Nurses Eat their Young ... ?
- Cristine
- Aug 18, 2024
- 8 min read
There is an infamous expression that sadly exists in the nursing community: nurses eat their young. This saying is used to depict the bullying that novice nurses may endure in the workplace. Think of it as the hazing process that college freshmen go through when they join their first fraternity/sorority. However, remove the aspect of physical torture and instead replace it with emotional abuse that can be tenfold.
But Cristine, are you sure that professional adults in a professional setting would do such an unprofessional act?
Absolutely!
To have endured it myself, and to have had to defend new grads and student nurses, the things that experienced and senior nurses say to those in their learning phase is conniving and upsetting.
What if it's just tough love Cristine? Maybe these new nurses are just being sensitive ...
While I am a very pro-tough-love-type of teacher, there is a fine line between helping new nurses develop thick skin and blatantly degrading them to boost up one's own ego. Let's get into the details.
When I first started out as a clinical instructor, I had no idea what type of teaching approach I would take. I reminisced about my own nursing journey and thought of the mentors that have shaped me into the kind of nurse I am today. Like many students, I also wished I would get the easygoing and laidback instructors. The ones that acted as your friend, the ones you could joke around with, the ones who wouldn't make you feel bad if you didn't know the answers to their questions. However, it is the tough, strict but understanding professors that have created a significant impact in my career growth. And so, I'd like to think I became a combination of both types: one that expected plentiful from my students all while acknowledging their limits and their efforts. After all, we were all students once, we had to start from somewhere.
When I introduce myself to a new group of students, I usually do not say much about myself. They didn't know where I worked, they didn't know my work background, nada. The only statement I made to them was that my goal was for them to be in an optimal learning environment. I was in my "assessment" phase. I had to get to know them just as they had to get to know me: by working together. I quizzed them relentlessly. They'd answer nervously. I'd ask if they were sure of their answers. They'd take a few seconds, rethink and get back to me. I'd walk down the hospital halls ensuring if they were okay with their patients. They'd try to hide from me for fear I may ask them more questions. Eventually, they understood my intent and approached me in cases of uncertainty or in need of assistance. As the weeks went on, unpleasant situations were revealed to me, and that activated Mama Bear Cristine mode.
Situation # 1: To Sit and Shit in Peace
One of my students came up to me visibly upset after the primary nurse of one of her patients scolded her for putting him on the commode to do a #2.
To give you more context, this was a man in his 70s who recently underwent an orthopedic surgery. He was known to have a drop in blood pressure when going from a lying position to sitting/standing (this is called orthostatic hypotension). He would express dizziness when changing positions. One of the main issues this gentleman was facing was his inability to defecate in bed, in a diaper. I mean ... who would want to be in that predicament?
When my student nurse came to me to express her frustration, I first asked her to tell me her side of the story. She had explained to me that she knew her patient, and she knew that, despite his varying blood pressure, the only way to get him to "eliminate" was to get him in a sitting position. He was as stubborn as any of us would be in his situation. I nodded and then proceeded to help my student get him back to bed. Little did we know, a rather big surprise was waiting for us ...
Upon returning to his room, a pungent smell reminiscent of iron filled the space. As we got this man up to return him back to bed, what filled the bowl of the commode was a horrific sight; a puddle of dark red-brown "waste". Melena is what that would be called. We advised the doctors and related interventions were undertaken (vital signs and blood draws). At the end of our shift, the patient appeared as white as the bedsheet that he lay on top of.
The next day on the unit, we heard of the passing of the gentleman twelve hours after the incident occurred. The patient had an active upper gastrointestinal bleed. But, after contact with the family was made, it was decided that no invasive interventions be done. No gastroscopies, no blood transfusions, just comfort. My student became tearful and expressed guilt for having stood him up. I spoke to her stating that it is in fact thanks to her that the most likely main cause of his low blood pressure was discovered. And nothing that she could have done or not would have prevented him from having so. It is thanks to her that, as dramatic as it may sound, that he could "shit with dignity" like the rest of us. It is thanks to her that his suffering is over.
