Is it normal to quit a job because the culture isn't welcoming?

[Naturally Brilliant]

I'm a tech (nursing assistant), not a nurse, but I'm certain that this topic is equally applicable to LVNs and registered nurses alike, so I wanted to bring it up.

I currently work two jobs (one full-time, the other PRN) at two separate hospitals, each a part of a different healthcare network. I've been at my full-time job for about two years, and I love it. I get paid well, I love the hospital culture, and I feel that my co-workers and are not only respectful and warm, but very collegial. About seven months ago, I was hired at my PRN job, but have mixed feelings about it. Most people at this PRN position are respectful enough, and I feel like that I my job competently and have no issues whatsoever with management. The only thing is, at my PRN job I feel like there's a lack of support and positivity between the staff members, and sometimes it's a bit depressing.

For instance, at my full-time job when a nurse asks me to do something, they phrase it as a question. "Can you get vitals on patient suchandsuch?" or "He needs an EKG. Are you cool with getting it?" Obviously, I never say 'no' and am quite compliant. Moreover, the nurses will say 'Thanks for doing that' if I help them out. So I do feel like I'm contributing to a team effort.

But at my PRN job, the nurses are more like, "Grab Room 214's blood sugar" or "He needs an EKG at 4 o'clock." I still cheerfully say "Sure!" and comply, but is it strange that the communication feels more hierarchical and less collaborative? Also, I don't feel like I'm ever recognized if I'm particularly busy and do a whole lot of things. I don't expect accolades, but many of the nurses could at least say, "Hey, thanks for doing that!" Is that too much to ask?

Also, at the PRN job it just feels like there's so much negativity among the nurses and other techs, as if they're burnt-out. I've never witnessed it myself, but I've overheard staff (nurses and techs alike) talk about how the doctors yelled at the nurses, or a nurse chewed out a tech. To me, that seems really unprofessional in a workplace environment, and it resembles what 'nursing culture' was years before. I've verbally conflicted with a particular nurse twice, over various issues, since I value my self-respect more than any pretensions to "hospital hierarchy". I'll stick up for myself if need be. Still, I hate conflicts and the perceived aggression, and afterward I always feel like my chest is beating fast and my eyes do get a bit moist.

On the one hand, I consider quitting my PRN job since I feel that I don't particularly need it (I make good money with my other job), already have a solid resume with work experience, and really don't like the atmosphere of negativity. I aspire to be a BSN-prepared nurse someday, and I really don't want to feel like what I do is "just a job". I want to be inspired. For the record, the patients at my PRN job love me (one guy told me he loved having me as his tech because I "treated him as a human", and another patient said I was really positive and they needed more people like me! Aw).

But on the other hand, I haven't hit the one-year mark that's traditionally used to quit a job. Moreover, I may do clinicals at the same hospital system (though probably not the same hospital) as a nursing student in the future, and I don't know if being a former employee over there would make any difference in me being able to do clinicals there. Also, I have doubts as to whether I just need a 'thicker skin' and be more detached from what I do.

Sorry if it's a long post. Just wanted to get all my thoughts out there!

Thank you so much for your replies, folks!

[BuckyBadgerRN, ASN, RN]

What do you suggest as the alternative? Being tolerant of a culture that promotes hostility or workplace bullying?

Well that escalated quickly!

[Kooky Korky, BSN, RN]

Do you thank the nurses for working?

I don't know why you expect thanks for doing your job. That's why you get a check. You're not a child, just do your job. And there is a hierarchy. Respect it. Don't have to like it, but the nurses are in charge and they aren't required to thank you for doing your work. Believe me, no one thanks them for doing what they were hired to do.

I have found that techs think a nurse is "good" when the nurse is not enforcing rules and when the nurse does the techs' work. A bad nurse is one who expects the techs to follow the rules and do their own work.

Is it smart to have good relationships? Sure. Is it always possible? Probably not.

So what is your decision. Will you stay or quit? Good luck with your schooling and future plans.

