How do you develop thick skin?

Specialties Operating Room

Published

This is a question for all. I've been told many times that you need to have thick skin to work in the OR and you can't take things personal.

Ok so i was wondering how do you develop thick skin and how do you learn to not take things so personal? I'm already nervous as a new grad, new RN but i notice i get really nervous when someone snaps or yells at me. Because i'm not on my own yet i don't feel as stressed, but i know once i'm on my own and a surgeon or someone is yelling at me i'm afraid i'm going to go blank or freeze up or maybe break down and cry later on. I'm afraid i'm going to be too sensitive and take things too personal and go home crying after every shift. I know its inevitable and that i will have to deal with surgeons yelling, throwing fits and taking it out on nurses but i'm afraid i won't handle it well. I'm the type who normally doesn't talk back or give attitude. I believe in not feeding more fuel to the fire, just let it burn out on its own. I just hope that i won't be taken advantage of or walked all over having this philosophy. I had a nurse yell at me today for being in the way and now i don't even want to look or talk to her anymore. She's a dominant type who i thought was nice but now i see her in a different light. She's on my witch list now and someone i hope won't precept me. Would this be considered taking it personal?

I would love to hear any tips, advice, words of wisdom, your experiences and what type of personality do you have. Please share. Thanks

IsseyM

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
I would love to know how you OR men and women manage not to pummel some of those surgeons to death with all their shennanigans.

Just because we haven't, doesn't mean we haven't thought about it (many times lol)

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Specializes in Hospice, OR, Home Health, Orthopedics.
I think it's all that formalin they have to handle for specimens. That stuff can do a number on your skin!

Ok, bad humor I know.

I would love to know how you OR men and women manage not to pummel some of those surgeons to death with all their shennanigans.

Ahhhh, the days of the old operating room. I do miss them. Surgeons fussing, cursing, throwing instruments. But the worst were the nurses who eat their own. I was not a new graduate when I came to work in the O.R. and to have that added to your plate (being a new grad) makes it harder on you for sure. It's almost like a hazing when you first start unless you have a really good staff. I think it's because everyone is so conscious that sterile technique and sterility are such important areas, and a patient is very at risk. Anxiety is a factor for the established staff (speaking as a staff member who has been on both ends) and you have to prove yourself as a reliable competent and consistently dependable O.R. nurse. Many a day between cases I ran to the bathroom to shed a few tears, blot my eyes and head back into the fray because steely words hurt my feelings. It's rough in the beginning, but oh...the rewards. The comraderie is like none other I've found except for my Hospice team. I believe what makes it like that is that for a brief moment, everyone on the team holds that person's life in their hands, their really skilled and competent hands. From the person who mops the floor and gets the debri and yuck from the previous case making the room clean for the next case, to the scrub who honestly admits she touched her nose, to the circulator who cautiously observes every aspect of her room and keeps things moving through the day. All of the jobs are hard, demanding, but makes the surgical O.R. team one of the most cohesive in nursing. My friends from O.R. were some of the closest in life. Good luck in your Operating Room career, and you make me wistful and misty eyed about mine.

sincerely

Jenny

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Specializes in Surgery.

I guess I have been lucky..All of the RN's Ive worked with have been really nice and havent snapped my head off..Ive been there for a student as 1 year and a RN for 5 months..At first I was shy and really took things to heart..Mainly the surgeons were my problem and my educator..She was very up tight and put alot of stress on the nursing students..All of them quit but me..Anyways over time I have learned peoples attitudes and how to handle them...Ive learned that you have to hand certain people differently...If a surgeon says something to me I tell them that I am doing the best that I can or that I am working on the situation..If something is my fault then I let it roll off of my back but if its not my fault I will take up for myself......I think it just takes time..Goodluck

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If someone is yelling or screaming inappropriately, your best response is always to remain calm, maintain eye contact, and tell them that you what they are doing is inappropriate and is it really necessary to yell or scream at you in that manner? Setting boundaries to let others know what you will or will not accept is important. If people see you as a doormat, they will kindly wipe their feet on you time and time again. Maintaining your composure and reacting in a calm, professional manner, sets a tone that puts a mirror up against the person's face. Just because you are new does not mean that your co-workers can treat you with disrespect. But, also learn to pick and choose your battles. Sometimes, when we are in a panic or hurry, we might be curt with others. It does happen from time to time. If this is an ongoing occurrence, it is up to you to draw the line and keep those who are being intolerable behind it. We learn about setting boundaries with our patients, the same applies to co-workers. If you choose to take the person who is repeatedly offending you aside, then it is always best to take along a witness. You will not be new forever and you will find your niche. Give yourself time and remember that developing "thick skin" is a process and can help you in other areas of your life.

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Specializes in NICU, ER, OR.

You know what, though? For me, the problem was not so much that people verbally abused me (and the other new people) , its that they treated you like you were invisible. They were rude, but in a way more like they would ignore you.Like you were an intruder on their turf. Sometimes, that is just as hard. Its like being the new kid from a new state on the first day of , like, 4th grade.

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You know what, though? For me, the problem was not so much that people verbally abused me (and the other new people) , its that they treated you like you were invisible. They were rude, but in a way more like they would ignore you.Like you were an intruder on their turf. Sometimes, that is just as hard. Its like being the new kid from a new state on the first day of , like, 4th grade.

I agree with you 100%.

