A Lesson from My Bullies

I awkwardly picked up a patient’s blue chart, ensuring the EKGs and other loose papers wouldn’t fall to the ground as I made my way to the edge of the nurses’ station. I needed to not make a scene or mess up. I needed them to believe that I belonged there. Just as much as any other nurse. I inwardly sighed, thinking how was it that I felt I could go on to become a physician when I found the job of a nurse to be so initially intimidating?

“No!” I told myself. That was enough. I could do this. Those types of thoughts had to go. Because that was not how I was going to play the game.

Even still, there was so much to take in. So many new faces. Doctors, PAs, APRNs, nurses, patient care associates, physical therapists, social workers, respiratory therapists, nursing supervisors and so on. So many names to learn and people to get to know. More, it wasn’t just getting to know the various staff members. It was now dauntingly crucial to know specifically which doctor worked in which specialty, so that when a patient’s renal failure was suddenly worsening as noted on urgent labs, I would know which nephrologist to call. Or when a patient’s oxygen saturation status suddenly declined, I would know which pulmonologist to call. Or when a patient was becoming combative, biting and spitting at staff members (which I came to learn was not uncommon on my particular unit), I would know which psychiatrist to call.

How would I ever learn all of their names in such a short amount of time?

My saving grace during those first few weeks was my orientation period. While I had several months of nursing under my belt from my prior job, I was not treated as a seasoned nurse. And while I would have liked the recognition of having had prior experience, I found myself secretly grateful for the chance to start over as a novice. Because truthfully, it all felt so foreign.

It was as if I hadn’t changed specialties but had instead changed my entire career.

Gone were the toy trucks and wagons in the hospital hallways. And no more were the paintings of flowers and balloons spattered across the walls of the pediatric ward. The cheerful colors had been replaced with more solemn tones of beige and the occasional faded blue. And with the change in colors came a sense of gravity I had not yet encountered. An overall sense, deeper than the décor, that this unit encompassed a vast array of people, each with their own stories of brokenness that I knew nothing about, some having shouldered their secret pain alone for years.

I made my way to the break room, putting away my purse in preparation for my shift. As I passed the nurses’ station I was struck by the sight of a frail older man lying in bed in the middle of the hallway, which I immediately found odd. His bed was adjacent to the nurses’ station, and I was quick to note his cachectic arms were secured in blue restraints. I knew this only happened when a patient needed extra supervision for severe behavioral disruptions. As I walked by him he looked up at me, and I found myself retract inwardly, hoping he wouldn’t harm me in some way.

I immediately despised myself for feeling that way.

How was it possible that I could want to help others (and I knew I did), but then almost instantaneously react in judgment and not love, assuming he would hurt me?

It was a dreadfully eye opening juxtaposition of my ideals versus my current (and lacking) state of emotional maturity.

This new job of mine was going to be a different kind of hard.

Because it was going to unveil some things.

Some ugly things.

Not so much about others and humanity.

But about me.

I had much to learn.

I inhaled deep and made my way to front desk, immediately overwhelmed by the large volume of call bells that seemed to be simultaneously going off. It was change of shift, and I knew I needed to get report from the night nurses before I could start my day. I hated to make patients wait. I found the more I made them wait, the harder it was for me to bridge any sort of relationship with them. Even still, I stood with my computer on wheels, paper in hand, waiting patiently for reports to be given. All the while watching the secretary frantically page nurses and patient care associates to this room and that.

As I waited, I glanced at the white board, listing the patients by room number, diagnosis and attending physician. I sighed, noting we were full, again. I hoped my patient load wouldn’t be too much. A busy day on this particular unit was anywhere from four to six patients. But I quickly came to learn the number of patients one was responsible for often had little bearing on the flow of the day. It was the particular patients that a nurse had, how involved and /or sick they were that dictated how busy one would be. More, one had to be flexible throughout the shift, as there were always discharges, admissions and transfers to complete. So, one could easily go from four patients to six patients in a matter of minutes.

It had been a few weeks, and my orientation period was coming to a close. I had managed to find a way to organize my day despite the chaos that ensued all around me. I wasn’t used to having to think and chart in a loud environment with patients shouting, visitors and staff alike bustling by and codes being called. I was so thankful for those few nurses, two in particular, who encouraged me early on, showing me the ropes and telling me I was doing great. Telling me I was picking things up quickly. I didn’t know it then, but they would go on to become like second moms to me. And our friendships would extend far beyond the walls of the hospital.

But they weren’t all encouraging. Some were cold. And others were stressed themselves to the point that they just simply weren’t able to teach. But I found I learned even still, and in no time at all

I caught my stride.

There was, however, an unexpected toughness to the unit. Something about it that I couldn’t put my finger on. An uneasiness followed me through my shifts in those early days, as I began to pick up on subtleties that I had perhaps initially missed during my training period. While a handful of nurses had been welcoming and fun to work with, I found others to be difficult, showing little interest in getting to know me at all, making it all too clear that they ‘weren’t here to make friends’.

This was particularly evident at change of shift where I was to give and receive report from nurses of varying shifts. I often provided a thorough report including patient histories and past medical problems pertinent to the patient’s stay. However, some nurses were sure to give me wild looks of disapproval, wanting only the bare bones of information to get them through their shift which I often found frustrating and quite honestly unfair to the patients in need of good care.

More, some of the patient care associates proved to be challenging to work with as well. I felt their glares as I sat down one afternoon in the breakroom with a cup of coffee and a salad I had just grabbed from the cafeteria. My legs and feet were weary from having been on them for the past four hours, and I was thankful for a moment to rest. I knew exhaustion had been steadily creeping in, but I did my best to refute it by consuming one too many cups of coffee. I figured heart palpitations were an okay tradeoff so long as I could complete all necessary tasks. And while caffeine didn’t completely energize me, I did find it helped mask things for a while longer.

And I just needed to make it through my shift.

As I sipped my coffee, removing the lid and briefly inhaling the soft scent of French vanilla, I was struck by the manner in which conversations were directed away from me around the wooden breakroom table. It felt intentional, despite my efforts to engage. I exhaled, realizing I had entered somewhat of a hazing period among some of the staff.

Moments earlier I had overheard several of the patient care associates discussing a summer picture I had posted to my personal Facebook page months prior. My stomach turned in hearing their comments, feeling betrayed by these women I barely knew. Even so, it came as little surprise, recalling being faced with bullying since the very beginning in nursing school.

I knew a field predominantly run by women would be subject to the pitfalls of competition and bullying.

I knew I wasn’t the first and most certainly wouldn’t be the last to be faced with such frustrations.

I did however, find it ironic that the ones making it most difficult for me, a few of the patient care associates, were also the ones who were supposed to take orders from me and the other nurses. Even so, I felt no need to establish any sort of balance of power, despite what my nursing professors would have said. I only wanted to show them I was not the stereotypical self-absorbed and superficial tall blonde that they perhaps believed me to be.

Oh, if they could see where I had been!

But I knew they couldn’t. And quite honestly, I wasn’t sure even that would have made a difference.

I knew I couldn’t see where they had been either. I was sure they had been through some things. Some things I knew nothing about.

And given the difficult patient profile of the unit, perhaps these tough ones were needed.

More, perhaps being tough was something they had previously needed to survive.

They seemed to speak the language of the patients far easier than I.

Which humbled me, while also causing me to realize perhaps it was time for me to toughen up too.

Even still, I was determined to win them over.

And in time,

there were a few, I did.