How do I overcome toxic hospital environments?

Ruby Vee, BSN · Apr 9, 2008

i'm going to do you the courtesy of assuming that you meant it when you asked for advice. i suspect you won't like the advice i have to give, but i'm hoping you'll at least think about it rather than dismissing it out of hand.

you say you've had the same problems over and over: mean, unfair charge nurses, lazy cnas who don't do their work, toxic co-workers, inept managers who encourage backstabbing (and presumably either don't care about or haven't noticed the mean and unfair charge nurses, lazy and incompetent cnas, toxic co-workers or backstabbing) patients are complaining about you and you've had personality conflicts with your peers. things are so bad that you're repeatedly losing jobs and according to your own admission "don't last long at jobs."

i hope you'll consider changing your approach. something you're doing isn't working, and while you have no power to change anyone else, you do have the power to change yourself. from your post, i can't tell if you honestly have no idea that the problem might lie within you or if you suspect that it might and aren't sure what to do about it. i don't know you personally, but i suspect you're hanging on to a lot of unresolved anger. letting go of that may be the first step in turning things around.

i hope you "get" that i'm not judging you -- there was a time many years ago when i could have written a similar post. i'm trying to give you the benefit of my experience and i hope that you can figure things out and turn things around faster than i did!

good luck -- you've got your work cut out for you. the good thing is, though, that once you let go of the anger -- or whatever it is that's holding you back -- not only will your work relationships improve, but your entire life will improve.

ecnav · Apr 9, 2008

Anyone have any suggestions, other than leaving hospitals?

May I ask a few questions?

Are you male?
Are you self-assured, not arrogant?
Did you have a life/education/career prior to nursing?

Let me know... thanks.

RNperdiem, RN · Apr 9, 2008

There are no perfect work environment.

Accept that and move on.

Have you considered a float pool, per diem or agency job?

You do not have to stay anywhere too long. As an outsider, you avoid most of the gossip and vendettas.

If you float to many places, you might find one that you like and can try to apply for a job there.

UM Review RN, ASN, RN · Apr 9, 2008

I've learned that in nursing, "It is what it is."

In other words, you have to accept the job, its positives and its negatives.

Not an easy task. But IMO where you're having a problem is that you go to each job hoping that certain things are different and get disappointed and angry when they are not.

I've tried to overcome that by focusing on coming in, doing my job, and getting out on time, and putting everything else in the "don't sweat it emotionally" category.

ArwenEvenstar · Apr 9, 2008

i've had repeated problems with controlling/mean charge rns who make unfair assignments, cnas who do poor work, toxic coworkers, inept managers, and managers who encourage backstabbing by coworkers in every hospital unit i've worked in. somehow patient complaints don't seem to be taken seriously about other nurses, while they are when made about me. i've tried informing management of the problems i see - with suggestions for improvement - but that seems to backfire on me. while some managers will inform me of complaints made about me, they don't seem to ever have suggestions for improving the situation and never care to hear my side of the story. due to the above, i don't last long at jobs. while i so far quickly get new jobs due to my experience level (several years) and have good cover stories for why i left all previous jobs, i'm getting quite paranoid and wonder when this will change due to my frequency of job changes since becoming a nurse and i'm also tired of this repeating pattern. it seems that problems with coworkers and patient complaints are what hangs me over and over.

i am very focused on work, make few mistakes as i don't cut corners, try to avoid gossip and complaining, and get numerous compliments from day shift when giving report (you're so thorough & i know you get things done) and from patients. but i personally have great difficulty with all the numerous (& often unneccessary) interruptions at work, often feel overwhelmed & get frazzled, and tend to run behind & work ot due to the time needed for documentation esp. when stuck with a bad computer system. at every job, while i am feeling like this i see some of the other nurses calmly going about their work, spending most of the night on the computer documentating, having lots of time for personal conversations, and leaving on time regularly.

