Got "nurse face"? How'd you get it?

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Specializes in Med Surg, Home Health.

"Nurse face" = the calm, collected expression that a nurse wears

I am a BSN, graduated Sept, no job yet (but looking hard), 2 years experience in LTC, and right now doing temporary caregiving/sitting work in an LTC (private pay).

I'm working on improving my practice. One aspect I'm working on improving is my "nurse face".

I'm pretty good (I think!?) at keeping nurse face when directly speaking with patients and families. At least, I've only rarely gotten feedback that I look tense while talking to them, and I've gotten a lot of other good feedback about how they feel about the conversation.

It's in the spaces in between - hurrying down hallways, trying to collect my thoughts, interacting with coworkers, working on the computer, untangling IV's, mentally counting what supplies I'll need to come back with, trying to punch meds accurately - that the tension gets into my face. And according to some of my former coworkers, it gets in there pretty good. Almost like I just bit a lemon with my whole face.

I'm trying to notice this more and consciously relax my facial expression, but it would really help me to hear some success stories.

Did you ever have to work on your "nurse face", and what helped it happen for you?

Any help appreciated!

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I already have a restricted affect and have difficulty showing or feeling emotions at any given point in time, so the 'nurse face' came easily to me. Some of my former and present coworkers have commented that I look "so calm."

Don't bark at me when I admit this, people. . . . .but I also have some difficulty with empathy. So when a patient is grimacing with extreme pain and rates it a 10/10, I'll quickly intervene without experiencing the range of emotions or achieving the depth of feeling that other caregivers seem to feel.

So, my 'nurse face' is partly due to being emotionally detached.

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Specializes in Pediatrics, Emergency, Trauma.

Early in my nursing career, I had a really good "nurse face"...after being in health care for 12 years, I stopped being concerned about my face...what I worked on was my body language of maintaing a "calmness" in my body, despite a firm tone or a tense face...it becomes interpreted as me being determined. Once you get comfortable with the flow of nursing care meaning, expect the unexpected, your own "nurse face" will appear on its own.

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Specializes in Pediatrics, Emergency, Trauma.

@ TheCommuter, No barking here...some form of emotional detachment can be beneficial...as long as you are aware of your emotions and are helping your patients.

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Specializes in Emergency Nursing.

So funny, I was thinking about this yesterday. I was trying to process a lab draw from this lady's PICC line and COULD NOT get the SoftID program to work. First of all, the MD put the order in wrong ("Renal Function Panel, each morning, collect at 5 pm"?), so I had to change it, and it would not come up in the program we use for processing them.

Turns out that since the lady was from a rehab unit and it is a different phase of care, she needed a new wrist band to scan. Anyway, add to this that she was a very, err, challenging patient (she is a rheumatologist in the same hospital), and the fact that it's 1900 and time to give report, the draw is probably hemolysing in the tube, the patient's close friend is a nursing student watching me like a hawk, and you can imagine I was all abuzz on the inside.

Somehow I was able to work through it without giving any signs of distress or irritation (although I was both distressed and irritated). I don't know if this is because the SSRI I am taking is working or because I am learning "nurse face"...maybe a combination of both.

The latter seems to be borne of a realization that "freaking out" is, at best sub-therapeutic and unprofessional and at worst a guaranteed ticket to corrective action.

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Specializes in Emergency Nursing.

TheCommuter,

Great observation. I think I am similar. I have no difficulty acting and in being empathetic, but I just don't get all frantic by things like walking into a room where the patient has de-foleyed himself, or someone is actively bleeding, or in the middle of a really active session of enhanced hematemesis, or coding unexpectedly...

Having said that though, when its something stupid and picayune like not being able to get a machine to work properly, I have, in the past had to walk away and come back to it in a better frame of mind...

Yesterday I didn't and it was nice.

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Specializes in LTC, Hospice, Case Management.

To Thecommuter (and others like you)..when I first started my nursing career way way way back in the day, people like you frustrated me and even intimidated me. I thought "Are they made of stone or what" "Maybe they are just mean"

Many years later I have learned that I would pick someone like you to work with 100% of the time. All that drama crap is for the birds. Give me a hard working co-worker that won't flip out over every little thing anyday of the week!

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Specializes in Emergency Nursing.

I'd like to see a thread on nurses who flip out unnecessarily. I dont mean nurses who get terse and sharp in high stress situations. i mean nurses who havent learned to keep their emotions in check.

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Don't bark at me when I admit this, people. . . . .but I also have some difficulty with empathy. So when a patient is grimacing with extreme pain and rates it a 10/10, I'll quickly intervene without experiencing the range of emotions or achieving the depth of feeling that other caregivers seem to feel.

I think experiencing a wave of emotions rather than acting first to correct the situation is a sign of being a little to emeshed in your patients. Patient in severe pain? Let's get that IV going, flag the MD down for a pain med order, and get that med in. THEN I'll pat their hands and make the requisite cooing noises.

But I am also completely befuddled by nurses who will post here about hating to cause patients pain with IV starts or other necessary interventions. Forget that, I love starting IVs. I don't have to struggle with guilt before starting one. It's being done for a reason and is part of what the patient needs to get better.

Anyway, OP, I apparently look like a witch with a b when I'm thinking or concentrating. I've gotten some comments that I look like I'm angry or about to yell at someone and I'll be all "I was just trying to remember if I documented that PO challenge before I shart the discharge...." So, I do try to relax my face and not squint or scowl. Or accidentally roll my eyes (something that used to get me in trouble ALL the time in my former career. It's apparently an involuntary reflex reaction to stupidity).

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Practice. Lots of practice. Basically doing the same thing you are, which is self observation and noticing when my facial muscles are tense, then making a conscious effort to relax them. I take it a little further and extend it to my entire body. Are my shoulders tense? Yes? Then inhale deeply and let my shoulders drop as I exhale, and so on.

I've been told I looked angry, when I was really just concentrating. I've been told I looked like I was stomping around in a huff, when I was just trying to get things done quickly. When I have been mindful of my posture and facial expression, I have been complimented on my calm demeanor.

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Specializes in ICU/PACU.

Botox.

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Don't bark at me when I admit this, people. . . . .but I also have some difficulty with empathy. So when a patient is grimacing with extreme pain and rates it a 10/10, I'll quickly intervene without experiencing the range of emotions or achieving the depth of feeling that other caregivers seem to feel.

So, my 'nurse face' is partly due to being emotionally detached.

I am the exact same way! I've been called stoic or emotionless to the max as one old coworker said. Tears don't move me either. I intervene but crying won't help the situation. I tried being more sympathetic but it just isn't me. I want to help but I'm not going to get all worked up helping you. Because to me being all worked up leads to mistakes being made. And again this is me and I won't change. Actually I have patients tell me all the time they want me as their nurse from now on. Unfortunately I'm a PRN float nurse so you will probably never see me again.

So the nurse face will come in time unless that is your personality already.

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