How can I toughen up?

classicdame, MSN, EdD · Apr 16, 2014

Focus on the needs of the other person. Worked with a nurse who would be too sympathetic, which casued her to cross boundaries and also get behind in her work. Doing nobody any good. She finally left the hospital to work in a clinic, then returned several years later. The term too discribe her later was "mature", meaning she acted immature previously.

thenightnurse456 · Apr 16, 2014

10cc of IV cement- STAT!

NOADLS · Apr 16, 2014

10cc of IV testosterone- STAT!

Fixed.

Caution: Possible ovary action

thenightnurse456 · Apr 16, 2014

Fixed.
Caution: Possible ovary action

Evidence based practice states either testosterone or cement is acceptable.

RNperdiem, RN · Apr 16, 2014

I agree with classicdame. Take the focus off yourself and put it on the patient. It comes with maturity to realize that people are not looking at you and observing you or judging you nearly as much as you think. They are busy with their own problems.

When I encounter a tragic, sorrowful situation, I keep the focus on what I can do for them, not how I feel about it.

toomuchbaloney · Apr 16, 2014

I agree with other posters.

Realize that not everything is about you or how you feel. Not every comment made is made with your response, reaction, or emotional needs in mind. While you will encounter bullies and mean people (they are everywhere) most things are just business.

Determine to focus on things other than how you "feel" about the situation at hand.

annaotis · Apr 16, 2014

Empathy is a positive trait. It helps you to be compassionate, which is a highly desirable trait in a nurse. Don't be afraid to feel. You will learn to channel your feelings so that you can do what you need to do, what is best for your patients and their families. (You will also grow a thicker skin as you gain experience).

brandy1017, ASN, RN · Apr 16, 2014

I was too anxious, "performance anxiety" to feel sad. Fortunately I had a very kind, friendly preceptor who helped ease my anxiety. I've heard other nurses talk about instructors from hell who would single student's out and harass them. I'm glad mine wasn't like that. I will always remember her fondly! She was a wonderful teacher and RN and still worked ICU bedside, but definitely not an eat your young kind of nurse as the stereotype goes! I too still remember how hard it was as a new nurse and keep that in mind when mentoring the newbies! I'm amazed at how confident and calm so many appear, when I think back to my own anxiety and trepidation!

melissagee · Apr 17, 2014

I was that way in nursing school also and had been previously all of my life - this is what I learned in nursing school:

#1 Choose your friends wisely. You will likely see a lot of back biting. One of my best friends had a stroke early in our 3rd year (dissected artery - you'll learn about that) and lost much of her cerebellum. Nursing school was very hard for her, so I helped her and supported her through fundraisers etc. Her childhood friends, who were in our class, had the nerve to tell her that she would never have made honor society without me and that she leaned on her stroke to get special treatment. All of this was untrue and motivated by sheer jealousy. Don't let people who lack empathy get you down. They're everywhere, and they're smaller people than yourself.

#2 Cover your behind and put yourself first. I had a clinical instructor who regularly would take me aside and say abusive things to me due to some disabilities I have. She would also lock doors and isolate me from my medications and testing supplies (I have type 1 diabetes). I recorded her doing these things with the technology the school required us to have in clinical. My dean wasn't a fan; I didn't care. I didn't get expelled, and I *did* stand up for myself at a meeting between my dean, this instructor, my course liaison and myself. Closely related: sometimes, you will need to pull all-nighters. Sometimes, you'll fall asleep anyway. Be gentle with yourself and forgive yourself for your mistakes and difficulties. You aren't yet a nurse. You can't know everything, and even nurses don't know everything!

#3 Show your nursing team you love them each and every day. I'm not kidding. Nursing is a team sport. I'm a little intellectual, so it took me my first rotation to realize this. Nobody gets a prize for being able to answer every question right the first day. People will hold you in greater esteem though if you help them help themselves to be better nurses. Offer to help turn heavy patients. Offer to help do vent care. Offer to help with GI feeds. Help the nurses too. You'll become more familiar and more comfortable with the techniques by repeating the processes, and you'll gain confidence. That's what it's all about.

#4 Even if you think you'll never need them, GET LETTERS OF RECOMMENDATION FROM EVERY TEACHER YOU HAVE! The new grad programs are requiring these now; it's not just for grad school. Also try to get into class government or your local student nurses association. Looks good on your resume also, which helps you not require AS thick of skin later on when people say - well we have 300 nursing applicants who had ALL the same clinical experience you had, what did you do that was so special? -Then, you can talk about your work with the nurses association, helping out at fundraisers etc. Let your accomplishments lift you up when people try to shove you down.