i ask lots of questions in interviews to try to find out about the unit environment, but it seems managers will say anything in order to get a new nurse on the floor. i tried agency work, but was given the worst patients, had to deal with a new computer system, and coworkers were quite unhelpful so i don't want to try that again. while i had "personality conflicts" with a few coworkers here and there in previous jobs & in my previous career (ma level), it has never been anywhere close to this magnitude. anyone have any suggestions, other than leaving hospitals?

hello! i feel your frustration. you said that you often feel overwhelmed and frazzled and don't handle interruptions well. perhaps this is just your personality type, and you need to find a work environment that is less "stimulating" (less interruptions, less chaos, etc). i have a personality exactly like this - i simply can not handle too many interruptions or changes. i was in the float pool at a 800 bed hospital for almost 2 years. sometimes they sent me to the chest pain section of the er because i was telemetry certified (although not acls). anyways, the chest pain section was insane - constant coming and going of patients - new pts rolling in, patients being discharged, pts being transferred, new orders to do, etc!!!! i could not take it! by the middle of my shift i had to go to the bathroom and cry. i felt so overwhelmed that i can not even explain it in words. i went to my manager (of the float pool) and asked him not to send me there. thank goodness, he was very understanding and agreed to no longer float me there. what a relief!

other ideas? i am guessing you work day shift? day shift is for sure the most "stimulating" shift with more coming and going of patients, procedures, etc. maybe try a different shift. i worked evening or nights all of my hospital career. although nights can be busy, it is a different type of busy. it is a less chaotic busy. the hospital is overall quieter, routine procedures are not being done, visitors all go home after 9pm or so, etc. maybe try night shift - 7p to 7 a, or 11p to 7a.

a thought regarding toxic co-workers and unit "politics". i was in the float pool at 2 different hospitals. one great advantage of this is that you totally avoid floor politics! you float in and out, and do not have to get tangled up in floor politics! if there is an employee you don't like on a certain unit, well you only have to put up with them every so often when you happen to get floated there. it is easier to put up with someone when you know it is only for one shift! ya know? also, floating will expose you to different units in the hospital so you can see what they are like for yourself. and you may eventually find a unit that you really like and fits you well. then you could apply for a position on that unit.

with what you have described in your post, i would say agency work would not be a good option for you! as an agency nurse, you would always be going to different facilities, different situations, different charting, etc. that would be too overwhelming!! being a float within a hospital (an an employee of that hospital) is different. at least it is one hospital you are floating in, so the charting, equipment and such is the same.

a final comment, some of your remarks almost reminded me of someone in "burn-out". after being a hospital nurse for 14 years, i totally burned out. toward the end i was very cynical, miserable, and unhappy with everything. could you be in burn out? maybe find some articles on handling health care burn out.

you also mentioned that you are conscientious (you don't cut corners, you are very thorough, etc). i am the same way. this is the exact type that is more prone to burnout! our perfectionist tendencies make things harder for us.

it sounds to me like you might be a "highly sensitive person". i am! this does not mean we are "touchy". it means we have more sensitive nervous systems and do not handle excess stimulation well as a result. looks for the book: the highly sensitive person, by elaine aron, phd. i highly recommend this book.

i burned out of hospital nursing after 14 years, and left hospitals 3 years ago now. i now do private duty - i like it. a much nicer (less chaotic) work environment.

medsurgrnco, BSN, RN · Apr 11, 2008

I don't know why some people think I'm angry or have anger issues. I'm frustrated with this situation. I had no idea that so many professional adults could be so mean-spirited, petty, immature and dishonest, and in my personal life I do not associate with those type of people. I had a prior MA-level career, rarely had problems with coworkers before nursing. I'm assertive, not obnoxious or arrogant or aggressive, definitely not passive-aggressive like many in hospital units. I do need to deal better with the often chaotic environment of nursing, as I've never worked before in an environment where you are continually interrupted while trying to get your work done. And somehow I need to get on the good side of charge RNs and CNAs, who typically are the difficult staff I work with who attempt to get me in trouble with management. I focus on my work and the patients, which leaves little time for those social interactions that improve work relationships with coworkers. Thanks for the suggestions regarding other areas. I think float would not be good for me, as I imagine it would feel too chaotic dealing with the increased number of staff from working on different units. Anyway, I'm starting to think the real solution is to find a good, cohesive unit with a reasonable patient load where staff are pleasant and management doesn't cater to malicious gossip. Maybe if other staff were happier, they wouldn't feel the need to tear down their coworkers.