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hi

i agree with everything that has been said and it is the same over the pond. i think it must be a universal thing.

at my hospital as a new nurse you have to wear a white hat, you have 6 months induction and if you pass you get to wear a pink hat. at 4 months in i thought i was never going to make it or even if i wanted to due to all of the above...

i thought most of the staff hated me some of the surgeons where awful to me and i cried in the sleuce room more than once. then at 6 months i arrived one morning and tpld to change my hat from white to pink. everyone congratulated me and i had a fantastic day and finally started to feel part of the team

i was told it takes AT LEAST a year to feel comfortable in the OR and i can agree with that. but i wonder if the attitudes from some of the staff is that they are so used to people hating the OR or starting work and not making it to the 6month mark that they just dont want to bother with you until you have a pink hat on and you are DEEMED fit to practice.......i just dont know but i love the OR and try to pass that on to students when they are on placement with us.

debbie

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hi

i agree with everything that has been said and it is the same over the pond. i think it must be a universal thing.

at my hospital as a new nurse you have to wear a white hat, you have 6 months induction and if you pass you get to wear a pink hat. at 4 months in i thought i was never going to make it or even if i wanted to due to all of the above...

i thought most of the staff hated me some of the surgeons where awful to me and i cried in the sleuce room more than once. then at 6 months i arrived one morning and tpld to change my hat from white to pink. everyone congratulated me and i had a fantastic day and finally started to feel part of the team

i was told it takes AT LEAST a year to feel comfortable in the OR and i can agree with that. but i wonder if the attitudes from some of the staff is that they are so used to people hating the OR or starting work and not making it to the 6month mark that they just dont want to bother with you until you have a pink hat on and you are DEEMED fit to practice.......i just dont know but i love the OR and try to pass that on to students when they are on placement with us.

debbie

Hi Debbie! Congrats Congrats to surviving the OR. It is a very challenging place to work! When i hear how people have cried at work or go home crying, hating their day, don't think they're gonna make it...and then make it/love it , i start thinking more positive. It gives me something to look forward to. I sometimes ask myself, "What am i doing here? Why did i become a nurse? Am i ever going to get it? Did i make the right decision?"

Yeah Deb i'm not sure why some of the OR staff dish out all this attitude, but i've heard your theory from a few others. Again congrats on your success in the OR, thats a major accomplishment!!!

IsseyM

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This must be a world wide issue in theatre! Im in australia. Been an RN for 2 years and recently (5 months ago) joined operating theatre.

I thoroughly enjoy the work... loads to learn of course.

But I find there are so many staff members who have been theatre nurses for 20 years+ that they just have no idea how to support new staff.

Often they stop you from trying to learn new skills, even if a basic procedure.

Our area is renowned for being very bitchy, clicky etc.

The advice by Tracey was great I must add! But so hard to remember when your in the thick of a really bad day. Im 34 and I do my best to support the younger grads as I know they find it so hard. But Im hanging in there and trying to toughen up and in my own small way change the system.

I work hard ALWAYS and try not to give anyone real reason to complain about my work.

Hang in there guys!

:wink2:

Nicki

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think i am gonna have to try and take my own advice now, i was told yesterday that i have to go to orthopeadics (or awfulpeadics as it is commonly known here) aaaaahhhhhhh!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

i have finished my 6months in general surgery and was getting to the point that i was happy with my work settled into the team and did the odd bit of ENT and MAX FAX ans the general and thaese are the same team, but awfulpeadics i just don't know, they have the worst surgeons and overrunning lists you are lucky if you get home before 7pm some days and the politics are horrendous in there.

but..... the operations are fantastic, the first time i saw a hip being dislocated for a replacement i nearly passed out! i remember standing there as a student with my chin on the floor as i couldn't believe some of the things they where doing , i hope i still feel the same.

i love the OR i really do but i have the feeling that i am going to be tested soon..... wish me luck

debbie

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IsseyM,

One of the first things I learned in my perioperative course was not to take things personally. Usually, the surgeon is reacting to the situation at hand. If it becomes personal, then you can address this person after the case if necessary...

Two sayings I have lived by in this business..

1) Don't waste good mascara on anyone

2) If the person/people you are working with are horrible, just say to yourself, "thank gosh I don't have to go home with these people"

Good Luck!

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Specializes in OR.

I was discussing this topic with an OR friend of mine and I came to the conclusion that you want thick skin, but not too thick. Meaning, that sometimes, we as OR nurses tolerate treatment that shouldn't be tolerated. I read an article about 2 years ago in a nursing journal that said that many nurses, especially those in "high stress" areas such as ER, ICU OR(although all areas of nursing can be high stress, IMHO) came from dysfunctional childhoods or relationships, so they learned to tolerate too much. Think about it, we see so much horrible behavior from some doctors and nurses tend to say thinks like "he/she didn't mean it" or "it was my fault he/ she got that mad". We sound like battered women sometimes..I have gotten to the point where I nip this nonsense right in the bud. I don't raise my voice, swear or throw things but I don't wait until after the case. Docs tend to have selective memory so if you wait that long, they'll have managed to switch the situation around to where you're the bad guy. I don't worry about "escalating" their behavior either-again, I wouldn't tolerate this behavior from someone I'm sleeping with, even less so from a doctor. Keep in mind, I'm talking about the real nasty, hurtful behavior over an extended period, not just someone having a bad day. Don't worry, you'll get to the point where you're practically bulletproof, it just takes time and experience(and big cahones!)

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