Tag Archives: Nurse Together

Surviving Modern Healthcare: Dealing with Intimidating Physicians

Throughout our lives, we are always going to be in situations where we will need to deal with difficult people whether they are physicians in the work environment, co-workers or people in our personal life. In my 35 years of experience in healthcare administration and as a CNO, I never tolerated abuse of my staff in any way, and over these years I had been involved in several investigations that have led to the discipline action or loss of privileges for abusive physicians. Abuse of physicians by nursing staff was also not tolerated and probably as many nurses lost their positions for inappropriate behavior over the years. Especially with the need for healthcare workers to function as a team, it is critical for people to treat each other with respect and dignity. All that said, there are still going to be situations where nurses are abused by physicians and other people in the work environment and there are things to do to prevent, minimize and resolve such issues.

Abuse from physicians is difficult to handle because nurses are, for the most part, under pressure throughout the course of the work day. When abusively confronted, there is a loss of balance and personal control that arises first followed by an assault to the ego, which evokes an emotional response of anger, hurt and insignificance. Because the ego needs to feel accepted at all times, this response is intensely uncomfortable and painful. There are three choices when confronted with this type of situation: we can run from it or avoid it, handle it poorly or handle it well. The choice is ours but it is important to introspect and remain in control.

Patteron, Grenny, McMillan and Sentzler (2002) in their book Crucial Conversations identify several strategies to help you decrease your emotional response and keep you in control. They include:

The first step is to first introspect and analyze what the problem is and what your feelings are toward the situation, which now identifies your stand in the conversation. During this step it is critical to place the patient at the center of the conversation and the only goal being a positive outcome for them. It is important to realize that this is not about you but the patient. The next step is to find your bearings and get ready for the discussion, as well as controlling your body language to stand straight, do not retreat and continue to exude an aura of self-confidence.

Learn to Look

When dealing with difficult people, oftentimes it is not a surprise that they will act poorly and you can be ready for that. When we learn to look proactively for situations, it is easier to handle. First of all, you can watch the conditions that lead to poor behaviors. Is it a surgeon that usually acts badly when there is a difficult case on the board or when it is excessively busy? Also be aware of safety issues. Will a bad confrontation affect the quality of patient care? Will it endanger the safety of other patients or staff? How serious do you think the outcome of this communication could be? It is important to prevent silence to violence in the work environment

Make It Safe

With difficult confrontations it is important to keep the conversation safe, by establishing a mutual purpose which, in this case, is the patient. Always behave respectfully toward the physician in the hopes that mutual respect will be returned. Apologize only when appropriate and apologize only for the individual’s perception of the situation and not for something you did not do. Step out of the conversation if you need to, by simply saying “I am choosing to excuse myself and we can pick up this conversation with others in the room.”
Master Your Story

Be prepared and know your story that you will present. Also, understand your personal feelings and be aware of the fact that it is common to be upset and off balance in such situations. In the conversation, stick only to the facts pertinent to the conversation and leave other topics, especially those that are emotionally charged, out of the discussion.

State the Facts

Throughout the confrontation stick only to the important facts and keep the conversation as simple as possible. Always attempt to return the conversation to the important facts at hand and to focus on what is important for the patient.

Lastly, when all else fails, it is important to reach out for help when necessary. It is not acceptable to be treated poorly by anyone in the work environment and all organizations should have a zero tolerance policy to this type of behavior. Speak to your manager, and if the manager does not address, you need to go up the chain of command. In my experience, it always frustrated me when someone would say, “that’s just the way he/she is”. My response was always, “well, that is not acceptable”. Over time, adopting an expectation of mutual respect and dignity will tremendously improve the work environment for all.

This article was shared with us by NurseTogether.com.
Based in Charlotte, NC, NurseTogether.com is one of the fastest-growing, free online professional communities for nurses. Specializing in unique nursing lifestyle, career and professional development information, NurseTogether.com’s mission is to empower the nursing community through top-quality original content from experts, interactive web-based social media tools, and value-added services through key strategic partnerships in a variety of nursing and lifestyle disciplines.

Take Five: Simple Strategies with BIG Results for Overwhelmed Nurses

Does your life feel like a tug-of-war? Nurses continuously juggle the demands of their personal and professional lives. At work, they provide high touch-high tech care for sick and dying patients. In addition, many nurses perform ‘double duty’—caring for friends and family members when not at work. Being pulled in so many directions can seem overwhelming. Learn how to manage stress and regain your balance by taking a few small steps each day.

