when you hear "prove yourself 1st, then.."

[astral92]

So here's my story: RN, former Lactation Consultant, 3 years in this particular level 3 and 2 NICU, and 7 years prior to coming to Canada. Yet I hardly ever get challenging assignments, whereas younger and less experienced nurses get them routinely. I spoke to my manager more than a year ago and she said she will inform charge nurses about my "desire". In the meantime I enrolled myself in a university-level neonatal certificate (15 credit course) - very intense and interesting, I've learned a lot - and waiting for opportunities to arise.. But still nothing, I feel I forgot how to take care of a 26 weeker, or inotrops/sedation/paralytics, or chest tubes or on jet ventilator/oscillator and all since I took this job in Canada. Recently I went back to my manager and she told me that "I have to prove myself first" or to be more assertive (she told me that I look like I have no confidence and perhaps I should fake it by putting some make up on my face or color my hair because "you look tired all the time") and since I was there.." she said that a couple of charge nurses complained about me saying I am disorganized and not willing to go for breaks when busy, etc.. I was shocked at all I was hearing and could not believe how judgmental pple were, including my boss! My attempt to find a family physician and get diagnosed and treated for anemia took me more than a year (yeah, this is Canada's health system...) and just now I found out that the charge nurses deemed me less professional for looking pale and tired and none of them told me so to my face! Our manager is very laissez-faire in a sense that there is no clinical support for nurses like me, nurses that are willing to learn more, to improve or enrich their skills. I spoke to the two nurse educators we have in our unit and they totally support me - morally - but they have no power; all the power is with the charge nurses, they get to chose/assign who gets whom and the gap between them and us, the bedside nurses is getting wider with time. It's hard to believe for you guys but some of the charge nurses on my unit don't even have the neonatal certificate completed, don't have any kind of lactation or BFing course done just because is not mandatory (!) and only about 3years nicu experience which is less that my 10 years and one can imagine I know more than them and have to go right to the resident when we don't agree over clinical issues. Obviously they hate to be anything but right and although I have a very good rapport with all the doctors, just because some of the in-charges don't like me, here I am stuck in a situation that feels like a dead-end job. I used to be in love with my job and smile everytime I would see a tiny foot/hand behind an incubator's drapes.. that was a lot of smiling in a 12 hr shift but NO, not anymore and I fear I lost all that unique joy for ever. Please, please give me an advice or just share your opinion with me. This would help me more than counseling - which I've consider if found depressed! Thank you so much for reading this!

[Mimi2RN, ASN, RN]

On my unit we discuss staffing issues during our shift report (charge nurse to charge nurse). We are aware of the skills of the different nurses, and the care needs of each patient. Have you tried talking to the charge nurse on your shift? Unless we have a major problem, our manager is not interested in patient care concerns. I can and do assign staff to more complex patients when I know that there is a nurse to answer questions and assist when necessary. If it's necessary I'll get an orientation day (or reorientation) as the case may be.