other part which is the fact that nurses rarely seek psychological help or advice.
    I don't mean to be disrespectful, but how would you know that people are not seeking psychological help? Perhaps these employees are not seeking it from you but elsewhere if it is needed. Additionally, if you are talking to the head nurse about employees seeking/not seeking advice on the unit, I would be spooked, personally.
  6. by   Ruby Vee
    Nurses aren't going to seek psychological help from a colleague -- just not done. No one wants their peers -- or their boss -- to know that they think they need some psychological help. You would be a valuable resource in the aftermath of a code or a sentinel event if you were available to debrief the group after the event. And you'd be a valuable resource in dealing with certain patients and family members. But not your colleagues. I'm amazed that anyone ever thought that would be a good idea!
  7. by   Orion81RN
    I see my own personal psychiatrist and counselor, with NO ONE at my place of work kmknowing. Unfortunately, there is still such a stigma to mental health care (though I believe EVERYONE would benefit from talk therapy.)
    I recently had a colleague tell me about another nurse who "was crazy and had to be on meds." Meanwhile, I'm listening to her with my Celexa and Xanax running through my veins keeping me a functional member of society. Ugh the stigma. And, no. I wouldn't trust talking to the hospital psychiatrist. I see HIPAA broken all the time.
  8. by   KatieMI
    1). Re. everybody being excited about psychologist available: something tells me that it was a cool idea which stemmed directly from administration and no one ever asked bedside nurses if THEY would want it. Although, if someone did ask them, they surely said "yessirma'am" because that's what they always do for every new "initiative" which is put upon them.

    2). As you can see now, nursing is a very secretive and very concervative profession. Nurses are trained, from the day #1 in school, that they are a kind of guardian angels hovering over everybody and everything 24/7 to "ensure safety". This obsession with "protection" and "safety" rather easily goes at unhealthy level, ensuring resistance to change - any change, just for the sake of perceived risk, however minor and unrealistic it might really be. This is a well-known phenomenon and there is impressive amount of research dedicated specifically to studying it and the multiple, pretty equally ineffective ways supposed to help in overcoming it.

    As it was said here by many posters, nurses are also fighting powerful stigmas - every day and every minute of their working time. Dealing with "difficult" families, terminal disease in pediatics, communicating with physicians, etc., are sure to be hot topics among them - you can observe it on this forum as well. But among nurses to express dislike of caring for human beings everyone else avoids - drug addicts, criminals and abusers of all sorts, etc., and to demonstrate natural disgust in any form toward them - can be thought only in form of pure anonimity, like we do it here on this free online message board, hiding behind out nicknames. It is unimaginable to see nurses, in the presence of their colleagues, openly and honestly discussing their feelings toward patients, physicians, family members, even their own bosses, because it attaches a stigma which disrupts their image of unconditional care and dedication - and also because, as it was said, they trust absolutely nobody and nothing.

    3). "During their worktime" the nurses may not have a moment to pee 12+ hours in a row. They value their 30 min breaks - when and where they can have them - as ultimately precious commodity. Many of them have second and third jobs ans busy lives otherwise, so they might not at all feel like attending some sort of support group when they are off.

    I do not want to say that the idea of bringing clinical psychologist on floor was the bad one from the beginning. Nurses might deeply appreciate your work with families, especially if you take the load of speaking with "difficult" ones off their shoulders. But they for all likeness won't tell you - because they will have to either openly tell you how they quietly hate even to see that Ms. Johnson with her multiple issues, or expect this question from you. Both situations will make them extremely uncomfortable. You'll have to break the ice and gain the trust of staff nurses before they will tell you anything at all. And just forget about "groups" and "consults" on workplace - that won't happen, ever.

    I highly advise you to familiarise yourself with the phenomenon of "nursing culture" and read this forum, especially topics marked as "vent". After doing that you might better understand why we're doing what we're doing.
  9. by   Rnis
    I don't I would ever feel comfortable participating in that type or relationship. even with work related stuff.....I would only share stuff I would be comfortable mgt knowing. interesting concept though.....

    On a more general discussion I have pondered for years that I could probably benefit from counseling regarding a high stress long term issue in my life..... can't bring myself to set it up. Too busy and too aware of how much goes into the medical chart....don't really want my business out there for every future nurse, provider, MA to snoop in when I go to the dr in the future. It's not even a 'secret' issue I'm pretty open about it.....I just like to be in control of what is shared and when it is shared.
  10. by   canoehead
    I would thank my lucky stars for a psychologist on the unit to give extra support to families, or help us care plan and stay consistent. I would never divulge my own issues to someone at work. Ever. I've seen and personally experienced informal breaches of confidentiality that affected nurses' career. Just a small example...if the manager refers a nurse to talk to you about a difficult case, she does, and the manager follows up, asking you if the meeting occurred. You say yes, but have a concerned look vrs a bright chipper look. Now the manager wants to talk to the nurse, and there's not really the option of telling your boss to mind her own business. Things could get messy.
  11. by   amoLucia
    There are times when I have been among the many posters here to suggest to some OP that a talk with EAP or another counselor might be helpful to get over some distressing occurrence.

