Team

You need a team.

If you’re a nurse, you need a good team. There is no way to survive on any unit without team work.

When you interview for a position, ask about the team work. How well do the nurses work together? How is bullying handled?

You’ll want to know these things. A unit that isn’t a team is a unit headed to hell in a hand basket. It can’t function effectively. Trust me, I’ve worked on units where it was every nurse for themselves. It was horrible. There were nurses that wouldn’t help with the new admission. It took an act of congress to get someone to help clean up a patient. Gossip spread like wild fire. Nurses ate their young for fun. It was two years of nursing that I never want to experience again. From that point on I decided I would not waste time on units like that.

That’s why finding about the team mentality is so important. You want to work somewhere with nurses that work together. You want to work in an environment that is not toxic. Regardless of how the shift is going, you want to know your coworkers have your back.

Nursing isn’t a solo job. We aren’t super heroes that can handle everything on our own. We have to depend on each other to get through the day. When the shift is nuts, you want someone you can vent to. When you aren’t able to save the patient, you want someone that understands the pain. You’ll want someone you can ask questions to that won’t make you feel like you’re stupid. You’ll want a team.

Do yourself a favor, find a good place to work.

“Exceeds expectations”

So, it’s evaluation season. Doing my own eval is uncomfortable for me. It feels like I am tooting my own horn, so to speak. I don’t like talking about myself. I don’t want to sit down and tell you about the great things I’ve done over the past year.

So, I sit down for my eval with my manager… As we start going over each section she tells me the ratings she has given me.

They were all “exceeds expectations”!

What?

I have been a nurse nine years. Every eval I have gotten was rated “fully meets”. I was always content with that. However, for the first time I exceed. My manager started mentioning all the things I’ve done that’s she’s noticed. She gave me compliment after complement for the care I deliver. I honestly didn’t know she paid that much attention. She manages over 100 nurses, she’s always on the move. However, she makes it a point to stop by our department and check in on us. She is always available. To be honest, she’s the best manager I have worked for. To know that with all she is doing, she still noticed my hard work, it felt great.

My actions are not so that I can be noticed. I just do what’s right for the patient. Ultimately, that who we are here for. I never thought I was going “above and beyond”.

It was a great feeling.

I’m in the right place. I’m definitely in the right place…

Keep calm

So that one coworker has managed to get under your skin.

Again.

The non-constructive criticism. The passive aggressive behaviors. The gossiping. The outright rudeness.

You have had it. You’re ready to blow a fuse.

Don’t.

As hard as it may seem, take a deep breath and keep calm. Easier said than done, I know. This one individual has made it their mission to drag you, and probably others, down to their level of misery. That’s exactly what it is. Misery. Perhaps their home life is falling apart. Perhaps they are struggling in school. Maybe someone they know is extremely sick.

Or maybe they are just an asshole.

Either way, they bring their misery to work and try to project it on others. It’s not your job to deal with their poor coping mechanisms.

I am not saying you need to ignore their behavior. I am saying don’t let them get you so worked up that you snap. When you snap you look like the aggressor and they get to play the victim. That’s why I want you to stop and take that deep breath. Walk away if you need to. Go take a break in the bathroom. Once you feel you are ready you need to pull them aside, if you’re comfortable, and speak your mind. Let them know you do not appreciate their behavior. Stand up for yourself. Calmly. Respectfully.

Then continue on about your day.

Two things will come from your conversation:

1. They realize they need to change their behavior.
2. They take no accountability and try to play the victim.

At this point, you have done what you need to do to handle the situation. If the behavior continues, take it to management. It is their turn to address this person. If you have a good manager they will step in and handle it. Conflict resolution is a part of their job. If your manager sucks, they’ll try to place it back in your hands and make you feel like you need to handle it. If your manager is the latter, take it higher. Make sure you communicate with management (through email so you have proof of escalation) that you are not comfortable with the way the situation was handled. Most places of employment have an HR department. Report the toxic behavior. You aren’t being a “snitch”. You are standing up against a toxic individual creating a toxic atmosphere. You are bringing attention to the fact that the behavior has been allowed to continue. You are taking a stand against lateral violence. You are taking the opportunity to fix a situation that has probably gone on for FAR too long. You are doing what is appropriate to create a positive work environment. You are doing what needs to be done. Take pride in that.

If you need to distance yourself from the individual(s) do so. If you can schedule yourself on the days or shifts they don’t work, do so. If you need to find a better place to work, DO SO. You became a nurse to help people, not deal with coworkers crappy attitudes for 8-12 hours. Self-care can mean removing yourself completely from a bad situation if need be. If you are treating those you work with respectfully, you deserve respect in return.

