Type B in a Type A world

Nurses General Nursing

Published

Bg: started new job a couple months ago. Love my job but my problem?

I have been dealing with a couple of super type A ICU nurses. You know the type. The ones who seem to be super nurses. Always think their **** doesn't stink and think their way is the only way.

This wouldn't be an issue if I wasn't being precepted by a few of them and know they throw each other under the bus. The night shift preceptor I have is amazing but the day shift ones I have seem to enjoy picking me apart. They are always riding me and breathing down my neck.

I am type b. I learn by doing and not having some watch me like a hawk and criticizing every...single...thing that I do while I am doing it.

How do I deal with these people? I am almost done with orientation. My night shift preceptor is great and I only have a couple more weeks until I am on my own. But I know that I will be having to deal with those type A nurses and giving report to them.

Hoe does a type b introvert who is more about the big picture and less about the details survive in a type A icu nursing world that is always caught up in detail?

I am afraid to be ripped to shreds out of orientation for not being "perfect."

Specializes in Psych,LTC,.

There have been studies since that show more introverted people are the creative,in tune, in depth thinkers. Neither is better than the other.

OK - I'm not getting the "type A / type B" alignment here. Friedman & Rosenmann's 1950 study (where these terms originated) identified a distinct (Type A) personality that are highly competitive, hard working high-achievers, very driven to accomplish and exceed expectations... versus the laid back (type B) tolerant, reflective, even-tempered other end of the spectrum. A's tended to strive for perfection while B's are less stressed overall and were more resilient and philosophical when faced with failure. No evidence that A's were less empathetic or socially aware than their B counterparts.

Specialty, high-intensity clinical areas tend to attract 'type A' nurses who are always looking for new challenges - but I think that the harpy shrews described by OP are just nasty people who are determined to make themselves feel better by tearing down someone else. Please don't sully a perfectly good psychological theory - LOL.

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Specializes in CVICU.
Suck up to them, let them think you think they are god, compliment them like crazy, feed their egos, . maybe they will even watch your back for you. and learn all you can from them. play their short game while you play the long game.

I strongly disagree with this advice. Why should the OP brown nose some nurses who are being catty towards her? Constructive criticism is welcome and should be encouraged. Nitpicky behavior should not. I don't think the OP should flat out tell these nurses that they are wrong, since she is still on orientation. However, she does not have to pander to their ego and be fake. She can remain professional and cordial without having to go the extreme.

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Specializes in Psych,LTC,.

I agree she shouldn't have to. But a lot of things aren't the way they should be, and I've got the lumps to prove it. They do hold her job in their hands to a degree, and she has to get past them. We're only talking a couple weeks here. Hopefully after hearing a few opinions, some conflicting, and looking at the situation only she knows, she'll have a few more tools in her toolbox for how best to address it. Remember she is a relatively new nurse and will probably lose and pay a price for confrontations, even if she's right, they know the politics better than she does and can play a better game. . Then she can urinate in their cheerios all she wants, and they'll deserve it. es who are being catty towards her? Constructive criticism is welcome and should be encouraged. Nitpicky behavior should not. I don't think the OP should flat out tell these nurses that they are wrong, since she is still on orientation. However, she does not have to pander to their ego and be fake. She can remain professional and cordial without having to go the extreme.

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Specializes in Family practice, emergency.

I'm an A-.

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Personality types aside, you're brand new, they may have valid concerns even if given via terrible delivery.

I'd be more concerned about my base competency than anything being discussed here. I would want to get an *outside* opinion from someone on the inside. Is there anyone there that will give you unfiltered feedback?

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One of the biggest problems with being new in some specialty or the medical field in general is that you don't really know when to call bull****. Is your coworker belaboring a small point because he or she is convinced that this small point makes a significant difference to the quality of care we provide, or because he or she just likes lording it up over an easy target? Even if it's the former, are they correct, or are they peddling misconceptions? You don't really have any way of knowing when you're new, at least not until after the fact.

I developed a habit early on that I think helped me. When someone points out a mistake I'm making in my thinking or my practice, unless I'm certain they're just incorrect (in which case, I explain why), I ask them for their rationale and thank them for the correction. On the one hand, it tends to disarm people who use clinical practice as a kind of pissing contest. On the other hand, it also encourages coworkers who might know more than I do to share the wealth, and helps to improve my own performance. I've learned a lot from some of my more Type-A coworkers, including a few who at first seemed standoffish or pedantic.

