Struggling to get Assertive

[bunnyRGN]

Hello fellow nurses- any advice for a nurse with two years experience who is still struggling to get assertive? When members of nursing management or a doctor or some other members of the hospital higherarcy ask me something about a patient like... whats their history? or when was their last seizure? I clam up totally my mind goes blank I stutter and stammer and have to take out my paper where I have the info written down even then I'm still not sure then they ask me more questions. but alot of the time I find as soon as the person quizzing me leaves I find I do know the info but I can never seem to give them the answers when they want and if /I hesitate at all in my response I get accused of 'guessing' my answers. I look like an idiot and whats worse is then some of the higherarcy will deliberately pick on me again the next time they are on the ward to see do I know my patients well. I know that this quizzing is actually good for me it causes me to think more and link together aspects of patient care and ultimately if I improve my knowledge and capabilites it will benefit my patients. However I feel my own nervousness when speaking to these other staff members draws negative attention to me and makes me look incompetent. I feel it is my own fault as I have quite a passive personality and it is in my nature to be unassertive. When I was a student I was miles more confident and was very sure of myself. I don't know what has happened to me I think I have lost my nerve

Any wise words would be much appreciated

[tokebi]

It sounds like when you're intimidated, you go blank. I have similar problems, mainly with talking to doctors. I often end up like a blabbering idiot when answering doctors who I know have quick temper. But I realized I have no problems with easy-going doctors or those I have known well, and actually have quite intelligent, productive conversations.

Once I realized it is the intimidation factor and the fear that the other person induces in me, I started to "block out" the identity of the person. Instead of "the scary doctor," I picture a ... oh I don't know, a talking watermelon...

Point is, shifting the focus from what that person does, could do, might do, which all contribute to the fear, and keep reminding myself what I am here to do -- inform the doctor what I know about the patient -- seem to help me act like a professional, and even manage calmly when that person starts yelling or whatever.

[KattyRN]

I have the same problem. I'm still a student and a couple of my clinical instructors have told me that I need to be more assertive and let people know that I know what I'm doing. I'm naturally pretty quiet, reserved and some would say shy (even though I don't think I'm that shy) so sometimes it's hard for me to be assertive. I'm still working on it.

I do the same thing with going blank sometimes when my instructors ask me something and having to look at my notes and getting tongue tied. I guess it just takes practice.

[Doc Lori, R.N.]

Oh, that whole deer in the headlight thing...argh..hate that. I think you hit the nail on the head at the end of your post, Bunny, and it's confidence, I'd guess. One of my old college professors used to tell us to "Fake it til we make it", put a smile on, ease the tension yourself, know that you know what you know and that you are very competent, and that will ooze out of your pours. I agree totally with katrina and tokebi. Good luck, you will be fine!

[Scarlette Wings]

i understand the feeling of helplessness that happens when your mind goes totally blank. my mind after a quarter of a century of nursing will still do that if someone catches me off guard. i think doctor's are determined to keep asking questions, any question, until they stump you. it must be one of their first year classes called "stump the nurse 101."

don't let having to look at your notes or your chart to find information allow you to feel incompetent. it is a wise nurse who knows her limits and knows what resources to use. when a family member or patient asks about a new medication i always used my treo smart phone and looked the medication up. there is no way i could keep up with all the new drugs and side effects so i loaded a drug book into my treo. it is perfectly normal to realize you cannot know the answer to absolutely everything and once you get started the rest triggers your memory and you will be rattling off the details without even thinking about it. trust yourself. if you need to glance at your notes or the chart it's fine and perfectly normal. you'll get better as you gain experience.

[greenfiremajick]

I have the same problem. I'm still a student and a couple of my clinical instructors have told me that I need to be more assertive and let people know that I know what I'm doing. I'm naturally pretty quiet, reserved and some would say shy (even though I don't think I'm that shy) so sometimes it's hard for me to be assertive. I'm still working on it.

I do the same thing with going blank sometimes when my instructors ask me something and having to look at my notes and getting tongue tied. I guess it just takes practice.

I may be naive about the environment, but I don't see anything wrong with having to conswult notes.....Professionals do it all the time, even in healthcare....Admitte4dly, I am not a nurse, so could someone tell me if this practice of looking at notes, etc WOULD be some sort of major faux paus?

[greenfiremajick]

it is a wise nurse who knows her limits and knows what resources to use. when a family member or patient asks about a new medication i always used my treo smart phone and looked the medication up.

np's, pa's, md's do that, as well....seems to me, to be expected!

[PostOpPrincess, BSN, RN]

First and foremost, I highly recommend you do not use the name Bunny at work.

Second, all of this comes with time and experience...be easy on yourself...

[medicrn13]

I find that if you simply view them as a person, and not someone who holds something over you (which by the way, doctors hold nothing over you, they are not your boss nor are they to be feared...) reporting to them becomes much easier.

Remember, we are all part of a TEAM. The doctor may be responsible for prescribing therapies with which to make the patient better, but ultimately it is the nurses/techs that carry out those therapies, and report back to the physician.

If a doctor begins to yell, I would simply say something to the effect of "Well, if you want something done your way, I suggest you do it yourself..."

We are no longer living in the 19th century, doctors no longer "lord it over" nurses.

[carolmaccas66, BSN, RN]

Did the poster say she used the name Bunny at work? I couldn't see this anywhere...

[carolmaccas66, BSN, RN]

I consult my cheat sheet (notes) all the time re patients. What is wrong with that? I certainly can't remember everything when it changes so fast, so I write it down. Writing down changes shows you are conscientious person.

If management/Drs/whoever aren't happy with that, ask them why. You won't remember everything at first anyway; some wards are just crazy busy at times.

Try to play little games with yourself, go through their diagnoses in your head, what care has been planned for them, why are they on certain drugs, then try to answer yourself without looking at your notes (I used to do this). What questions are you asked by others, write them down for next time.

Start also writing a journal re all of this and reviewing it, then maybe you will start to remember.

It is hard not to be intimidated by others more senior, if you can't remember something just say 'I will check and get back to you'. If you can't remember anything at ALL, you may need to learn some memory tricks.

Hope this helps a little!

[carolmaccas66, BSN, RN]

BTW I look up medications all the time, because I float to many different wards/hospitals, I can't remember what the meds do specifically & all their side effects - no shame in that.

If someone queries doing this, reply it is a sign of a good nurse to be looking up this info, instead of just giving meds to a patient without doing all the relevant checks. You will just have to stand up for yourself in a professional manner, and start answering back to people. Don't see how else you are going to become assertive otherwise. Remember YOU are also a health professional, and I also tell people that too, even if they don't like me answering them back.