#5 Study groups aren't just for students who need help studying - my study groups were an incredible place for me to safely release the tension and frustration I felt at being an empathetic person in nursing school. It was helpful to see others had issues too and to be able to help them. Especially if you're an empathetic person, I recommend you do study groups.

#6 Always strive to learn more than the minimum. It will HELP YOU tremendously. In that vein, buy NCLEX books - I used Saunders, which had a laid out section of each topic and questions. Please don't feel I'm plugging books - I bought mine used on Amazon, and it was an edition old. It served me well though because it allowed me to see what the main points of each system were, to differentiate the nitpicky details from the major ideas when we were in a time crunch. This comes back to confidence. Nursing school, NCLEX tests, and varied patient care methods will make you question your confidence in everything. The best way to have thick skin is to know you're doing the best you possibly can.

That's all I can think of right now.

I wish you the best,

-M

nurseprnRN, BSN, RN · Apr 17, 2014

As in so many other dilemmas, the Fat Man's Laws* can be helpful.

IV. The patient is the one with the disease.

You will develop a sense of professional boundaries. Do not expect to develop this sense any faster than you learn everything else about being a working RN. It takes time.

* Laws of the House of God, Samuel Shem

GOMERS DON’T DIE.
GOMERS GO TO GROUND.
AT A CARDIAC ARREST, THE FIRST PROCEDURE IS TO TAKE YOUR OWN PULSE.
THE PATIENT IS THE ONE WITH THE DISEASE.
PLACEMENT COMES FIRST.
THERE IS NO BODY CAVITY THAT CANNOT BE REACHED WITH A #14G NEEDLE AND A GOOD STRONG ARM.
AGE + BUN = LASIX DOSE.
THEY CAN ALWAYS HURT YOU MORE.
THE ONLY GOOD ADMISSION IS A DEAD ADMISSION.
IF YOU DON’T TAKE A TEMPERATURE, YOU CAN’T FIND A FEVER.
SHOW ME A BMS (Best Medical Student, a student at the Best Medical School) WHO ONLY TRIPLES MY WORK AND I WILL KISS HIS FEET.
IF THE RADIOLOGY RESIDENT AND THE MEDICAL STUDENT BOTH SEE A LESION ON THE CHEST X-RAY, THERE CAN BE NO LESION THERE.
THE DELIVERY OF GOOD MEDICAL CARE IS TO DO AS MUCH NOTHING AS POSSIBLE.

Ruby Vee, BSN · Apr 17, 2014

As in so many other dilemmas, the Fat Man's Laws* can be helpful.

IV. The patient is the one with the disease.

You will develop a sense of professional boundaries. Do not expect to develop this sense any faster than you learn everything else about being a working RN. It takes time.

* Laws of the House of God, Samuel Shem
GOMERS DON’T DIE.
GOMERS GO TO GROUND.
AT A CARDIAC ARREST, THE FIRST PROCEDURE IS TO TAKE YOUR OWN PULSE.
THE PATIENT IS THE ONE WITH THE DISEASE.
PLACEMENT COMES FIRST.
THERE IS NO BODY CAVITY THAT CANNOT BE REACHED WITH A #14G NEEDLE AND A GOOD STRONG ARM.
AGE + BUN = LASIX DOSE.
THEY CAN ALWAYS HURT YOU MORE.
THE ONLY GOOD ADMISSION IS A DEAD ADMISSION.
IF YOU DON’T TAKE A TEMPERATURE, YOU CAN’T FIND A FEVER.
SHOW ME A BMS (Best Medical Student, a student at the Best Medical School) WHO ONLY TRIPLES MY WORK AND I WILL KISS HIS FEET.
IF THE RADIOLOGY RESIDENT AND THE MEDICAL STUDENT BOTH SEE A LESION ON THE CHEST X-RAY, THERE CAN BE NO LESION THERE.
THE DELIVERY OF GOOD MEDICAL CARE IS TO DO AS MUCH NOTHING AS POSSIBLE.

Read "House of God." If it doesn't make you laugh out loud to the point that your family comes to check to see if you're still sane, you shouldn't be in nursing at all. Problem solved -- you won't need to toughen up!

The patient is the one with the disease . . . It's not about you. Keep that in mind while you're dealing with patients.

But you'll also need to toughen up to deal with fellow students, nursing instructors and future colleagues. Again -- it's not about you. Learn to not only accept negative feedback in a positive fashion, but to seek it out. Learn not to take other people's attitudes, stress levels or lack of good manners personally. That's about them, not you. (Not everyone's mother taught them manners, and at the risk of exposing myself as an old fuddy duddy, the younger the person the fewer manners seem to have been internalized. Or maybe that's a regional thing.)