Wednesday, March 22, 2017

Reality Bites

“I guess I just thought I was going to get to love on and take care of people all day.  Instead, I was just running around like crazy barely getting through the day.  I was just chasing down doctors’ orders and giving meds.”

This was the response I got when asking a nurse I’d just met why she was changing jobs so early in her career.  She left a trauma step-down unit to move to a day surgery unit and she’d been a nurse for less than a year.  

Yep, for new nurses, reality bites.  The disconnect between nursing education and nursing practice, the reality shock felt by nurses new to practice, is well-documented.  Reality shock is definitely a thing in nursing.  

There is a great blog post on Nurse Buff about the “14 Things Veteran Nurses Should Tell New Grads”, you can read it here.

There is some excellent advice in that piece. 
I’m a veteran nurse.  I would add one thing to that list:

HANG IN THERE, it gets better.  It really does.  Nursing is certainly not all “loving on patients” all day, but after you get through that initial period, the tasks get easier and the true caring for patients becomes a reality.  

In interviewing newly licensed nurses, I’ve found that they are very surprised at how experienced nurses can really hone in on exactly what they need to know about their patients.  Once that happens, once nurses understand which of the millions and millions of tidbits of information about their patients are important, they become free to truly practice their art – the art of nursing. 

So, if you’re new, HANG IN THERE.  It will, I promise, get better.

Thursday, March 16, 2017

Should You Speak Up?

Should you speak up when you know something is wrong? Good question.  

The American Nurses Association (ANA) Code of Ethics for Nurses, under Provision 2, states that:

The nurse’s primary commitment is to the patient, whether an individual, family, group, community of population.

In the interpretive statements, the ANA, acknowledges that:

Nurses may experience conflict arising from competing loyalties in the workplace…

Yeah, no kidding.

Of course, we have a responsibility to our patients, but we also have a responsibility to our families and ourselves.  Most of us cannot take lightly the chance of retaliation.  We need our job, our income, our career. 

I personally have not experienced retaliation, but I know it happens.  Leah Curtain wrote a great piece for consideration on this topic; you can find it here.

So what should you do if you feel you need to speak up at work to address an issue?

1.       Stay calm.  I’ve seen nurses put up with a situation over and over and then just blow up.  That never works, it just makes the nurse look bad.  Address issues calmly and professionally.  It’s hard to fault the nurse who takes that approach.
2.       Circle the wagons.  Talk to your coworkers.  Again, calmly and professionally.  Are they witnessing the same issue?  There is safety in numbers.  Garner support from your team.  I’ve also seen this be very effective – a whole team addressing a concern in a calm and professional manner and it works. 
3.       Write it down.  Keep your own journal, record, diary, notes, whatever.  Dates, times, details.  Keep this away from your work environment and be considerate of privacy laws. 
4.       Get professional advice.  Consider asking for assistance from legal counsel, your state nurse’s association, and/or your professional association.  Again, keep a record of all interactions. 
5.       Get advice from a mentor.  Talk to a nurse who you trust and who you admire. 
6.       Make sure you have the facts straight.  Always present only the facts; keep personal judgements and opinions to yourself. 
7.       Know your organizations policies.  Policies offer protection for you.  Get a written copy of the policy or policies surrounding the situation and keep them with your personal documentation. 

I hope that you are never in the situation of being expected to participate in something that violates your professional ethics.  But, if you are, be sure to take steps to protect yourself. 

ANA Code of Ethics for Nurses with Interpretive Statements, available at