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Andy:Hey everyone welcome back to Friends of Flo this is Dr. Andrew Whitters here
Rebecca:and I'm Dr. Rebecca Porter.
Andy:Today we're missing one of our colleagues.
Rebecca:I know Tessie had another obligation. So we miss her and a shout out to Tess
Andy:Yes a shout out to Tess, right there you go. Hey Tess. So it's just us today, Dr. Porter and myself, so here we go.
Rebecca:So we've had some comments about people talking about being bullied or incivility at work and what to do. So have you experienced, had people being rude to you or felt that you were bullied?
Andy:Yeah, oh yeah.
Rebecca:Tell me a story
Andy:In my experience even observationally now as an advanced practice nurse, I mean, I think it's still pervasive in our in the nursing culture. I think that the idea that nurses eat their young. I think it's very real. I have personally experienced it. I remember as a new nurse, this is the better part of 10 years ago now, being in an ICU setting. Off course won't won't say where, but just getting my questions answered was seen as a pervasive degree of annoyance. I was treated like a lesser form of a of a nurse. When I had questions about our system or if I had questions about a particular clinical issue with a patient I might not have had exposure to. It just really added to my frustration and daily stress grind. So I do think it's common I think it continues to happen today. I don't think that nurses are very good about supporting each other. I think that we as a culture as the nursing culture is far more inclined to break each other down than we are to to build each other up. And so I think there are stories out there all over the place.
Rebecca:Yeah when I was looking at the literature on civility or bullying. Almost 100 percent of people in the workforce, 99% of people say that they've been a target of bullying and less than 1% of people admit to having been a bully. Isn't that interesting? And in nursing most of the bullying seems to come from upper management, from nurse managers to staff. But I would like to just take a step back, two steps back. One is to talk about a continuum of what is bullying and and then we need to move into what does it cost. And then let's go into how do I respond.
Andy:Solutions
Rebecca:Because I don't think we're taught in nursing school conflict resolution. And what to do when we encounter conflict. So incivility, when do you feel disrespected Andrew?
Andy:I think when when I'm either questioned, especially now that prescriptive care provider if I'm being questioned in a way that's just not professional.
Rebecca:Like what? Give me an example
Andy:I think there's a way to to question a prescriptive care provider.
Rebecca:By another nurse?
Andy:Well by anyone. I mean I think that we have an obligation to be open to hear constructive feedback. But if I write an order and I hear someone mumbling under their breath, well that's just dumb. I immediately put it to bed and say, well hey why do you disagree. Like tell me why you think it's dumb. And then I have to bear witness to someone you know maybe getting embarrassed that they didn't think that I heard it or something. It just needs to be...at my level I just want to kill it.
Rebecca:These sort of under the breath comments that you feel disrespected. So I feel disrespected when somebody rolls there eyes when I've said something and...
Andy:The nonverbals
Rebecca:The nonverbal stuff really grates on me. Or when I'm teaching and people in the front row we're actually looking on their cell phones at bridal dresses right in front of me.
Andy:Just not engaged.
Rebecca:Am I really that boring? I thought this was pretty exciting stuff that I was talking about. So it's this nonverbal stuff that we can call bullying. It can be gossip. You know it's sitting in the conference room chit chatting or at the nursing station. Not saying nice things about somebody. So that's another kind of bullying and then you see the person that they're talking about or that you are talking to her that I've been talking about walk by. Or my favorite is when I said something not very nice you know about, within my family about another family member, you know how that goes. And then I thought, oh! Did I include them on that e-mail mail and just break out into this sweat because I've been not nice and it reminds me of what it feels like to not be nice. So there's that kind of bullying and then there's the kind where you get yelled at. What are you doing? Who do you think you are to do that. That kind of bullying or you feel disrespected by that or challenged.
Andy:I do think that nurses get yelled at. I think that's another, I think that we get yelled at by other providers whether they be other nurses or physicians or...
Rebecca:But there are times when a voice does need to be raised.
