I feel like I’m not taken seriously?

[mph53953, BSN, RN]

Hello! So I’ve been a nurse for close to two years now. I was on a med/surg floor for a little over a year, and I’ve been in an ICU since April 2019. I’m 24 years old, but I look several years younger than I really am. I feel like this makes it more difficult for patients/visitors/doctors/etc. to take me seriously. Usually people just ask me how old I am, how long I’ve been a nurse, what sort of training have I had, etc. and I answer their questions professionally and honestly, and then direct the conversation back to the plan of care. But every now and again, I get somebody who really tries to push me around or acts condescendingly towards me.

Like once a patient had just come back from the OR about an hour before my shift started (so nothing was done). I had a drip with no order, wrong fluids hanging, about a million overdue meds and new orders to sift through, etc. The surgeon had just rounded and told her daughter the foley could come out. So the minute I enter the room the patient’s daughter demands I pull it. I explained to her that I would pull the foley, I just had some higher priority tasks I needed to complete first. She coldly said “Well do it then.”

And then a few days ago, I had a visitor come up to the nurses station because the patient was missing items from his meal tray and she wanted to file a complaint. I told her I would check with my charge nurse to find out who the best person would be to escalate her concerns to. As soon as I walk away, she asks my coworkers if I was a REAL nurse because I sure seemed unsure of a lot of things (note that the only interactions I had with her up to this point were regarding missing meal tray items). And the rest of the day, she kept making all sorts of little comments. Like I’d understand if I had made a medication/procedural error or something, but all because I didn’t know off the top of my head who to contact about a meal tray complaint? (It’s a neuro ICU so most patients aren’t intact enough to realize if their meal trays are incorrect...let alone swallow.)

So those situations are probably two of the worst cases I’ve dealt with. Usually when people comment about how young I look, I laugh with them and say “Hey, if it’s still working for me 20 years from now I’m not complaining!” Usually I just try to conduct myself with professionalism and confidence, and I answer honestly if I’m questioned about my age/experience. It’s just situations like this when people are unprovoked, and they attempt to assert themselves over me that I really don’t know what to do. Right now, I just take a “kill ‘em with kindness” approach. I’m afraid to put my foot down and say “I am not going to tolerate you talking to me like that” because I’m afraid it will escalate into an argument that I won’t win (not that arguing with a patient/visitor is acceptable in the first place). But at the same time, I’m so sick of feeling like a doormat in these situations. I have a more kind/soft-spoken demeanor, so standing up for myself doesn’t come naturally. Do all young nurses deal with this or is it just me?!?

[Cowboyardee]

Right now you are inexperienced in critical care. April 2019 wasnt long ago, and it takes, realistically 1-3 years just to be competent in an ICU. That's a bigger issue than being young looking. Visitors might focus on your apparent age now - that won't happen so much once you really know what you're doing and have the confidence and authority that comes with that. Give it time.

Fwiw, I looked like a teenager for the first 5 years of my career.

[etienhh, MSN, RN]

That's rough! Give me multiple GSW patient, cursing me out and threatening me because I won't give him a mouth swab any day, but when you get the snide little comments from patient family members that take digs at your integrity and ability as a nurse? Ugh! I've come home in tears after a patient's daughter told her mother (while I was in the room), "Don't worry, Mom. Some people just don't have compassion." It really eats away at you, and those are a couple of nasty scenarios that you had to deal with for sure!

Like yourself, I'm definitely not into confrontation, but I will agree with Cowboyardee: you're still a baby nurse and young in the critical care world. Add your youthful appearance, and you're a potentially easy target! ? While I don't think that's appropriate at all, I've seen it happen a lot, especially to the younger nurses with sweet, bubbly personalities. I imagine as you gain more experience, you'll learn to carry yourself with greater confidence and read the room better. Not saying you don't now, but I've certainly acquired a knack for faking it 'til I make it while in front of family members and patients.

It sounds like you're on the right track! This kind of stuff happens to the best of us! At the end of the day, I try to remind myself that we are getting a glimpse at one of the worse points of our patients' and their loved ones' lives. They're stressed, fearful, and want the best for their loved one. Unfortunately, that means they sometimes take that anger and frustration out on us! Keep your head up and keep on keeping on!

[DolceVita, ADN, BSN, RN]

It is crappy that people make remarks about your age/young looks, true. It unlikely that we will get away from appearance mattering in some way. Considered examining phrases and language that you are currently using. Make sure you're greeting family with a firm handshake and remember their names.

When family or a patient has a request that is low priority to something that affects their outcome I will tell them. “Right now our priority is...”. Also using “we” not “I” can help (you’re part of a team).

I read somewhere that a nurse introduced herself and said “I’m coordinating your care today” rather than “I’ll be looking after you”. I’ve experimented with this phrase and it still feels a bit odd. Maybe try it.

I think you’re doing fine. People will always be poopy. Examine what they say for anything you can change, then carry on.

[smf0903]

Aren’t people fun ? We recently had this happen with a nurse during a code situation. Literally the patient’s family asking how someone got to be in their position...during the code ? The family stated how much better they felt after one of the older nurses came I to the room. (If they only knew how little help the older nurse would be when tshtf)

Just keep on doing what you’re doing...your work will speak for itself ❤️

[viprn21, BSN, RN]

I'm 26 now, but I became an RN at 18. I had a lot of the same issues you had.

First off, don't dwell on rude patients and families. Some people are just nasty, and being in a hospital doesn't help. It's rushed, it's uncomfortable, the situation in general just sucks, and naturally rude people just get ruder when they're in the hospital. Not to mention a lot of people have entitlement issues. Oftentimes difficult patients/families will test you when they first meet you, as evidenced by the lady who demanded the foley come out immediately. People will oftentimes get more aggressive when they think they can get away with it--you've probably seen a lot more nurses get bad treatment from patients than doctors do. It's because they know they can be mean to nurses without consequences but not doctors.

Assertiveness is a necessary skill in this business. Remember that you are not a waitress or a hostess, you are a nurse. You are there to save their ***, not kiss it. And despite a lot of the conditioning you got in nursing school, you have a lot of power as a nurse. Recognizing that power helps put you in a position where you won't get pushed around so much.

Read up on building assertive skills and practice them outside the hospital. It takes practice. But it is a skill and it can be learned.

One last thing--staring young kind of sucks, but it will pay off. Keep with it, and good luck with your career!

[Gingeriffic]

Knowing answers to even basic things will come over time. Don’t feel guilty or inferior for asking questions about ANYTHING - questions = safe nurses. And you’re lucky you look young for your age, embrace it!! Hang in there and you’ll be more confident over time - you seem diligent and conscientious which are some of the most important attributes for a good human being and a good nurse. Until then, just own that you don’t know everything whether it’s to patients, family, or staff. It’s a lot harder to judge/not trust a nurse that knows their limits and involves resources, rather than those nurses that have to be the ‘hero’

[babynurse007, BSN, RN]

In my opinion it just kind of sounds like you need to develop a backbone and a voice for yourself. In the first example, I would have told this family that you as the nurse are responsible for removing the Foley and explain which higher priority tasks you must complete before doing so. In the second example, I would have called the cafeteria myself and inquired about the missing items. It seems like people are detecting that they CAN walk over you and you let them. Stand up for yourself and be clear and direct in your approach. You are the authority in the room!