Situation # 2: Power Trips
Nurses aren't the only professionals to abuse their powers on student nurses; patient attendants are just as culpable as any other health care professional. During our first few weeks of a surgical clinical rotation, a couple of my students admitted to me that this particular patient attendant (PA) was bad mouthing them right in front of their patients. She would tell them off with condescending remarks like "Do you even know how to do this?" or "No, you're doing it the wrong way". Additionally, she would also make them do her job for her (i.e. checking up on patients that they were not assigned to).
I decided to investigate for myself and get both sides of the story. I first gathered the opinions of the unit's staff members regarding said PA. I asked fellow nurses and fellow PAs of the way she conducted her work. I then confronted the PA with what my students have said. She, unsurprisingly, denied the claims.
I then consulted with my students to see which course of action they wished for me to take. I explained to them my options along with their justifications. Option 1: Keep cool and not mention anything to staff (to prevent further bullying)
Option 2: Reciprocate the PA's attitude back to her (to show force)
Option 3: Report the incidents to the head nurse (to create a better learning environment for the remaining weeks, and for future nursing students)
FYI: Option 2 was obviously not given to them, it is merely an intrusive thought ... lol
Option 3 was the obvious winner. After discussing with the head nurse, and gathering written testimonials from my affected students, the atmosphere on the unit became less toxic and much more optimal for learning.
Situation # 3: Believing the "Crying Wolf"
What I love about working with students is that they pick up on the subtlest symptoms their patients divulge. Although at times, the findings correspond to the patients' baseline, there are times when normalizing repeated events can become a danger for the patients. And that is when the saying "Better safe than sorry" becomes very VERY relevant.
One of my students had Mrs. H., a geriatric patient who was pleasantly confused. On the second day that she had her, my student came up to me to tell me that the patient was complaining of chest pain and difficulty breathing. She then went to perform a more complete assessment so that she may convey her findings to the primary nurse before going on break.
The primary nurse was on break. Therefore, we searched for the covering nurse to relay the information. After giving her a detailed report, which included stable vital signs, the covering nurse responded with a "It's okay, she's usually like that. I'll tell the nurse when she comes back."Although it wasn't the response expected, I told my student to document her assessment and the notification she had done to the staff nurse.
One thing to note is that the scope of what a student nurse and clinical teacher can do is at times limited. Indeed, as we are regulated by the college and not by the hospital, there are situations where boundaries are set. In this instance, stepping over the unit's staff members is tricky. In teaching hospitals, nurses often forget (or choose to forget) that although some of their patients are assigned to a student, it is equally their responsibility as it is the students to remain in constant communication. It is the primary nurses' responsibility as well to check up on the students, but more importantly their patients.
Upon returning to the unit after our break, my student nurse went to check up on Mrs. H. to ensure she was still okay. Once she returned to the nursing station, she told me that the primary nurse was back from her break but was upset at the fact she was not told of the patient's complaints of pain. My student then further explained to the nurse that she had made the covering nurse aware and was told that the information would be shared with her once back on the unit ... It obviously did not. My student then stated the nurse was still upset despite the explanation and told her off.
As Mama Bear Cristine began brewing inside of me (kind of like when Dr. Banner slowly transforms into his green muscular alter ego), I confronted the nurse about what my student had told me. I confirmed the story of my student as I had witnessed it. The nurse then proceeded to tell me that everything was okay and denied being rude to my student. I returned to my student and we carried out the interventions ordered by the doctor.
At the end of the shift, I had spoken to my group of students that at times, the way people treat you is a reflection of their own insecurities. There are instances where we can choose to pick a fight, and some where we choose to be the wiser and bigger person and not let such "negative Nancies" ruin our moods.
Some may ask me why I conduct myself in such manner with my students. Why do I feel the need to be as defensive as I am, or to share a few words of wisdom from the expected reality that lies ahead of their new career. The truth is at the end of each of my rotations with my students, I share the story of my mom in the form of a case study. Once we get to the end, I then reveal that it is the experience I endured myself.
I then shared the brutal words I was once told by a head nurse at the end of my orientation period in an ICU. Words that cut like a knife and made me question if I should even continue being a nurse. Those words caused me much emotional turmoil at first. However, a month later, those hurtful words were proven wrong, and have made me into what I am today.
"I wouldn't let you take care of my mother. Would you let yourself take care of your own mother?"
Yes I would, and I did a pretty damn good job.
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