Andy:Oh sure
Rebecca:If you are going to inject medication into an arterial line and your the preceptor and you watch somebody decide to inject something into the arterial line are you gonna go hey hey hey oh don't do that oh no no no no no. Or are you just gonna sort of, oh my gosh. Stop that!
Andy:Yeah.
Rebecca:And that poor student might take that as being yelled at when in fact it was necessary to stop something bad from happening.
Andy:After a situation like that I think there should be a debriefing. And I think that there generally is because it's a learning opportunity. And I think that's what most yelling situations can be turned into the right kind of positive attitude. I think it's the yelling episodes that challenges a person's intelligence or even decision making skills that might not even be critical in nature. But if they ask that question maybe or they get yelled at, that's just inappropriate. And those are the kind of things that now in my career I've learned to feel very comfortable just calling out a bully for what they're worth. Not necessarily calling them a bully, but just saying hey, like why are you yelling?
Rebecca:Well see I think that one of the ways to address that kind of behavior is, yeah you want to kind of put them on the spot...why are you doing that? But if you challenge them in that way it's going to escalate the situation. But what you want to do, I think what you want to do, is when you yell I feel scared and the patient isn't going to get what they need. So when you do this, this is what happens. When you mutter under your breath about, I heard some under the breath comments while I was writing that prescription or after I wrote that order. When I hear that it makes me feel disrespected. And it makes me wonder whether we should have a conversation about whether this is appropriate for the patient. So it gets it off of you and me and gets it back where it belongs on the patient.\
Andy:Right. I think when you can circle around and make the patient the focus of the conversation, emotions tend to just simmer down. And what no matter who it came from, if you can just call out the behavior and then say, hey can we can we come to a common consensus about what we're doing for this patient.
Rebecca:So one of the comments that somebody wrote was that there nurse manager was sitting in her office or sitting at the desk and not helping with some patient care and a comment from the nurse manager to this new nurse was, you just need to get out there and learn. How would you respond to that?
Andy:The younger me would have probably you know crawled under the desk and like you know metaphorically speaking of course I probably would have shied away from any further conflict.
Rebecca:Yeah the younger me, I was bullied terribly in my very first job and this is many, many, many years ago and in a different country. I was yelled at constantly by my nurse manager and berated and derided constantly in front of everybody and I stood up to her. I just said, I will not be spoken to like that. And I ended up leaving. It was a messy situation.
Andy:How'd that work for you short term? I mean how is the response?
Rebecca:Oh, I'm fine. It was at a small, small hospital and I went to the chief of medicine and said she had written my three month evaluation and it was terrible. And I know that I was not the person she was writing about because I knew I was a much better nurse and much better person than what she was saying. And so I went to the chief of medicine and I wrote an 11 page rebuttal and refused to sign my evaluation form. And I stood up for myself. I refused.
Andy:And what a cerebral response for a new and young person.
Rebecca:Oh absolutely for a brand new nurse.
Andy:For me now...my new younger novice nursing personality probably would not have done anything, I probably would have sunk back into my own shell, found another way to internally cope with it and move on. But I think now I would say to this nurse manager and this kind of situation that this viewer wrote in. I would just simply say to the nurse manager, I need your leadership advice...
Rebecca:The patient needs your insight and expertise right now.
Andy:I think turning it back on the nurse manager by saying your leadership is important, I'm in need of it, I need your help. It's an opportunity for...the ball's in their court and then to respond in a way that can then maybe make it more of a patient centered issue. So even that the person who might feel like they're being bullied in this situation or being ignored perhaps a better word, they can humble themselves even further by taking the high road and then putting it back right back in their court saying I need your leadership. Like what do you suggest like, give me your advice. What was your experience, what would you do in this situation. I mean like comments like that tend to deescalate. It tends to validate the opinion of of the person who might not be fully engaged, in this case the manager then and hopefully the response should be, especially in person who's in a leadership position, to come back and say yeah. Gotcha. OK. So you need some some guidance here. Let me provide that for you. And oh and yeah that's right. You know Mrs. So-and-so a patient X Y Z over here does need maybe some additional attention. But I can see where you're coming from. So it's a way of just rethinking, reengaging...and some of this is just personality flaws that we all have as nurses and trying to go around those.