Keep calm and make moves.

Appreciated

A while ago my nurse manager came down to the department I was in to check on me.

My nurse manager came to check on me.

The day was turning into a hot mess and I had to get help from our sister nursing department to help get things back on track and help me put out the flames. After things started to calm down, my nurse manager came down to where I was to check on me and do you know what she said? “Fred, I am so glad I hired you.”

Say. What?

Did… Did she just show appreciation for how hard I was working?

HOLY HELL MANAGERS DO THAT?!?

Turns out, good management does. I cannot even count how many times either my nurse clinician or nurse manager has popped up in the department giving us updates or just checking in.

I have never really had that happen before. In fact, I was so unused to it that the first time my nurse clinician came down to the department checking in I thought I was in trouble! I really thought I had gotten reported for something and was about to be written up! That is how little I was used to seeing management (unless they were asking if we updated our whiteboards).

I was talking to another floor nurse, in fact, the one from the last blog, and telling her about management coming and checking in and she was also flabbergasted. She, too, was only used to seeing management whenever there was an issue.

That’s sad.

I don’t place 100% of the blame on management, though. I know they are encountering the same problem. Their higher-ups only want to discuss what they are doing wrong, give them unrealistic expectations, and unrealistic time-frames to complete the unrealistic expectations. Meeting after meeting they get bombarded with complaints. It’s a miserable existence and I can totally understand why so many nurse managers leave the job.

This is a bigger problem with how hospitals are a business focused more on numbers than patients. It trickles down. Miserable management creates miserable staff, and that leads to the high turnover rates in the nursing field.

No one feels appreciated and that needs to change.

I am lucky enough to work in a department where I actually feel appreciated. Yes, we have our foolishness just like every other area in the hospital. However, I find myself far less stressed in this position. I want more nurses to be able to feel this way. I want it to get to a point where seeing management becomes a positive thing. I wonder how we, as a group, can change this?

My first nursing convention

By the time this blog posts I will have gone to my first nursing “convention”. It’s a one-day event sponsored by my hospital but it is a whole day of speakers and learning related to leadership in nursing.

It’s actually meant for nurses already in a leadership positions but being a leader is something that interests me and I would like all the help I can get. I want to become someone that other nurses can look up to. While I don’t really plan on managing a unit or anything like that, I do plan on obtaining an advanced practice degree and I want to be a leader in whatever field I decide to go into. I have worked with and under great leaders and I have worked with people in leadership that I wanted to stab in the eye with a pencil (I have been a mental serial killer quite a few times!) I don’t want to be the person that someone else wants to stab in the eye lol!

I don’t feel like leadership=management position. Leadership, in my opinion anyway, has more to do with the person and less to do with the position. Some of my coworkers have been amazing leaders. Whether we have two codes going on simultaneously, admissions and discharges back to back, a super sick patient that is trying their damnest to circle the drain, or my personal fave: the wife and girlfriend trying to visit the trauma patient, there have been nurses that I worked with that immediately jumped in. They took the lead in the situation and helped turn chaos into control. I will say that in my experience most of those in management would have floundered in those very same situations. If you think about it, it is far easier to manage people than it is to lead them. You can’t be a leader while simultaneously saying “do as I say, not as I do”. At that point, a bad precedent has been set. I feel like a leader is going to search for the right way to do things and if they don’t know the correct way, they have no problem asking others for help. Leaders can provide positive feedback but also know how to provide constructive criticisms. The managers I have typically come across seem to be able to do one or the other, rarely both. That’s not to say I haven’t worked with management that wasn’t super badass. I will never forget one manager, Ron. He seemed so intimidating until I actually had to escalate a situation up to him. Long story short, I was working under “leadership” that wanted to be on a friendly basis with the team instead of lead the team. A certain situation continued to occur that ended up slowing patient flow. The supervisor didn’t want to step in because they didn’t want to hurt feelings. Well, you know me, I escalated beyond them to management. I remember exactly what he said to me when I walked into his office to complain “Shaunelle, don’t come to me with a problem without a solution.” We spoke and surprisingly I had a solution in my head without even realizing it.

His words changed how I handle situations to this day.

To me, that’s leadership. I want to be like that one day. I want to be able to not only provide solutions for my team, I want to encourage others to find solutions for themselves. So, off to the nursing conference I go. Hopefully next week I can come back and share some of what I learned.