[Kooky Korky, BSN, RN]

Thanks for replying. I really liked it! Communication's a skill and an art, it seems.

I think we've all been in that situation where something is needed immediately, and if someone said "We need a stat Accucheck on patient 245", it's totally understandable. Using "we" instead of "I" conveys a sense of teamwork rather than hierarchy. And even when the question-based order, saying something like "Could you do an EKG on this kid?" carries the implication that you're not going to say "no".

As opposed to saying, "Hey, go in there and get his vitals". You might as well say "Go fetch that chew-toy and bring me some coffee".

Even from the RN's point of view, if the tech replies differently, I think it matters. Would you rather hear, "I can't right now, I'm busy in here with Mr. Smith (a fall risk patient)!" or "Sure. Could you come and look at Mr. Smith for a second while I go get it?"?

It's really a cultural thing. Let's say I'm really busy doing vitals and lab draws, and a nurse tells me, "I've already got that patient taken care of", I'll still say "Thanks for helping me out with that!" I definitely want to feel like patient care is a team effort, and I'll do my part to convey that.

Chew toy? Coffee? Teamwork? Thanks for everything q 2 seconds? Oh, dear friend, dear newbie dreamer, I ache for you. you are so naive, so precious. maybe life won't beat you up too badly. Keep those stars in your eyes, that brotherly love in your heart. blessings, peace, good night.

[LadyFree28, BSN, LPN, RN]

And in all fairness, I'm not asking everyone else to transform themselves from Negative Nancies into bursts of positivity. I've worked in health care long enough to know you've got your grouches and A-holes as well as people who are sweet as can be.

But the way one communicates really sets the tone for the environment. I treat everyone, whether it be a physician or a janitor, with equal respect and professional warmth. Even if I'm unaffected by it personally, I still find it disturbing when I hear one nurse tell another nurse when a certain doctor yelled at her for calling him in late at night, but when she felt validated by her concerns when that patient deteriorated later on.

Nobody likes it when things don't go the way they envisioned, and nobody likes added stress. But in 2014, when the culture is so hierarchical and 'old boys club' at a hospital, I find it discouraging if people can't maintain their professionalism. I certainly think people can express themselves differently. Plus, you can't deny that when you're surrounded by pizzy people all the time, you worry that you'll end up like them, too.

Emphasis mine.

In all my almost 15 years in the business, I NEVER, and I do mean NEVER, ever worried about turning into a negative Nancy or a "pizzy"person, and I have worked in a dump or two or three, and have also worked as agency, and I have maintained the person and practice regardless of setting.

I'm more into the, "thicker skin " camp as well.

I've learned a long time ago to not have expectations of others, only for myself; it has served me well in life, and in this business, and hasn't altered my objectivity and the ability to enjoy what I do...I don't take stock in what people do or how they react because that is a reflection of their behavior, hence, I am less inclined to entertaining BS from people; I'm also not seeking a thank you or any complements from others, either; it hasn't affected my ability to have exemplary manners and my ability to use them.

[RNfaster]

I don't think there's anything wrong in realizing you like the workplace culture at one place and not at the other. On the other hand, as others have mentioned, you might have to ignore what you don't like at the one job if you need the extra money.

I do think it is important to thank teammates. Maybe there is not time in emergent situations or when there's too much going on.... But it's easy to find 30 seconds at some point in the shift to say, "Thanks, I really appreciated your help with x, y, and z" or "nice work." I think doing so promotes a better culture...

While I may think the above, it doesn't mean it's always going to happen...so as others have suggested, it's good to develop a thicker skin.

[jadelpn, LPN, EMT-B]

Cultures are different everywhere, as you have witnessed first hand. The very, very best thing you can do for yourself is to stop listening to people gossiping about other people. (who got yelled at by who, he said/she said, I know/he did stuff).