inthesky · Apr 11, 2008

ive been having a lot of trouble with other RNs and techs >_<. i had a nurse yell at me to talk again another one chewed out the other night.. ive talked others about both nurses..they are known for being mean..and singled out.. new grad young lets eat her yay>

im pretty ****** as well.. its (^)(*& up. it doesnt have to be this way!!!! i guess nurses tend to be super stressed and perfectionistic..and take out all that repressed anger out on peers >_<. im also getting how i have to kiss tech ass ask them do anything.. even a repeat blood pressure is like this hugggggggge favor>_<. arg..>

FireStarterRN, BSN, RN · Apr 11, 2008

I agree with Ruby. Any time there is a pattern that repeats itsself like this, there is something about us that needs to change.

Maybe there is a course you can take to improve your interpersonal skills? It sounds to me like you are having trouble bonding with your co-workers and being accepted socially.

Also, it sounds to me like you might be too anal about some things, since you report that you 'don't cut corners, are always running behind, are getting frazzled, feel overwhelmed'. If you don't learn some shortcuts and time management skills, you will burn out!

Someone mentioned that you may be 'Highly Sensitive'. There is a book about The Highly Sensitive Person that I recommend. 15% of humans fall into this catagory, as well as 15% of the animal kingdom. It's a trait that is useful to society as a whole, but the Highly Sensitive Person must learn to construct their lives to accomodate it and utilize it properly. Click the below link to find out more.

http://www.hsperson.com/

bagladyrn, RN · Apr 11, 2008

I don't know why some people think I'm angry or have anger issues. I'm frustrated with this situation. I had no idea that so many professional adults could be so mean-spirited, petty, immature and dishonest, and in my personal life I do not associate with those type of people. I had a prior MA-level career, rarely had problems with coworkers before nursing. I'm assertive, not obnoxious or arrogant or aggressive, definitely not passive-aggressive like many in hospital units. I do need to deal better with the often chaotic environment of nursing, as I've never worked before in an environment where you are continually interrupted while trying to get your work done. And somehow I need to get on the good side of charge RNs and CNAs, who typically are the difficult staff I work with who attempt to get me in trouble with management. I focus on my work and the patients, which leaves little time for those social interactions that improve work relationships with coworkers. Thanks for the suggestions regarding other areas. I think float would not be good for me, as I imagine it would feel too chaotic dealing with the increased number of staff from working on different units. Anyway, I'm starting to think the real solution is to find a good, cohesive unit with a reasonable patient load where staff are pleasant and management doesn't cater to malicious gossip. Maybe if other staff were happier, they wouldn't feel the need to tear down their coworkers.

You come across on these posts (and I know we can't always read nuances in print) as somewhat resistent to the idea that your behavior may be contributing to the issues. As a general rule, when the same issues repeat more than twice, you need to look at that possibility. Since we really can't see the situation and behavior, do you have a friend or relative that you can trust to be totally honest with you? If so, I'd suggest asking them to honestly evaluate whether you may be triggering this response in people in some way. It would be especially useful if it were someone who has seen you in a work setting.

