I am not talking about this:
I am talking about THIS:
There is something that has been on my mind lately and I have a hunch that it might make me sound a little harsh. But bear with me because its something that I think makes a huge difference in a nurse’s life.
What am I talking about? I know I am not the only nurse out there that has come across another nurse that makes your side-eye muscles flex. Maybe its their total lack of compassion or understanding, or maybe they made a shocking mistake that involuntarily makes you do this:
Or maybe they keep telling you stories or saying stuff that make you do this:
Either way, you’re left wondering, “What?.... Huh?” Sometimes you even ask yourself, “How are they a nurse?”
But that’s the thing. Not all nurses who make mistakes (AKA everyone) make other nurses wonder how they managed to be a nurse at all. Not all nurses who don’t fully understand something raise red flags. So what gives? How come some mistakes make people judge and other mistakes don’t?
It comes down to attitude.
Don’t worry, I am not here to talk about some boring self-help stuff. But I’ve been noticing the outlook and attitude of certain ICU nurses, and how that helps them be successful. What I realized is that your attitude can make or break you, just as much as your skillset.
Sure, some people coast their whole careers with their complainy-pants on.
So why should you care? Well, because you are reading this and that puts you in a category of nurses that inherently wants to be the best nurse they can be. That’s a good enough reason!
The Successful ICU nurse attitude
The way I see it, attitude can make or break you as an a nurse. In particular, I look at successful ICU nurses and I see a pattern of particular sets of attitudes and outlooks that have gotten them far. Of course, the reverse is true, and there are some negative attitudes that hold nurses back.
In the nursing world, a huge part of your attitude is in how you respond. Lets take a look at some examples.
Red-flag Nurse: Denies that there was a mistake, gets defensive when feedback is given, and they go on with their work as if they know everything and do everything perfectly. Because they are in denial about their mistake, they don’t reflect on the situation and continue the same dangerous patterns of behavior.
Meanwhile, nobody on the unit trusts this nurse at all anymore, and managements grows increasingly suspicious and frustrated with them. The nurse ends up committing a similar mistake a few months later, this time causing serious injury to the patient.
Successful nurse: Openly acknowledges their mistake, listens to feedback and uses it as an opportunity to learn and become better. They might even take away specific lessons about the situation (like what behavior was dangerous? Why didn’t they ask for help or research the drug? etc.)
The lessons learned were valuable and the experience taught the unit and management about a better way to do things. That nurse then realized that that pattern of behavior actually affected other parts of their practice, and worked to change that, eventually becoming a bad ass and admired by peers.
Red-flag nurse: Assumes they are just seeking drugs and after maxing out on the PRN options, stops answering the call light. The patient keeps calling out in pain and finally the nurse answers with a short and frustrated response along the lines of, “Stop calling for pain medicine! You can’t have anything else until 4 hours from now.”
It turns out the patient had legitimate reason for pain. They ended up with a ruptured appendix and having an emergent operation, and eventually did not survive the incident.
Successful nurse: After maxing out on pain medication, the patient continued writhing in pain. Thinking back on the history of this patient’s behavior, the nurse started to wonder if there was a new reason why the patient might be in such acute pain.
They dig deep into the chart and find trends in the vital signs and labs that raise concern. The nurse goes in to assess the patient and realizes the pain is a new sharp pain in the abdomen, something the patient has never complained of.
The MD is paged, and after further investigation, they decide to take the patient into surgery and successfully removed the appendix prior to it rupturing. The patient survives and lives to see another day of drug-seeking behavior. (Just kidding!)
You see, how YOU perceive something and how you respond to something can not only change the outcome for your patient, but for you as a professional.
Let's break it down.
Here are a few characteristics of a successful ICU nurse’s attitude:
Humility: Yes, I said it: humility. Its ok not to know everything. The human body is complicated enough WITHOUT disease; it gets even more complicated as disease is introduced. Own what you know, but also own what you don’t know. The more questions you ask, the more you will learn, and the more your co-workers will respect your willingness to expand your knowledge. Its what I call “The Question Paradox”.
So, ask questions and engage with the answers.
Also, if someone gives you feedback, take that as an opportunity to improve, not as an affront to your skills.
Be a go-getter: ICU nurses are frequently ready to jump into chaos, instead of avoiding it. Those who try to avoid chaos in the ICU typically have a hard time. Why? Because its hard work! But if you go all in with the attitude of, “Alright! Lets do this!” as if you were going to win the lottery at the end of it, then you will not only have a good day at work, but you might actually learn a bunch. This is similar to “rolling with the punches”. Because believe me, they come. They really, really do.
So, next time you get an admit before you even transferred someone out, put your complainy-pants away and get excited! You get a whole new chaotic mess to manage and learn from and to challenge your skills! That’s a great thing!
A find that the more a nurse is willing to fly by the seat of their pants, the more exciting their day will be. Who wants to be bored? And at the end of the day, you end up being that nurse with CRAZY stories.
Learn when to give a sh*t: Why is it that a seasoned ICU nurse rarely gets shocked by something? When I was a new ICU nurse, I never understood how we’d all be at the nurse’s station and an alarm would go off, and everyone would just look at the monitor, and keep going about their business. Other times, someone looks at the monitor, and goes to the room calmly. But there’s times when they look at the monitor, say, “OMGOMGOMG” and RUN to that room. What’s that about?
The way I see it, you have a limited number of sh*ts that you can give. The more experience you have, the more conservative you start to be about them. This might sound like a bad/mean thing, but really, its smart. Where you give your sh*ts will speak a lot about you.
And what I mean by “giving a sh*t” is: is this something I am going to freak out about? Is this something I am willing to become a stern biotch about? Is this something that I am going to stop everything I am doing to get this one thing handled?
Are you going to give a sh*t when the patient’s fever is 100.3 when they’ve been 102 for the last 5 hours? No. They got Tylenol, a bear hugger and some ice packs and they’re on a downward trend: we’re cool.
Are you going to give a sh*t when pharmacy hasn’t sent you the levophed drip and the blood pressure is 63/26? Yes. You bet you I am harassing pharmacy until I have that bag in my hand.
Are you going to give a sh*t if your patient is crashing and you remembered your other patient’s multivitamin was due 2 hours ago? No. Just… No.
Do you see what I mean? This is an important art form. That doesn’t mean don’t do anything about problems that happen, because of course you need to. But if you freak out at every little thing, you are going to drive yourself into the ground. Respond to all problems, but only give a shit (AKA run around like a crazy lunatic) about the important ones.
I am curious what you guys think about this. What kinds of attitudes have you seen or adopted that have contributed to someone being a badass nurse?