There will be nurses who are direct and to the point "get the ekg in room 345 at 1600 hours". Perhaps in this culture, the nurses have heavy patient loads, need to delegate to then stay on task and focus. It is much better than a nurse who says " I do not like the way you do EKG's, so therefore, I will get the 1600 EKG, SIGH, don't bother". Then go on to tell others how useless you are or some other foolishness. That would be an unwelcoming culture to say the least.

Remember, it is not about you, it is about the patient. So that you are "sticking up for yourself" can be taken as insubordinate, so be careful with that. And if what you are being asked to do is within your job description and scope, and serves in the patient's best interest, don't sweat the "tone" or that the nurses don't thank you enough. You do your job, you do it well, and the patients are clean, comfortable and have had all of the procedures that are in your power to do, done.

When you become enmeshed in nursing school, and start clinicals, and then become a nurse, you will soon see that being able to say to a CNA "do this, that and the other thing" and be 99.9% confident that it WILL be done, and be done on time, everything's golden.

Being proactive, you could also say "hey, I will get that EKG at 1600, and room 456's output at 1630 before dinner. Is there anything else on your list?"

Best wishes.

[Nonyvole, BSN, RN]

Well, I'd suggest that the culture of nursing and healthcare in general has become a lot less hierarchical than in decades past...sure, the doctors may give me orders that I carry out, but they don't have the power to fire or suspend me. If I feel that an order will make a patient worse, I ask them about it and offer alternatives.

If they have a problem with a nurse, then they have to go through the same steps that I would if I had a problem with them, by working with the unit manager, HR, and hospital administration. And really, it can be argued that I, as a nurse, have a bit more power over some things than they do. For example, if I get sent a nurse who is very much not suited to the unit and is putting patients in danger, I can tell them to sit down and not do anything, reassign their patients, and get a replacement. The doctors have a harder time doing that.

And yes, I know that isn't the case everywhere...but gone are the days where nurses are expected to stand up and offer doctors their chairs.

Not quite sure what you're going for when you wish that the word "we" was used more. "We" don't need anything. Teamwork doesn't require the use of that word - and it can be said that you're already working as a team, even with the direct orders from the nurses to you. For an analogy - sports teams. Coaches tell the players what to do. The players do it. At the end, in front of the public, yes it's "We went out there and worked hard" but in the heat of the moment it's "go out there and do X." Yes?

Stories are rarely worth the paper that they're printed on. When it comes to interactions between two people, there are always three sides - my side, your side, and the truth. You heard a nurse getting upset over the way the doctor acted when they were asked to come in and see a patient, and then feeling validated when the patient got worse. Well...what would the doctor say about the call? Was it the middle of the night, and instead of having a succinct SBAR from the nurse, they had to drag the entire story out while their significant other grumbled at how long the phone call was taking and would you please go to the other room so that I can go back to sleep? Was the call supposed to go to a different doctor? You don't know any of that, just what you overheard.

Finally, I say please and thank you to my coworkers. Usually. And believe it or not, it's very cultural for me to do so. But for coworkers, I rarely hear those words. I don't take offence; it's not worth my time or energy and I know that it isn't personal.

So, if you don't like your PRN job, then quit. But just understand that your full time job sounds like it's a work environment that isn't seen a lot.

[Ruby Vee, BSN]

Also, at the PRN job it just feels like there's so much negativity among the nurses and other techs, as if they're burnt-out. I've never witnessed it myself, but I've overheard staff (nurses and techs alike) talk about how the doctors yelled at the nurses, or a nurse chewed out a tech. To me, that seems really unprofessional in a workplace environment, and it resembles what 'nursing culture' was years before. I've verbally conflicted with a particular nurse twice, over various issues, since I value my self-respect more than any pretensions to "hospital hierarchy". I'll stick up for myself if need be. Still, I hate conflicts and the perceived aggression, and afterward I always feel like my chest is beating fast and my eyes do get a bit moist.

