A prevalent issue in nursing, and health care in general, is intimidation - or any attempt to exert superiority and instill fear in a colleague. How does this happen, can it be avoided, and how do we survive it?
1. In nursing school; Nursing instructors, and at times other nursing students, whom are consistently calling to attention your weaknesses, when you really want to be just left alone. Intensely frustrating when your grades are in the hands of your professors, and awkward when you are assigned to pair up with the students who just aren’t nice.
-Know your material, for yourself, and for the patient, study what you are going to do before a clinical, or before you go into a patient’s room. Gather supplies, know your meds, be prepared always for your own peace of mind, as well as being part of a team when you are going in with fellow students. Avoid conflict. Divert your concentration to learning, the patient, and the task at hand - not at belaboring why they are targeting you. Nothing is ever lost in gaining knowledge.
2. Hazing; As a new graduate, discovering there is unfair treatment, which sometimes involves a sink or swim mentality, first admissions, the worst district/zone, nursing assistants who refuse to help.
-If you’re a new graduate, or new on the unit, hazing is almost certainly expected: for the most part, it is charge nurse specific, and a sort of prayer you don’t work with them too much, it’s either a lesson in endurance and a sh!tload of brand new knowledge and skills, or you can quietly mention you’ve been receiving all the first admissions, worst districts. Alternatively, you can go about your work and silently prove them wrong. Focus less on what’s fair, focus more on your own learning, and how you can make the best of each situation.3. During hand off report; Constant interruptions with “why didn’t you do this?” And a sort of passive aggressive attitude designed to intimidate.
-During hand off, the interruptions can actually be unsafe. If they’re interrupting you, it disturbs your train of thought, and you may forget an important piece of information. Subtlety does not work here. Remind them you have not finished, (or a variation of requesting they wait a damn minute). An alternative way is to lead by example, when you’re receiving report. Quietly allow them to see you are not interrupting them. Allow them to see you are respecting them, and focusing on the patient.
4. Exclusion, via cliques, and favoritism; Unit outings, parties and favoritism, where only certain nurses receive help. Quiet or introverted nurses assumed snobbish merely because they choose to not be involved in unit gossip, find themselves at the forefront of discussion.
-It takes time to build solid friendships, but it takes less to ascertain who is genuine and who is not. Steer clear of drama, avoid conflict, and steer clear of gossip. Always help other nurses, regardless of whether they help you. It’s about the patient. People will always have opinions, interpret things their own way, say what they want to say, but they will eventually run out of new material and move on. Concentrate on the few people who have shared work ethic, similar interests, and a little humor to get through the day.
5. Challenged; New graduates who aren’t familiar with medical team rounds, and put in the spotlight by the Attending MD, as a sort of test of knowledge.
-Keep your written report on your patients with you, during rounds. If the attending attempts to make an example of you, answer as best you can, and ask questions about your patients. Never let anyone diminish your ability to admit to not knowing, and maintain your interest in learning about what you can do for your patient. Listen attentively, and observe well. Keep the focus on the patient.
If you’ve experienced, or witnessed intimidation, what perhaps comes to mind are two things; something needs to change, and, likely standing up to intimidation is easier said, than done. (And sometimes there is no recourse except to consider moving to a less contentious environment). Why it is occurring is not as relevant as how we are reacting to it. Avoid conflict. Practice patience and tolerance, but never allow anyone to underestimate you. Release the tension, remember the lesson. Above all remember that no outer being can disturb your inner consciousness, your ability to learn, or your desire to do what’s right for your patients.
Our real journey in life is interior;
it is a matter of growth,
and of an ever greater surrender
to the creative action
of love and grace in our hearts.
~ Thomas Merton
1. Write your own mission statement; Not all recruiters require this, however a written objective for you personally may help keep you focused on what you are aspiring to do. E.g.,for a recent nurse graduate; “To work within an acute care setting, that encourages communication and fosters learning, while working as part of a collaborative team member that seeks to advance quality of care.”