Rebecca:Conflict avoidance and I'm just not going to...I got a response from nurse manager that didn't make me feel good. So I'm just going to go crawling in the hole and feel really insecure or quit. But I read a really interesting article yesterday in The Wall Street Journal it's called, managing up. And what we need to learn to do no matter what your position is figure out how to communicate with your manager, no matter what position you're in. So study your nurse manager when you interview for that first job or your interviewing for a job
Andy:That's great advice
Rebecca:Is to really study the nurse manager. What does the unit look like, what does the manager's office look like, is it chaotic and a disaster? Can you work in a chaotic environment where the nurse manager looks like papers are all over the place and scattered. Or do you want to walk into an office and interview with somebody where the unit is tidy...and you have to know what you want.
Andy:Sure
Rebecca:So when you're working and you managee up. So in that interview when you're learning your nurse manager is to watch how he or she communicates with everybody.
Andy:Yeah the interactions are important.
Rebecca:Study them, study them at work. How are they interacting. What are they doing. Is this a good fit for you. And think about what you would do in that position. And my best advice is to keep the patient first and not make it about how you feel or how the nurse manager or co-worker...I remembered that when I was giving a talk on incivility to radiology technology people. Somebody said, well this person keeps coming in and saying, will you help me? And this manager said, well I always say how come you haven't asked for help from Person X. How come, why aren't you doing this. And so how do I handle that. This manager said and I thought about it for a minute and I thought maybe they're being bullied. Maybe they're feeling insecure by their co-workers. And so a better response for the nurse manager instead of saying, have you asked Tom or Karen for help, is to say to that person who wants your help is to say, have you asked and in a quiet place say, can you tell me about your interactions about why you haven't asked or what have your previous experiences been. And just to feel that kind of nurturing mentoring. But also when you think your nurse manager is just sitting on her butt, to stop for a minute and think about what are the myriad of responsibilities your nurse manager has. True. Yeah. And to just one day go in and say, tell me about your job.
Andy:Yeah
Rebecca:Tell me what it's like to do...like how do you be a nurse manager, how do you do this? What are you looking at? How do you know what's important?
Andy:Understanding processes. I do think that's the responsibility of nurses as they grow into their specialty and just general profession. Understand the what the engagement looks like for...
Rebecca:Everybody
Andy:For everyone yeah for especially for your leadership because I think sometimes we again, culturally nurses will perhaps bad mouth their leadership in the break rooms and in conversation around a nurses station. But they're human too and they're tasked with some pretty heavy duties that aren't often patient focused.
Rebecca:It's invisible work.
Andy:Right. It is. Not to mention budgetary issues that oftentimes aren't shared because they can't be
Rebecca:They can't be and you don't want to stress the staff.
Andy:Yeah, exactly. So in my experience a good nurse leader will always make sure that his or her staff is engaged at the patient level and the rest of the duties that are above that whether it be the financial duties or the capital management issues. It becomes a non-issue for our floor nurses especially.
Rebecca:But, it's still important to manage up. For you as a staff nurse or a new nurse practitioner in a workplace...manage up. Know what the management is doing. Figure out what the issues are and get a global feeling of what's going on here. Somebody else wrote in and said that they're being laughed at. That's really hard to know you're being laughed at. I'd like to unpack that with that person
Andy:I want to know sort of the context I guess. I mean being laughed at, sounds on the surface, is humiliating.
Rebecca:No kidding. Maybe she asked or he asked a seemingly innocent question. Right. And so a senior person just went,"oh hahaha, you don't even know that"
Andy:Yeah I mean that's a difficult one to unpack. Especially without knowing like I guess the context.
Rebecca:I guess my advice would be my insight would be to this person who asked that question or made that statement and others who have been laughed at, I think we've all been laughed at for something, is to sit back and think about what did I just say. How did I say it and how will I respond next time. Because it is really humiliating to be laughed at and if it happens again. Maybe take that person aside and say, when you were laughing at me I wanted to know what it was and something related to patient care because if it is can you share with me.
Andy:That takes a lot of courage though to take someone aside and be like hey
Rebecca:Yeah but we're adults.
Andy:Sure
Rebecca:I mean you're not a 15 year old nurse you're probably. a 22 or 23 year old adult who votes, you can carry a gun, who can drive a car. You can get married. So put on your big boy panties and your big girl panties and stand up straight and have an adult conversation. Stop being a little wimpy.
Andy:Yeah yeah. So I guess in a way get get some thick skin though to is what you're saying.
Rebecca:Not everybody gets a trophy all the time.
Andy:Yeah. And that's goes into like the generational issues though too that we have discussed on previous podcasts of Friends of Flo. So yeah, being laughed at
Rebecca:That's a tough one
Andy:I like to kill those issues....
Rebecca:With humor
Andy:And if it is something that I guess I would look at myself first and be like, gosh am I being a goofball like right now. Maybe I can turn that into
Rebecca:Maybe I can turn it into something funny
Andy:Yeah, yeah maybe I can turn into something that's funny.
Rebecca:Somebody else said that they had been told in response to asking advice to look it up, whatever that means. So again that comes back to if it's really life threatening or has to be answered immediately kind of question for patient safety. How do you what's the best way to ask for information. If it's a critical situation of course ask a senior person that you trust, a mentor. But if it's not so urgent or if it can wait you know five minutes or 10 minutes.
Andy:It's the art of how the question and when the question is perhaps asked.
Rebecca:So do you look up stuff yourself before you ask a question of somebody.
Andy:Sometimes I mean and sometimes I remember being when I was a brand new nurse in the ICU I would try to know what my care assignment might be the next day. I would do my homework on the patient, be as buttoned up as I could to understand the diagnoses, maybe what labs, what drugs I might be passing those types of things and that was just a professional expectation on my floor. I liked it because it was challenging, but I could come in the next day and I felt I was relatively prepared.
Rebecca:I get the same thing Andrew. I was a critical care nurse before computers.
Andy:Yeah
Rebecca:I'm that old. And I used to come, I did the same thing. I would come in, I would know my assignment for the next day and I would come in with books. I would have three or four textbooks with the physiology, pharmacology, nursing critical care nursing textbook and I would have them all at the bedside and I would just be reading voraciously for what my patients situation was in addition to understanding who my patient is as a person. So when you're told to look it up and when you want to know something do a quick literature search. In the real literature not just a Google question
Andy:Sure when time permits for sure and that is a critical question. Say to the person I would otherwise look this up, but this patients blood pressure is tanking should I put up the medication. Do I hydrate this hour. How do I do this? Hey let's take a break for a few minutes
Rebecca:Perfect, let's do this
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Andy:Hello and welcome back to Friends of Flow. This is Dr. Andrew Whitters and we've got Rebecca Porter over here.
Rebecca:Yeah we were just talking about incivility or bullying. ON our break we were talking a little bit about nonverbal, the eye to eye contact and what happens in the cath lab what happens in the OR our another procedural. And how much non-verbal communication there is and Andrew you started to talk about that. Can you remember your story.
Andy:Well we had a viewer comment that what do you do in the operating room environment when you have eye rolling in the OR environment as many of our listeners might might relate to the OR environment is, you're in a sterile environment with gowns and gloves on. You might have a hood on certainly a mask. So you're physical features,facial features, everything is covered so you just have your eyes to deal with and sometimes communicate other than your voice and the listener commented, what do you do when someone is eye rolling in the operating room environment and so the OR is a unique place for a lot of the reasons that I just mentioned. It doesn't get any more patient focused than the OR in my opinion. You have someone who is anesthetized. They are truly in a greater sense helpless. They are depending on others to literally intervene to save their lives. So I think it requires a great deal of focus. And to a degree you need to let things roll off your back in the OR and then once the case is over if you had a colleague who you want to debrief with as I like to say then approach it that way. During the case is...
Rebecca:Not the time
Andy:Just not the time like that. And this is an opportunity for nurses to grow some thick skin and refocus your energy and you can show it too by your actions in the operating room by making sure that your instrumentation is certainly ready, asking questions to the anesthesiologist or the operating provider, are we doing okay up here are the vital signs looking good you know just talk it out. Be vocal about being patient focus, refocus the group. Circulators within the operating environment do the same thing. So I would say rise above with your actions. And in this case certainly show that you're patient focused and then after the case...
Rebecca:Yeah I like your idea of a debriefing and to be able to ask that person can have a chat just for a few seconds and make it in a private place in a corner of the locker room and just say, I noticed that you were your eyes communicator...I perceived that, I felt that you were angry, you were frustrated, you were mocking me or something was wrong and that I just didn't respond at that time. Can you tell me more about what you thinking at that time.
Andy:In the OR situations it might truly be nothing because like that's all you have to express yourself are your words and sometimes like you can't use your words because you know we need to concentrate. But then your eyes do a lot of that nonverbal communication. So sometimes it just needs some simple clarification. But I think those are the opportunities for growth and growing some thick skin if you will
Rebecca:It's also time for team building.
Andy:Sure
Rebecca:And I was talking to an OR nurse where I work. And I asked her what drew her to working in the OR because I I couldn't imagine working in the OR. And she talked how great the team is that she loves the team that she works with and that they know one another and the respect among everybody on their team and how they get to know each other and she talked about...people could just look at you and you know what they need or what they want. And in those few fleeting minutes with the patient awake and it gets everybody focused on the patient and then the patient is anesthetized and and you go to work and you're there as a team with one purpose.
Andy:Yeah, it's game time.
Rebecca:It's game time. And she just sparkled when she talked about....so one of the things to think about is in addition to, I like your comment about building thick skin, is self-awareness. Are you in the right place for you. And I had a comment from a nurse a couple of weeks ago we were talking about a resolution of some conflict, staff conflict. And this nurse said to me, I love my job. I want to be here every day that I'm on. I come in here because I want to be here. I sometimes feel that some other nurses are here because they"need to be" I mean we all need a paycheck but. There need to be"that's where we get our professional integrity" I am nobody if I'm not an ICU nurse I am a nobody unless I'm a med surgeon nurse, I am a nobody unless I'm a nurse practitioner when that's not the truth at all. The truth is you are who you are no matter where you work. And so are you where you want to be. Or do you have this crazy need to be where you are because then you're not going to be your best self.
Andy:Well it's very interesting. Yeah that's some philosophical thoughts too perhaps
Rebecca:Oh you know me
Andy:That's all good.
Rebecca:So this sort of segway into one of my other favorite topics which is developing resilience. Because what nurses do we help everybody get health care. The nursing aides, the nursing assistants, our physician colleagues, everybody is working so hard. And you and I were talking earlier Andrew about the impact of technology and losing focus on the patient and the person because there are so many distractions. And in addition to the technology distractions away from the patient is just what we're talking about, about bullying because that takes our eye off of the patient.
Andy:Exactly, yeah
Rebecca:And you talk about developing a thick skin and I think that's a great analogy to building or developing resilience, the verb resilience, to be resilient and to develop, adjective, resiliency.
Andy:Yeah. I do think if we could just take a step back from the bullying issue just one last time. I think it's important for when a person feels disrespected or if they are being bullied or are not being communicated with in a way they feel built up is to talk to your fellow colleague without necessarily going to the nurse manager first.
Rebecca:Right, good point.
Andy:Because I think....we talk about respect. If you even feel disrespected it's important to turn around and show that person respect anyway. I mean it's that whole golden rule thing right. And you can get yourself to to have thicker skin by exercising the behaviors that you want to be treated with as well. And so we did speak about that in the break as well that just going to your nurse manager as a sort of that....
Rebecca:Gut reaction
Andy:That gut reaction or that prepubescent you know sort of action of I'm just gonna go tell, you know. I mean that doesn't work in the nursing world all the time. I think that if you can approach it head on with your fellow colleague...
Rebecca:In a way that you would like to be approached and not the mean girl or the mean boy. That's high school mean girl junior high stuff. This is just being an adult and talking to that person how you would want to be talked to. If I had been and I have been rude to people I mean we're all human and we have our boiling points. And when I've been mean to somebody I feel terrible and what I want to do is apologize sincerely and so when somebody comes to me and says, wow I was really hurt when you did that or I just didn't feel confident in my care of that patient after you said that. Really hits me in the gut. So I I think it's to approach that person how you would like to be approached. You have to think about that like Michelle Obama said, when they go low we go high.
Andy:Yeah. And that that makes you a tougher person you know.
Rebecca:So it's debriefing with one another. And I think a lot can be gained from sharing perspectives. And what did you think. Well you know I thought this was a really stressful code that we just had. And I felt like why did you yell at me at that point. You were so directive and I've never seen you like that before. Wow, I felt really intimidated because you were really stern and telling people what to do. And I just got really scared in that code and and my friend would say there was a code. This person's life was on the line. We don't say please, we don't say thank you. I am focused on getting this person back to life if we can and friendships aside. This is what you do in a code. So wasn't it great we got them back and now we both know what to do
Andy:And how to roll forward
Rebecca:How to roll forward and that's that resilience part of rolling forward.
Andy:Yeah
Rebecca:One of my favorite slides I have is a Jack in a box did you have a jack in the box when you were growing up? Round and round the mulberry bush and up pops the weasel that little jack in the box clown thing. That's not resilience. Yeah, that's not resilience
Andy:I would agree
Rebecca:So did you take physics?
Andy:I did.
Rebecca:Yeah me too I almost failed
Andy:Really?
Rebecca:Yeah my teacher in high school I didn't have physics to get into nursing, grade 12 physics about did me in and I was getting coached by the football coach who was a physics teacher. And he made me promise never ever to take physics again if he passed me. I obliged. Did you get physics in university.
Andy:I did.
Rebecca:I am impressed
Andy:And I think that taking those upper level science classes it translates well in my opinion to the nursing profession. I I do actually wish that there were more science classes in nursing program
Rebecca:I wish there were more liberal arts so that we can learn critical thinking and philosophy and understanding.
Andy:Well I think a combination of all those things is critical
Rebecca:But let's go back to physics because I was talking about resilience
Andy:Yes resilience
Rebecca:And so when you think about the definition of resilience from physics properties which I was going with this...is that we in physics things rebound to their former shape. But in human capacity resilience is our ability to be transformed. And we all feel stress differently. What you find stressful might not even ruffle my feathers.
Andy:Right, exactly.
Rebecca:What rocks my boat and tips over my boat might not even be close to anything that you feel. So everybody is different and we all respond differently, but when our capacity is exceeded chronically we begin to move into that burnout phase. And you might see people at work. And again that's looking at, do you want to be here. Does that person want to be there or do they need to be here for her own kind or personal credibility. When we look at being burned out why did nurses burn out? There's a whole bunch of reasons we're taught in Nursing school what we can do it all. We're taught in nursing school not to do conflict management. We were never taught conflict management. I'm in nursing school we're taught to be perfectionists we're taught to be the lone ranger. You go out there and you do it. Which is why that nurse manager might respond, you need to learn or get out there and do it or go look it up. So that's the old school of nursing
Andy:Yeah, it is old school I was I was just going to say that.
Rebecca:So nurses now because of our job, it can be pretty overwhelming. And when patients die...
Andy:It's rough
Rebecca:It's hard. And sometimes we're taught to maintain that cool exterior and not cry. We're taught not to get close to patients and that's not normal. That's not being a normal human being. We respect professional boundaries, but you can show concern and care with a hand on somebody's arm
Andy:Absolutely
Rebecca:You can show care and concern by having tears in your eyes because this is a human being who's suffering and you are witnessing suffering quite often. Nurses have a huge amount of responsibility. You just got a call while we were talking here about a patient in the hospital with a weird blood infection. That's really stressful. I mean it's a distraction. It's a huge responsibility. And sometimes in nursing we have huge responsibilities, but we don't have the autonomy to make those decisions or that they have to go through somebody else. And it's this invisible work that we carry with us. Nurses burn out because of shift work. Nurses burnout because we're tired. So we're not really taught how to blend work and personal life. You talk about balancing it, but I don't think you can balance that. I think it's a blending, in our earlier segment today Andrew we talked about how we prepare for work for the next day. And that's a blending.
Andy:Oh it certainly is
Rebecca:And so we blend our work because it is who we are. We are nurses, but we also are people with outside interests. So that goes into the resilience part about making sure that we take time to decompress
Andy:Sure
Rebecca:That we get the sleep that our bodies need. That we get to exercise that our bodies need and deserve. That we're eating well especially at work that you take no junk food to work, but you take food that nourishes your body because you need this body for the next, I don't know, 50, 60 years.
Andy:I'm hoping to make it that far, yeah
Rebecca:You'd better. I plan on it. Well that would make me about 180.
Andy:(laughs) Yeah you never know
Rebecca:So the other other ways to build resiliency are positive relationships
Andy:Oh, for sure
Rebecca:You know I'm at work when the chemistry is right between people it's not work. It's how you spend your time. It's just you know you're in your sweet spot when you're working with your friends. You know? And so the positive relationships at work are really important. And those really important social relationships in your life outside of work and it might be work friends. Some of my best friends are people from work from 30 years ago. Other ways of looking after yourself...oh my very favorite is gratitude. There's some great research from positive psychology at UPenn from about 15, 18 years ago showed that by writing down everyday 3 things you're grateful for actually changes the chemistry in your head.
Andy:It changes your behavior too I would imagine
Rebecca:So that when you're in these really stressful situations you automatically start thinking of things that you're grateful for so that you're not focusing on the person who is bullying you. You're not focusing on feeling overwhelmed at work. You're not feeling horrible at work, but you're saying I'm so grateful for Tara at work because she answered my question with such grace. I'm grateful for Brian at work because you made me laugh in the middle of a really hard day. I'm grateful for my kids because they bring me this unconditional love. You know and you just stop and think. My husband and I have dinner together almost every night and we always start with a conversation about how did your day go. And then in that we say, I would say so what are you grateful for today. And he'll say well what are you grateful for today. And it always includes one another.
Andy:Yeah, absolutely
Rebecca:And one of the doctors I work with after he's had a really tough conversation with a patient or a very difficult situation. He goes out into the hallway or into the conference room. And he said he pulls out his cell phone and he said people can think whatever they want to think. But what I'm doing is I'm pulling up my gratitude list. And every time I think of something I'm so grateful for or a person I'm grateful for I have it on my cell phone and my list of things that I'm grateful for. And he said it helps me instantly reconnect with who I am and what I'm about and why I am here doing the work that I do. So being grateful is just the key to helping to change head chemistry and having the compassion for yourself that you have for your patients and compassion for one another. And you know what's really cool is that the new 2014-15 nursing code of ethics actually has a whole section on self-compassion and self-care and self-respect. So it is important that we carry that with us in this tumultuous time in where we work and environments that we all work in. It's so very important to go back to that basic human caring.
Andy:Yeah, absolutely. That's probably a good place to end right now. So thank you Rebecca.
Rebecca:Oh you're welcome it's been really fun talking to you Andrew and we have a guest here today one of Andrew's students who has been writing little questions and notes and making comments so we're grateful for her being here today.
Andy:Yes thank you Harmony Tamboura
Rebecca:Thank you Harmony.
Andy:So this is Andrew Whitters here telling you to innovate agitate and educate.
Rebecca:And this is Rebecca saying farewell for today and time to be grateful.
Andy:All right Friends of Flo out.
Narrator:Here at NCLEX Mastery we love nurses and especially nursing students, but we need your feedback about this podcast. If you have ideas on topics or questions you want us to answer, shoot us a message, leave a comment, go to our Facebook page and just tell us what you think because we want to help you in the most specific way that you need that help. Thank you so much.