So before we go off and eat some worms, lets think about the differences in how to communicate effectively. Let's think about how work and non-work are 2 entirely different lives. And lets think about the meaning behind being a nurse. The patient.
There has been more than one discussion about nurses who are feeling hated. That someone over them calling the shots are nasty, mean and give one all the "hard" patients. The behavior is such that it does happen. In many units, every day. But to tie an emotion onto it and project it as hateful serves little purpose than to drive a nurse mad.
It is eye opening to get into the working world and realize that difficult people exist everywhere. That sometimes no matter what good intentions on your part, that the people who we are tasked with are difficult. Most of us think we leave that all behind in school. Unfortunetely, it becomes part of the workplace, and this is where it gets sticky.
I have said many times, and I abide by this, that people who you work with are not your friends. You can leave your shift and go right back to your life, and not have to deal with anyone from work again until your next shift. Not to say there's not friendships that come from working with someone. There are. However, being mindful and careful are not bad things. Terms such as being a "doormat" or being "eaten" or any other emotional term for how one perceives to be treated can apply to one's personal life, but does little in one's nursing life then to be a stressor.
If you get into a mindset that you are not focused on how a coworker perceives you as a person, but mindful of how your patients see you as their nurse, then this is worth its weight in gold. It takes focus, communication, knowing your limits, negotiate if you have to. Non emotionally, just factually.
It does take being aware, being responsive, and communicating. Open your mouth and speak up. If you are feeling overwhelmed, say so. But with that statement needs to come a solid request. To say that you are feeling overwhelmed is less effective and does no good if you don't follow that up with "could you do xyz" to the person in charge.
We all want patients to be in a place where they are able to function. We all want to be careful and mindful in documentation, in assessments, and generally providing the best practice that we can. In this newer nursing world of scripting, communication can and does get difficult. To convey what you mean, you need to be clear. No one is a mind reader, not even your charge nurse (and sometimes, thankfully...).
To be able to ask for what you need, you also need to be aware of how to do that. When you go over the plan of care with your patient, you can likely go over the plan of care with the CNA. If you do not have a CNA available, then you need to think about what you tell a patient, and try to stick to it. As your shift goes on, find your charge nurse, and update. Be clear on the needs of your patients, and what you need to make that happen. If you are buzzing around task to task and seemingly look like you have it all under control, no one will know if you don't. But if you don't, you need to have someone to go to for help. You need to be aware of who that person is (usually your charge nurse) and specifically what they can do for your patients.
Finally, sometimes the intent of a heavy load of patients is because your charge knows you can do it. And there's nurses in this world who thrive on this scenario. It doesn't mean they are a better nurse, just have their own way of doing things that work for them and the patients. Bless them, but not every nurse can do this.
Ah, and then the almighty dollar. To work nurses to the bone with multiple patients hovering around 6 or 7 or more total cares doesn't do the patients a bit of good. Calling nurses off, sending them home, or any other tactic used to get fewer nurses to do more with less is an entirely different matter. If this is the case, then you need to speak up to your union, to your DON, to the ethics hotline of your company. Safe and effective nursing care of patients is why we all do what we do. If this is impossible in your current climate and culture, then use your voice.
Effective communication, making the needs of the patient known, and to speak up about limitations on what you are able to do are all important factors in one's nursing practice.
We can not and should not get caught up in the personalization of what ultimately is patient oriented care.
We need a positive team work oriented working relationship with our co-workers, we do not, however, need to be friends.
All of us depend on each other to have our backs when the chips may be down. That doesn't mean we have to be besties with whom we work with.
Exactly. You can have a team environment without the "friendship" attachment to it; over time friendships may develop with a core group; however, trust usually happens when the team work has been established and is the rule, that is more of a professionalism stand point, rather than "friend" stand point.
I agree with you, we also have to think of what is best for the patient and patient outcome when tasking the nurse regardless of their ability. I have worked with nurses that are more then capable but one has to wonder if the best care is given to that patient when that nurse is over tasked.
I have worked in many toxic/high turn over environments, I find that in the medical industry the abrasive and or harsh people can sometimes be more valuable and trustable in your growth than people who are over friendly and are never critical of you.
LadyFree28, BSN, LPN, RN
8,429 Posts
Exactly. You can have a team environment without the "friendship" attachment to it; over time friendships may develop with a core group; however, trust usually happens when the team work has been established and is the rule, that is more of a professionalism stand point, rather than "friend" stand point.