How I Survive as a Nurse

[Nurse Pleiades]

What are examples of kind and supportive nurses and co-workers in a hospital setting, and what difficulties do they help each other endure? Excluding the occasional Preceptor who was both patient and kind, a rarity to be sure, I will describe a few good experiences with coworkers who helped me survive. First, let me describe the toxic work environment. The first glimpse of the culture was when a coworker dramatically lifted her watch hand to her face as I clocked in a few minutes late. Her gesture said, "I see you are late, and I am pointing this out to you.” Was that intended to embarrass or shame me? It was instant criticism to start the day and not the slightest bit jovial. The same co-worker, an experienced nurse like me, physically erased the names I wrote on the patient's whiteboard and re-wrote them herself, another critical statement that my work wasn't good enough. You might think she didn't like me, which is probably true. You may wonder if I am just an unlikeable person, but hopefully, most people would say that is not true. 

What else was difficult to survive at this hospital? It took a lot of my energy throughout my twelve-hour shifts to ignore the constant drone of coworkers at the nurse's station criticizing other nurses, doctors, residents, aids, departments, and patients. This was where we updated charts and I felt drained because I did not want to contribute to this form of public shaming and humiliation, and I could do very little to change the topic without their cooperation - which I tried. By the end of the day, the nay-sayers would cry that they did not get any charting done and have to stay later. Yes, the management was aware of this culture and at times participated.

Many people have experienced cliques at some point in their lives. One of the other difficult behaviors to understand, endure, and overcome was experiencing people talking amongst themselves while deliberately ignoring others sitting and working alongside them. The isolation and low morale led me to resign within six months. It was a great relief to be free of this workplace that enabled people to exclude, mistreat, blame, and shame others. When I resigned, I promised to send my manager, who was working very hard to improve the culture and staffing, a short story of some kindnesses I had received, and here is what I told her. 

One day, at the beginning of my shift, Nurse Paula offered to be a resource if I needed any help. It was clear she genuinely wanted to help, and she mentioned she had a less demanding set. What a wonderful way to start the day!  By early afternoon, I think everyone became overworked with too many patients or a barrage of changes and new orders, but Paula stopped and listened when I explained the things I couldn't get to and asked if she could help with any of them. That felt like teamwork, backing each other up from the moment she said "I'm here if you need me.” When Paula is working, she is not critical of other co-workers, and that gave me moments of peace, where I felt safe from unnecessary criticism. I'm making a distinction from constructive feedback which is helpful and necessary. I hope I can bring that much positive attitude to my work. She also reminds me of a supportive Charge Nurse.

Speaking of Charge Nurse, whether she was Precepting, or Charge Nurse, or Floor Nurse, Kimla was always willing to stop what she was doing to help me find things, assemble new equipment, answer questions, or problem-solve when we were both stumped. And Kimla does so with warmheartedness and what seems like endless energy. She is a special person, who works hard and maintains a positive attitude. 

Similar to Paula, an ICU Nurse would help us during a couple of shifts, and I was so happy when she was there because she also offered to help when she said "If you need anything…” and it felt like she genuinely meant it, and that it would be no trouble at all. In conversations, I noticed she was more often cheerful and thoughtful.

Do you know how rare it is to have a Nursing Assistant who wants to provide care for patients? In my ten years of experience, perhaps twenty percent of the NA workforce will work their entire 8 to 12 hours. When Karena came on shift as a Nursing Assistant, I had a very difficult patient who consumed an endless amount of time. Near the end of that day, the patient needed a new IV and blood draw, but I could feel myself having less and less patience, and I had gotten behind on so many other tasks. Karena was willing to place the IV and get the labs drawn. What makes this notable is this patient had been difficult for many staff and had mistreated Karena a couple of days earlier, to the point where Karena was initially planning to avoid her, which was completely understandable. However, she put her feelings aside and provided help to her teammate while also providing patience and calmness that was helpful to the patient. The patient complimented her on her IV skills! Together, the three of us at the patient's bedside felt like a collaborative and therapeutic moment, one of those great, uplifting moments.

When we heal the problems that create toxic work environments, we will also improve patient care in measurable ways. People want to continue working on well-functioning teams, where they can feel successful, supported, and where they can survive.