Kayla is a nurse on a busy telemetry unit; she is married, has two school-aged children and helps care for her aging mother. Today she agreed to work another double shift to cover a last minute call-in. Kayla slammed the phone down after arguing with her husband Mike—he resents Kayla choosing her job over the needs of their family. Kayla was already feeling inadequate when her friend Terry excitedly announced, “I passed my certification exam.” Although Kayla bought a review book six months ago, she hasn’t started studying yet. Read more…

Surviving Modern Healthcare: Renew Your Spirit, Feed Your Soul

We live in a world of constant pressure and stress, which seems to be getting more challenging all the time. Especially in healthcare, organizations are forced to do more with less, putting pressure on the staff to exceed the superhuman pace that they are currently working at. Nurses are especially vulnerable to this level of stress because it seems that we, as a profession, are always “picking up the slack” when cutbacks are made in other departments or holds are placed on hiring. I used to laugh in my leadership positions when the CEOs would say, “but we’re not cutting nursing positions”, and, as a CNO, I would argue in a sense, yes, we are. When nurses “pick up the slack”, nurses are absent from the bedside, performing tasks that can be done by other people and at a premium cost. As nurses, we can also add on the emotional stress of what we deal with on a daily basis, followed by the tremendous responsibility of having precious lives in our hands. Read more…

Is Nursing Making You Sick, Fat and Old?

As nurses, you are certainly aware that stress is one of the major medical problems of our times. Studies show that nurses are the single sickest group of workers in the workforce. Ouch! This is appalling. When I worked nights in the PCU, I noticed that there were many more obese nurses working nights than days. What have you observed? In my experience, I have noticed that without exception, obese nurses apply to work nights. They want to work nights. These dedicated, long term night shift nurses also are on multiple meds and often discuss how many meds they are on, compare them, etc. What strikes me is that they speak about it in such a way as if it’s the most natural thing in the world. Please understand, I am writing this out of compassion for my fellow nurses, not as a critique. I am telling the truth, and yes, sometimes the truth hurts. Read more…

Therapeutic Yoga Nursing is Good Medicine

Nurses are the backbone of any successful healthcare facility and are prone to crippling stress. Stress related chronic anxiety is now the major medical complaint of our times. Stress is a killer, literally. Constant thinking, planning, worrying, wanting, and doing is literally burning our brain cells, releasing toxic hormones into the blood stream, causing harmful sleep deprivation, wrinkling our skin, de-calcifying our bones and wreaking havoc with our insulin levels…the nurse becomes the patient. Help is on the way!

As a practicing RN and certified medical yoga teacher, I have helped to heal over three thousand patients and students over the past fifteen years in Canada and the United States. How? Yoga is an ancient 5000 year old art and science which utilizes diaphragmatic breathing, gentle stretches and relaxation techniques to increase quality of life. Yoga Nursing® is the holistic, healing practice of caring and compassion provided by licensed nursing professionals who are also certified yoga teachers. Read more…

Nurses: Is it Stress, Burnout, or Compassion Fatigue?

Nursing is hard emotional, physical, and spiritual work—it is also very rewarding and satisfying. Tension and turmoil come with the territory of being a nurse. Are your feelings of frustration simple stress or something more serious? Decide for yourself: is it stress, burnout, or compassion fatigue?

Stress—Life’s Storms
Stress is a naturally occurring phenomenon in the life of a nurse. As a nurse, you regularly witness the pain and suffering of others. You work under demanding conditions in stressful environments. Staffing issues, budgetary constraints, and regulatory scrutiny complicate the care you provide.

Stress is like a storm—anything from a quick cloudburst to a hurricane. Like storms, stress follows a predictable life cycle—there is a preparation phase, a time to “ride out the storm”, and a recovery phase. All storms eventually pass.

To prepare for life’s storms build your support network, practice authentic self-care, and study stress management strategies. During the storm, use your resources, implement your survival skills, and ask for support. Read more…

Is a Nurse Still a Nurse No Matter Where You Are?

Most of the time, nurses are also employees. We go to work, and we leave work. While we are at our workplace, we practice nursing. Does that mean that I am only a nurse when I am on the clock and cease being a nurse when I am not at work? When that time card gets punched as I leave my workplace, do my nursing skills remain behind or do they come with me?

My husband is a Christian pastor, and we (along with our daughter, son-in-law, and two granddaughters) are currently living in the Eastern European country of Romania. Our mission here is open-ended, meaning we have no idea how long we will be here. This also means, at least for the time being, that my American registered nursing license is nothing more than a piece of paper. I have no workplace in which I can use my nursing skills. Read more…

Nurses Create Legacies | What Are Yours?

How many legacies are you creating today?

You need to know this as a nurse: you’re not treating one patient at one particular moment in time. You’re leaving a legacy. Your actions are woven into the patient’s lifelong health tapestry.

As a lifelong patient, trust me on this one. Forty years of close care by the medical community has given me insight not commonly gained.

I marvel at your dedication, day in and day out, through cranky coworkers and perturbed patients.

Many times over, I’ve seen you at your best. Many times over, you’ve seen me at my worst. And still you treat me with kindness and respect.

My story began forty years ago at age seven, when I was unexpectedly admitted to the hospital. It was my first time away from home on my own. I was terrified. My diagnosis-finding stay extended out to three months, smack over the entire holiday season, November through January. Read more…