FWIW, I'm not much of a Type A in my off-work hours, but after a number of years in nursing I've managed to adopt some Type A behaviors at work when the situation calls for it. It took some practice and experience to really get a feel for which situations require you to hold your ground on what might seem to be a small point, even at the risk of annoying a coworker, doctor, administrator, visitor, etc. It's part of the job.

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Specializes in Pediatrics, Emergency, Trauma.
I'm an A-.

Same.

I worked in the PICU as a new grad, didn't go well, took a detour, and in a Level I Trauma PediER and have been there for 14 months

Both have critical care components; and both have nit picky people.

Both require attention to detail while see the big picture, while practicing in anticipation phase-although the ED is a wildly different angle of anything can and will happen through those doors-prolly better for my personal motto of "anything can happen" ;)

It is like being a new grad all over; the nerves, the angst and managing personalities in a high pressure setting can be overwhelming and frustrating.

I agree with a previous posters analysis on approaching people in seeking rationalization; it does approach the situation and the person with more positive results.

Also, and challenging as it may seem, don't take it personally; if one is being a bit prickly and picky, just state your rationale as to your nuri and judgement; stating from your rationale may provide a teachable moment to both parties. :yes:

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Specializes in ICU.
I strongly disagree with this advice. Why should the OP brown nose some nurses who are being catty towards her? Constructive criticism is welcome and should be encouraged. Nitpicky behavior should not. I don't think the OP should flat out tell these nurses that they are wrong, since she is still on orientation. However, she does not have to pander to their ego and be fake. She can remain professional and cordial without having to go the extreme.

It is constructive criticism because it does work! I don't do it myself as the idea makes me feel a bit nauseous (?nauseated) but I've seen others do it effectively time and time and time again. It is one way to get people on side and I think in other industries it is pretty much part of the job description for getting ahead.

To the OP, at least one of the up sides of "nitpicking' is at least you are being told exactly the right way to do something even if you prefer to learn in a more relaxed way (although I sympathise with this). I struggled with a preceptor who in essence told me to work out what to do as she was busy and it was all obvious. Also, it gives you different techniques to pick from when you are on your own. And, you know "how things are done", so you are less subject to behind-your-back sniping from people criticising your methods when you were never told a better way. But I do feel for you! Orientation will be over soon and then you can enjoy your job much more :).

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Specializes in Med-Surg, NICU.

Thanks everyone for the insight. I will continue to do what I am told to do just to get out of orientation and on my own. I will try to be as type A as possible in the meantime and learn as much as I can. Thankfully I am towards the end of day shift orientation and will be back on nights soon.

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Specializes in ICU.
I strongly disagree with this advice. Why should the OP brown nose some nurses who are being catty towards her? Constructive criticism is welcome and should be encouraged. Nitpicky behavior should not. I don't think the OP should flat out tell these nurses that they are wrong, since she is still on orientation. However, she does not have to pander to their ego and be fake. She can remain professional and cordial without having to go the extreme.

With some of them it is the only way to get them to stop. Until their need to be seen as better than everyone else is met, they are just going to be nightmares to work with. It has been my experience that these people are usually charge, rapid response, team lead, etc. and have been on the unit for years and are seen in a very positive light by management.

Our team leads audit our charting as the shift goes on for things like restraint documentation being current, a fall risk score qshift, a pain goal, q2h RASS, qshift CAM-ICU, etc., and telling one the first time she calls to mention something is overdue that I appreciate how she's looking out for me to make sure my documentation is right will sometimes make the difference between my phone being blown up at least every hour with her asking when I'm going to get my restraint documentation done vs. her actually coming out to help me when I'm drowning so I can catch up my charting.

Generally speaking, these people can be pretty helpful if they decide they like you. It's worth a little bit of fakeness to have more allies than enemies, IMO.

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Type B here...I work in education now but still work prn in critical care. I remember when I was hired from a much smaller facility the clin spec at my new facility warned me about the "ICU snobs" as she called them. What I learned is that not everyone knows everything, including me. I got a lot out of how critical my new co-workers were, because it made me see all the important and unimportant details. But they also learned a lot from me, I actually caught a lot of things that they missed since they were very focused on the critical care side. The best thing to do is grin it and bear it until you are on your own. When you are on your own, stand your ground. If you are following policy and doing the right thing, no one should be able to make you feel like you're not doing your job.

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I've never heard that type A doesn't see the big picture. I suppose I'm type A though I don't have the energy level I thought those types had. I'm driven at work, both detailed and big picture, but come home to veg on my couch and wait for the house to clean itself. "Over achiever" at work, lazy at home.

I always thought that the difference was mostly in the sense of urgency. Patience has always been something I've had to work on but both detail and big picture have always been inherent to me.

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