2. Research; Write out a list of hospitals, clinics, and disciplines you are interested in. Research each of them well: if it’s a hospital, is it a teaching facility? Is it a trauma center? What level of trauma? Is it a magnet status hospital? Consider location - is it accessible if you live in an area that has the potential for difficulty to travel (I.e., snow). Read patient/doctor satisfaction reviews, see if there are consistent comments about services that may be warning/good signs. What are the prerequisites for particular units? Eg., ICU, it may put you a few steps ahead by obtaining the necessary certifications, such as Advanced Cardiac Life Support (ACLS).
3. Join professional organizations; Valuable info on education, practice advancements, job advertisements, credentialing, policy, advocacy, ethics, journals, and health and safety for nurses;
American Nurses Association (ANA) http://www.nursingworld.org
American Nurses Credentialing Center (ANCC)
(And) Nurse Zone, website that additionally provides links to the varied specialty organizations.
4. Attend conferences; A great way to network, and keep up with evolving practice.
Pest Health Care have year round courses on subjects ranging legal documentation, through infection control and critical care boot camp. Also, consider looking at specific hospital websites - some have open registration, with some fantastic classes taught by current practicing doctors and nurses. An insider’s look at the advancements that may be happening in that current field, institution, and another potential for networking.
5. Invest in professional journals; They contain a lot of information on travel nursing, job advertisements, and will keep you current on practice, while you await job securement.
6. Education; Consider enhancing your learning while you are searching. Non-employee continuing education in hospitals, online programs and personal research into pathology, pharmacology, and refresh anatomy and physiology. Keep your goals in mind, and focus on learning that will keep you abreast of what’s happening, particular to the discipline you are interested in.
7. Explore Other options; If you are already working in a hospital, and perhaps unhappy on your unit, consider floating/overtime to other units, to spark a new interest, as well as gain an idea of what else is available to you. If it is an environment you would consider working, what is the staffing like? Is the nurse manager approachable? Is it work you enjoy doing? Look into travel nursing, or per diem work at other institutions to gain insight into the workings of the hospital, prior to transferring.
8. Questions to ask in an interview; Do they honor shared governance? (Teamwork/accountability/equity/productivity/staff satisfaction/effective problem solving/patient outcomes).Are they a unionized/non-unionized hospital? (Benefits/Health Care). What are the orientation/mentoring/preceptorship timelines? (Learner readiness - some hospitals are cutting back on education, and may cut orientation once new staff are needed). What is the nurse:staff ratio on the unit you are working? (Safety). What opportunities for further education are available? (Long term goals). When you visit the floor, observe the interactions, it gives you an idea of the environment you will be working in, keeping in mind the chaos that may be prevalent in an unpredictable profession.
9. Questions they may ask you; What is your five year plan? What are your professional goals? Describe a conflict you had with a doctor/colleague and what you did to resolve it. Describe a situation where you felt patient care was compromised, and what you did to intervene.
10. Questions to ask your current Nurse Manager (or Nurse Educator, if New Graduate); What do you believe my strengths/weaknesses to be? What specific areas do you think I may improve upon? They may differ from your own view. Be open to constructive criticism.
10.25. Write a follow up email to the recruiter/nurse manager; Keep it light, short, thanking them for their time, with details outlining how they may contact you.
10.5 Feedback; You may encounter a lot of closed doors, a repetition of “No New Graduates.” You may find you interviewed well, and still knocked back. You may find other colleagues moving way ahead of you, that’s ok, it’s not your journey, (even if it’s frustrating), You may discover you need to make one stepping stone, (or many), in order to get to your goal. Timing, and patience are important, as is the belief that you will get there, eventually.
The world lost a kind soul today. Rest in peace to the most compassionate man, and gifted cardiologist I’ve had the privilege of working with. An old school physician with integrity, respect for all his colleagues, and a gentleness & humor that touched every patient he cared for. May God take care of you now, Dr. F.