    Perhaps I should have been clearer or prefaced my suggestion with a caveat that I was not advocating any thing deeply personal for which confidentiality would be highly expected and that any breach would be compromising for the employee.

    "Two people can keep a secret if one of them is dead" - Benjamin Franklin. I've quoted this truism before. As we know (and have made comment here), there is a reason military and law enforcement staff seek civilian/private practice counseling/assistance.

    Some time ago, I was required to attend a MANDATORY staff meeting during my shift. It was to be a 'quality improvement/employee suggestion' program. that was being initiated by some new management. It was supposed to be confidential. But on the questionnaires, it was required that just your position would be recorded (under the premise that educational opp'ties were 'avail' to all shifts).Well, on my 11-7 we had `~9 CNAs, 3 LPNs and 1 RN (myself).

    REALLY now! Do you think I would write anything suggesting improvement, much less anything disparaging. Hey! One time I put an 'anonymous" compliment into my facility's general community suggestion box - just a general blip of a compliment. I got a 'thank you' note waiting for me a couple days later.

    Talk about anonymity! So NO to anything that would require confidentiality. Maybe some general 'vanilla' concern, but nothing serious.
  12. by   Anna Flaxis
    Quote from manjar
    Since I often seek and get good information at this forum I had an idea I can ask you for help with my current issue.
    I am a psychologist working in a pediatric ICU. I am there mostly for parents and older children. But I am also supposed to be available for supporting staff with their professional or personal issues.
    Head nurse asked me to prepare a talk about the importance of talking to someone and receiving help after a mistake while giving medications to a patient. This I can handle. I can talk about the importance of talk support or therapy. But I am having troubles with the other part which is the fact that nurses rarely seek psychological help or advice. Head nurse encouraged me to talk about reasons for that. I do have my explanations but I would be really happy to hear what you think about that.
    So, to summarize: if you had an option to speak to a psychologist, working at your ward about your work or personal issues - would you do it? Why yes and why no?

    Huh? I have no idea what you are asking.
  13. by   Purple_roses
    Quote from manjar
    Thanks everyone for answering and sharing your thoughts.
    First, I do have to correct myself and say that what I meant was nurses rarely seek psychological help at work and not in general.

    All the reasons you gave, the most common being fear of negative consequences after trusting to someone in the workplace are also the reasons I have in mind. And I can truly understand the mistrust although I still wish this wouldn't have to be the case. Stigma is real. That is for sure. Total confidence is something I take really seriously (as every psychological worker should).

    As I said before I can understand nurses don't come for help regarding their personal issues. And I will definitely consider your opinion I should help with finding support in the community.
    What I am more surprised (and sometimes even get frustrated) about is the fact that they rarely come for consultation about professional issues.
    Let me explain the case. I work on this unit for 3 years now. There wasn't a psychologist before that. General atmosphere is that they hardly waited for a psychologist, everyone needs one, they are all happy to have one etc. Having this in mind I soon started offering consultations about dealing with parents, working with children in distress, talking about troubles at work, dealing with mistakes at work, enhancing communication skills, stress management etc. What happened was almost no one responded. We also tried group settings for mentioned topics, we ensured it was in their work time and nurses could pick which other members they want in their group. The result was the same.
    The biggest irony I think is the fact that not even head nurse applied for the group. When I was talking to her about that she told me that nurses are afraid of me. Not me personally but of a psychologist. And as I said before I can understand this in the light of not wanting to share personal issues. But it is harder for me to realize what gets in the way of accepting work related support. After all they expressed the need in the first place. Regarding work related problems I do believe that the fact I know the environment they work in I can better understand and consult some issues.
    Any thoughts about that? Is this something you think I rather stop trying to do? It is hard for me to accept that since I see nurses in distress, lot of young nurses leaving the ward, having troubles dealing with parents. I see so much I could do to help. Is there something that would stop you from consulting with mental health professional about work related issues?

    If this were me, my reason for not going would simply be that it takes up time. 12 hour shifts as a nurse can be brutal. My time away from work is my time-it's time I physically and mentally need in order to refresh myself. I've also opted out of attending things during my shift because I don't like leaving my patients. I'm still a fairly new nurse, so I don't know if that has anything to do with it, but I hate when I have to leave the floor for an extended period of time (new grad training, in my case) and then come back and try to play catch up. I also usually have a ton of documentation to catch up on (as any nurse has), and it feels more productive to spend my “down time” doing that.