I'm wondering what makes you think "nursing culture" years ago involved anyone yelling at anyone else. As a nurse of nearly four decades, I can assure you that nursing culture years ago didn't involve yelling. There were always anomolies, of course, but the nursing culture was actually far more professional years ago than it tends to be now. Now it tends to be more collegial.

It's interesting that you're so focused on "feelings." A professional environment isn't like they show on popular sitcoms with everyone worried about everyone else's feelings, all close friends who work together and play together.

[Naturally Brilliant, BSN, RN]

Thanks guys. Lots of great advice given here, and plenty for me to think about deeply on.

I'll certainly keep my PRN job until the end of the year, and will most likely continue in it for the time being. It's only 2 shifts a month, and the extra pay alone from those shifts takes a big chunk out of my rent. Plus, that leaves me with more money to squirrel away as savings for nursing school, which is the chief reason why I still chose to keep working both jobs.

Another reason why I chose to work at both places was to understand what it was like at another hospital system, and how things worked over there. Obviously, my mind can't help but discriminate differences between the two, and constantly compare, but that's only natural. So in a way, I'm getting what I sought when I took this job.

There are behaviors in others that I find quirky, or odd, but I've been a working adult long enough to know when it's best just to keep my head down, do my job, and observe. And most crucially, I've never been "pulled into the office" or had any trouble with management whatsoever, so I can only assume that I'm not truly conflicting with the workplace culture, whatever my misgivings.

It would be one thing if my manager, let's say, kept on saying things that I needed to change. Then I'd legitimately feel that I couldn't fit in and leave. But if I'm doing more-or-less fine on my job, maybe I'm overthinking how I feel about it.

What do y'all think?

[Ruby Vee, BSN]

Thanks guys. Lots of great advice given here, and plenty for me to think about deeply on.

I'll certainly keep my PRN job until the end of the year, and will most likely continue in it for the time being. It's only 2 shifts a month, and the extra pay alone from those shifts takes a big chunk out of my rent. Plus, that leaves me with more money to squirrel away as savings for nursing school, which is the chief reason why I still chose to keep working both jobs.

Another reason why I chose to work at both places was to understand what it was like at another hospital system, and how things worked over there. Obviously, my mind can't help but discriminate differences between the two, and constantly compare, but that's only natural. So in a way, I'm getting what I sought when I took this job.

There are behaviors in others that I find quirky, or odd, but I've been a working adult long enough to know when it's best just to keep my head down, do my job, and observe. And most crucially, I've never been "pulled into the office" or had any trouble with management whatsoever, so I can only assume that I'm not truly conflicting with the workplace culture, whatever my misgivings.

It would be one thing if my manager, let's say, kept on saying things that I needed to change. Then I'd legitimately feel that I couldn't fit in and leave. But if I'm doing more-or-less fine on my job, maybe I'm overthinking how I feel about it.

What do y'all think?

I think you're always going to find "quirky" or "odd" people -- especially if you're looking for them. And I think we're only hearing your side of things . . . wonder what THEY think about YOU.

[Naturally Brilliant, BSN, RN]

Undoubtedly there's people there who don't like me. Just like there would be people everywhere who don't like me. That's how life goes. But I really can't care what they think of me since I have no control over their thoughts.

[psu_213, BSN, RN]

I do think it is important to thank teammates. Maybe there is not time in emergent situations or when there's too much going on.... But it's easy to find 30 seconds at some point in the shift to say, "Thanks, I really appreciated your help with x, y, and z" or "nice work." I think doing so promotes a better culture...

I agree. At the end of my shift I will thank the nurses, techs, secretaries, etc. I worked with that day. If I am in charge, I will try to go around at the end of the day and thank all the staff. However, I am do not say please and thank you with every request.

In addition, when I am in charge, I occasionally have to assign patients to nurses when we are busy. I will say "Sally, I need you to take the chest pain in room 12." It is not a request, it is not a situation that demands please and thank you--it is the way it has to be. Furthermore, the nurse is not offended because I did not use pleasantries at that time.