ecnav · Apr 11, 2008

hello! i feel your frustration. you said that you often feel overwhelmed and frazzled and don't handle interruptions well. perhaps this is just your personality type, and you need to find a work environment that is less "stimulating" (less interruptions, less chaos, etc). i have a personality exactly like this - i simply can not handle too many interruptions or changes. i was in the float pool at a 800 bed hospital for almost 2 years. sometimes they sent me to the chest pain section of the er because i was telemetry certified (although not acls). anyways, the chest pain section was insane - constant coming and going of patients - new pts rolling in, patients being discharged, pts being transferred, new orders to do, etc!!!! i could not take it! by the middle of my shift i had to go to the bathroom and cry. i felt so overwhelmed that i can not even explain it in words. i went to my manager (of the float pool) and asked him not to send me there. thank goodness, he was very understanding and agreed to no longer float me there. what a relief!
other ideas? i am guessing you work day shift? day shift is for sure the most "stimulating" shift with more coming and going of patients, procedures, etc. maybe try a different shift. i worked evening or nights all of my hospital career. although nights can be busy, it is a different type of busy. it is a less chaotic busy. the hospital is overall quieter, routine procedures are not being done, visitors all go home after 9pm or so, etc. maybe try night shift - 7p to 7 a, or 11p to 7a.
a thought regarding toxic co-workers and unit "politics". i was in the float pool at 2 different hospitals. one great advantage of this is that you totally avoid floor politics! you float in and out, and do not have to get tangled up in floor politics! if there is an employee you don't like on a certain unit, well you only have to put up with them every so often when you happen to get floated there. it is easier to put up with someone when you know it is only for one shift! ya know? also, floating will expose you to different units in the hospital so you can see what they are like for yourself. and you may eventually find a unit that you really like and fits you well. then you could apply for a position on that unit.
with what you have described in your post, i would say agency work would not be a good option for you! as an agency nurse, you would always be going to different facilities, different situations, different charting, etc. that would be too overwhelming!! being a float within a hospital (an an employee of that hospital) is different. at least it is one hospital you are floating in, so the charting, equipment and such is the same.
a final comment, some of your remarks almost reminded me of someone in "burn-out". after being a hospital nurse for 14 years, i totally burned out. toward the end i was very cynical, miserable, and unhappy with everything. could you be in burn out? maybe find some articles on handling health care burn out.
you also mentioned that you are conscientious (you don't cut corners, you are very thorough, etc). i am the same way. this is the exact type that is more prone to burnout! our perfectionist tendencies make things harder for us.
it sounds to me like you might be a "highly sensitive person". i am! this does not mean we are "touchy". it means we have more sensitive nervous systems and do not handle excess stimulation well as a result. looks for the book: the highly sensitive person, by elaine aron, phd. i highly recommend this book.
i burned out of hospital nursing after 14 years, and left hospitals 3 years ago now. i now do private duty - i like it. a much nicer (less chaotic) work environment.

what a very nice post. thoughtful and fair. you are the kind of people i like to work with. thanks.

ecnav · Apr 11, 2008

I don't know why some people think I'm angry or have anger issues. I'm frustrated with this situation. I had no idea that so many professional adults could be so mean-spirited, petty, immature and dishonest, and in my personal life I do not associate with those type of people. I had a prior MA-level career, rarely had problems with coworkers before nursing. I'm assertive, not obnoxious or arrogant or aggressive, definitely not passive-aggressive like many in hospital units. I do need to deal better with the often chaotic environment of nursing, as I've never worked before in an environment where you are continually interrupted while trying to get your work done. And somehow I need to get on the good side of charge RNs and CNAs, who typically are the difficult staff I work with who attempt to get me in trouble with management. I focus on my work and the patients, which leaves little time for those social interactions that improve work relationships with coworkers. Thanks for the suggestions regarding other areas. I think float would not be good for me, as I imagine it would feel too chaotic dealing with the increased number of staff from working on different units. Anyway, I'm starting to think the real solution is to find a good, cohesive unit with a reasonable patient load where staff are pleasant and management doesn't cater to malicious gossip. Maybe if other staff were happier, they wouldn't feel the need to tear down their coworkers.

So some people say, 'you gotta change to meet the environment' or 'you seem angry...' It's a real hoot! What if you are angry - so what? Does that invalidate your assessment? No. Maybe the issues deserve a bit of heat exchange. What if the environment is broken? What if coworkers have no manners, consideration or professionalism... should we address this? Naw, it'll just continue to drift southward toward the lowest common denominator - bedlam.

And previous posts do address the neccessity to preserve self. Find methods to preserve yourself, improve yourself as you roam with the hurd. Don't get trampled in the journey. Be a smart operator.

:bugeyes: