Nurses Just Need to Learn How to Say NO!

Nurses are responsible workers and will usually never say no. They bravely power through difficulty, but everything has a limit. This article is about those times when I nurse just has to learn to say no.

Nurses Just Need to Learn How to Say NO!

I enjoy working as a nurse, I love being around patients and care for them; I like it because it is personable. But I also love being around nurses. I enjoy their presence because and I think of them as these wonderful caring human beings. I appreciate nurses because they feel comfortable in difficult situations and that says a lot to me. Compassionate and caring human beings are rare. But everything has a limit.

Because nurses handle important and difficult tasks they are expected to have great responsibility. If you recall what spider man's uncle said in that movie "with great power comes great responsibility" then I'll like to add - "with great responsibility comes great authority". This authority will be put to work by employing - great prioritization, time management and critical thinking.

In other words: because nurses are required to handle great responsibility they also should have a great power of authority to rule their work life - but unfortunately this power is often neglected or denied to them.

Because nurses are amazing and able workers, they usually find a way out of most trying and challenging situations by simply powering through, always saying yes. Nurses will always find a way to complete their tasks. They stay after hours; they find a way to make ends meet, when there is lack of resources they compensate the system by overworking. This is all good but there is a high price to pay.

Nurses often lack the ability to draw the line between when they should sacrifice themselves, and whey they should simply say no.

Unfortunately, this super hero status is ingrained into nursing culture, so much so nurses need to learn how to get out and protect themselves. Self-preservation is also a form of health care; mothers should first protect themselves insuring they are safe so they will be there to take care of their children. A burned-out nurse is unsafe to patients, therefore defeating the whole purpose of nursing. All you should do is remember that day you were exhausted and how unsafe it was.

So, with that in mind I like to put forward the creation of a new program: just say no. Not angrily, not emotionally, but just say no. And to achieve the wonderful art of saying no, will take a lot of training and soul searching, so be patient. How you say no is also important. And I'll leave that to your own nursing creativity. If you don't know how to say no properly it could get you fired so be careful.

Say no to abusive patients

Patients at times can be manipulative; aggressive; disrespectful; vindictive; unfriendly and several other undesirable things at the same time. When a patient tries to abuse you, just say no. Let them know in known and certain terms that you'll not tolerate any of it. Let them know that you are not their personal servant. If they threaten you by saying they will report you to the state, just say that likewise you'll now have to stop giving him/her care because you'll be busy writing a detailed report regarding his behavior. (no don't say anything, just write the darn note). As a nurse, you must learn to protect yourself by saying no.

Say no to abusive staff

Confront your bullies; every workplace has one. Medical staff can be abusive and aggressive because everyone is under so much stress (or other reasons you might never know). But some individuals take aggression to a whole new level. They get pleasure seeing others fail. Special targets are the new nurses. Just say no. Report bullies immediate, confront them and if they happen to be your boss, do the same. If you end up being fired you just did yourself a favor, no one deserve to work in toxic environments.

Say no to unsafe assignments

Just like your patients, nurses also have the right to refuse treatment; that is to give medication or do anything he/she deem to be an unsafe assignment. New nurses are unaware of this. They think that any job given to them is an non refutable order. Think it through, if something is unsafe just don't sign up for it. You'll never get into too much trouble by not taking an assignment specially when there is a reason; but you'll get into big trouble if you make a mistake or an error. Remember, nurses cannot fail so just say no.

Say no to being pushed into burnout mode

Sometimes nurses are thrown into the fire. Short staff can bring what I call the burnout cascade effect" as nurses try to do everything without proper staff then tend to get sick and as other nurses get sick you are required to work extra hours to cover for your poor unfortunate coworkers. One thing leads to another and soon you have what I call: workplace hell.

Don't forget: nurses are powerful

Use your power. Remember that people demand a lot of responsibility from you. So, use your judgment and decide how you can better manage yourself so you can deliver what's expected of you. What is good for you is good for your patients. Learning how to say no is a good thing because it set limits to what you can and cannot do. And, set limits within people's expectations of what a nurse can or cannot do. If you don't say no, no one will. People will demand impossible things from nurses because they trust you'll do the right thing in the end - so the power is with you, have a good nursing day.

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Leonardo Del Toro

About Leonardo Del Toro, RN

MSN, RN

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Specializes in Travel, Home Health, Med-Surg.

