When the going gets tough, so does your skin...

jojotoo, RN · Sep 24, 2007

It's like anything else: Repeated exposure to "whatever" allows you to build a tolerance to it. It's a survival skill. Think of it as if you were making "emotional antibodies".

I can still remember the first time a patient called me a fat b**ch. It made me cry. Now, I just think "Is that your best shot?"

The ER has made me a lot tougher, but I'm not always sure that's a good thing.

stayseerrn · Sep 24, 2007

It's a hard thing to balance. You still need to show your pts compassion, but yet you can't let it consume you. You need to be able to step back from the situation. Being in the ER were exposed to one of the highest rates of workplace violence (I think psych units had the highest), so you have to learn to distance yourself a bit. So, you must keep a sense of humor about you, and support your co-workers. They are the ones who will keep you sane. And don't take anything personally. That's probably the most important aspect.

gam3rchic · Sep 24, 2007

People mentioned that when working in the ER you developed toughened skin...:pumpiron:
Do you find this true and how did you develop your tough skin?
I'm a new ER nurse...and I guess because I haven't gained much experience yet...I have ELASTIC SKIN

Well, I'm not an ER nurse (yet) but I would say that nursing in general will give you tough skin. People are rude, crude, and will say nasty things to you no matter what specialty you're in. In the ER, I would imagine there would be a lot more of this as a lot of "riff raff" comes through those doors.

For me, tough skin came with time. I used to get upset when a patient would call me a f***ing b****, now I just laugh it off.

Don't take anything a patient says to you personally (they don't know you and you don't know them), just do your job and don't get too attached. I do care about my patients very much (I wouldn't put up with all the crap nursing gives me if I didn't ) but I keep my distance emotionally as well.

wizap · Sep 24, 2007

People can be rude and crude. Especially drunks who just ran their car into a tree and are trying to get out of their spider straps and off the back board. It is your job to keep them safe, even if they have a "potty mouth"

Do not take anything they say personally. I will never forget, it was change of shift one night. I went in to introduce myself to the patients and to tell them I was taking over their care. One jerk said, "Thank God, I don't want that f** B**** any more." I said, "That f** b**** is your physician, and if I were you I would treat her with the kindness and respect she deserves!"

alkaleidi · Sep 26, 2007

People mentioned that when working in the ER you developed toughened skin...:pumpiron:
Do you find this true and how did you develop your tough skin?
I'm a new ER nurse...and I guess because I haven't gained much experience yet...I have ELASTIC SKIN

Haha... I developed mine working in a maximum-security adult male prison. After hearing and seeing everything those guys dished out, there's probably nothing anyone in the ER could possibly say to me (staff, patients, even physicians) that wouldn't roll off like nothing. I love me, I don't know everything, and I deserve respect. Say those things daily.

Trauma Columnist · Sep 26, 2007

I worked for 10 years level one trauma center, inner city hospital - yep you do get tougher. But...like one of the other posters, am not always sure its a good thing.

teeituptom, BSN, RN · Sep 28, 2007

I just smile and go with the flow

I never get excited over little things

Lurksalot, BSN, RN · Oct 3, 2007

My personality/temperament has changed tremendously since I became an ER nurse. Curt, quick, direct communication no longer bothers me, in fact that is the way I expect everyone to communicate with me now! (A trait I must try to subdue when speaking with my own family and loved ones). Drama and emergent situations...they seem somehow mechanical instead of panicky, I'm not sure if I am explaining that correctly...and example is how I felt the first time an MI rolled in an needed to get to the cath lab--I felt chaotic. Now I feel confident and controlled, and am calm to reassure the patient and family and go about what needs to be done in an efficient manner. Nothing in life seems too hectic anymore....because all I do at work is control the chaos. It doesn't bother me anymore when people "bark" at me....I speak to them matter of factly back and move on. Patients being rude---well, I don't take it personally anymore either---and if they don't want my help, there are always several more patients waiting who do want it!

Yes, your skin will toughen up. You may not see it happening, but one day you will look back and think--wow, I can't believe some of the things I use to get upset about!

bigsyis · Oct 4, 2007

I worked for 10 years level one trauma center, inner city hospital - yep you do get tougher. But...like one of the other posters, am not always sure its a good thing.

Me too.

longjourneydream · Oct 4, 2007

Me too.

Yes I guess skin can get tougher,

I have only worked as an RN in the ED for 4 months now.

One obstacle I had to learn to endure;was the staff on the other floors.

When we are backed up with patients in waiting and EMS's in the halls, and noblody on the floors can take report, I always would stay on hold, or let them call me back in 5- 10 min.

One day I was not feeling very well; I was a little grouchier than usual.

The nurses would absolutly not take a report. I demanded that they take it immediately, and that any nurse could take the info now.

I then called the nursing supervisor to take report,and that I had to get this patient to the floor.

My co-workers commended me, and told me that was the way to handle things, with the Dr backing me up.

At the same time I felt like a bully, but knew I had a job to do, and a goal to move on to the next patient.

I know that we are looked upon in the ED as mean and unfeeling.

They just do not understand how things are down in the ER.

But I cannot worry about that, I have to know I am not there to run a popularity contest.

So it can be a good thing, and sometimes not so good