Thick skin

midlife101 · Aug 7, 2011

Forgive me for not reading all of the responses, as I assume that I am being redundant in my following statements.
To develop a thick skin requires a recipe of self confidence, knowledge of facts and knowledge of resources.
For example, if a doc tells you to give Labetalol for 185/90 HR 56, you would adamantly refuse, providing the factual information that you have learned; HR is too low for Labetalol to be the appropriate drug to give.
Most of the time, docs and peers will test you to see what kind of backbone you have. We all want to please and want to be accommodating to our co-workers. However, we must always be spot on with our assessments and challenge orders that seem incorrect to us.
I once was in a case where the CRNA wanted to give Toradol. He had the syringe loaded and ready to push. He announced to the surgeon that he was going to give the drug. I immediately stopped him and pointed to the whiteboard where the pt allergy was listed in bold red letters "Allergic to Toradol". This CRNA was from the Middle East, and didn't take kindly to a woman correcting him. He actually said to me at the end of the case, "Don't you EVER correct me in front of men. EVER again." I had no qualms about tactfully telling him to get bent, and that I couldn't care less who was in the room; man or woman-my priority was the safety of my patient. I let the director of the program know what had happened, and this CRNA is now on probation.
You develop thick skin for the greater good of your patient. You can challenge anything you witness that you deem unsafe for you or your patient.
The way that I developed a thick skin is by imagining that the patient was a family member of mine. What would I choose for this pt if they were my own family? I would fight tooth and nail for their safety and demand the implementation of best practices for them. I have always had this mindset, and I have always been staunch in my verbalization of such. As long as I know for a fact (and can back it up with evidence based research) that what the doc is ordering is inappropriate, you can bet the farm that I will be refusing the order outright.
In regards to developing a thick skin with co-workers, my view is that you should set boundaries from the get-go. In doing so, you must state your expectations clearly if you are delegating tasks, you must communicate with confidence and without hesitation. Staff will respect you if you know what you are doing and can in turn teach them the rationale behind your decision. Using this technique, you are at once establishing the fact that you know what you are doing, and also are willing to share your knowledge so that others can understand and then implement your teachings into their own practice. It takes the "Nurse Ratched" image away because you are offering pearls of wisdom to others.
Some co-workers will find this off-putting and label you as a total witch. Let them. Who cares? You know that you are focused on your patient and want only the best care for them. I have found that the people who label me as a witch are more focused on the milieu of the staff; they would rather fit in with the group and not make waves. They are not focused on patient care.
The reason we are employed is to take care of PATIENTS. The rest is static. Never lose your focus.

DukeGirl-

Outstanding! See Kudos below.

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