I agree with you that nurses need to learn how to say no. It is extremely hard to do that in the current work environment as managers/admin will usually blame the nurse for everything saying its the nurses fault r/t poor management/time skills, not being nice to patients/families, not understanding the bully etc. So, that being said, I agree with you that nurses can learn to "work the system" to their advantage, at least as much as possible. Every situation will be different and will be trial and error, and nurses also need to be careful how they go about it.

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Nobody is going to give you power. You have to seize power, starting with your own personal power. Get on it.

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Specializes in LTC, Rehab.

I could write so much, but I'll just say that I generally agree. Thanks for the article.

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Specializes in Pediatrics, Women's Health, Education.

Thank you for your article and I do like the underlying message, however, I don't think its as easy as "just saying no", though I wish it were.

"In other words: because nurses are required to handle great responsibility they also should have a great power of authority to rule their work life – but unfortunately this power is often neglected or denied to them."

It would be great if responsibility granted authority, but it does not. In healthcare, as in the rest of the world, bringing in money brings authority. So the people in the C-suite, physicians, and investors are the ones with the authority. As long as nursing care is billed under "room and board" nurses will not have a say equal to the others. (Ask anyone working in an OR, who has the power.) Add patient satisfaction scores to the mix and any patient complaint involving a nurse will probably look bad for the nurse, even if the nurse's behavior is warranted.

"So, with that in mind I like to put forward the creation of a new program: just say no. Not angrily, not emotionally, but just say no. And to achieve the wonderful art of saying no, will take a lot of training and soul searching, so be patient. How you say no is also important. And I'll leave that to your own nursing creativity."

This is the part where most non-confrontational types will need help. If they knew how to do it, I'm sure they would "just do it". Many people operate on two speeds, lay-down or steam coming out of their ears. It's navigating that middle ground that will require role-modeling or some other form of teaching. I think it would help the reader if you add an exemplar of what this looks like, to your article.

Again, I agree with the spirit of the article. But I don't think it's as easy as flipping a switch from yes to no.

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This is a great topic. I work as a psychiatric nurse at a UHS facility that of course, likes to understaff. I have been put into impossible situations, left to manage as the sole nurse on the unit. When I ask management for help, I am told I just have poor time management skills. Nothing is further from the truth.

Can we keep this discussion going? I have taken on the philosophy that if I am feeling the pain of understaffing, then management is going to feel my pain. But that hasn't worked. The blame is always placed back squarely on my shoulders.

I don't know how to remedy the situation.

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Specializes in "Wound care - geriatric care.

Yes. Saying no is not an easy task. There are risks and consequences and it is like walking on eggs. The idea of the article is to channel some of that power nurses have to take care of so many difficult things and take care of themselves too.

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Specializes in "Wound care - geriatric care.
This is a great topic. I work as a psychiatric nurse at a UHS facility that of course, likes to understaff. I have been put into impossible situations, left to manage as the sole nurse on the unit. When I ask management for help, I am told I just have poor time management skills. Nothing is further from the truth.

Can we keep this discussion going? I have taken on the philosophy that if I am feeling the pain of understaffing, then management is going to feel my pain. But that hasn't worked. The blame is always placed back squarely on my shoulders.

I don't know how to remedy the situation.

That is precisely the idea of this post: how can we transfer the pain of our lack of support to management (and at the same time spare the patients)? The idea of saying no is nothing more or less than that.

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Specializes in "Wound care - geriatric care.
Thank you for your article and I do like the underlying message, however, I don't think its as easy as "just saying no", though I wish it were.

"In other words: because nurses are required to handle great responsibility they also should have a great power of authority to rule their work life – but unfortunately this power is often neglected or denied to them."

It would be great if responsibility granted authority, but it does not. In healthcare, as in the rest of the world, bringing in money brings authority. So the people in the C-suite, physicians, and investors are the ones with the authority. As long as nursing care is billed under "room and board" nurses will not have a say equal to the others. (Ask anyone working in an OR, who has the power.) Add patient satisfaction scores to the mix and any patient complaint involving a nurse will probably look bad for the nurse, even if the nurse's behavior is warranted.

Thank you for your input. yes, this article is only designed to be inspirational or to make you think. Of course "just saying no" here is a figurative speech. I myself have a hard time saying no too! But without even thinking and just complying to anything and everything without questioning is not the way.

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Specializes in Hospice.

I want to be a CNA so I can care for my patients but sadly I don’t have the certificate. I am a nurse for 54 years but they now want me to be a secretary ?

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