Last month was all about lessons learned as a new graduate. For this month, I am talking to the veterans. Let's get into some of the lessons that come with time, including some that I am still learning. A career in medicine can be long and fulfilling, but there are some roadblocks along the way that you have to learn to navigate.
Even in the best of settings, conflict with staff members will arise, and establishing professional boundaries can be difficult. Getting too close to co-workers, especially when in a leadership role, can make difficult conversations much harder. Holding people accountable for their actions is always a heavy lift, which is why finding the line between friend and co-worker is so crucial for long-term success.
After working in a role for several years, the grind can start to get to you. Some people settle into their perfect role early on, and ride that train all the way to retirement. For many of us, though, the winding roads of life can reshape our view of the professional landscape. After having children, those long, crazy shifts in the ED or ICU may start to feel less exciting, especially when you are having to leave your family behind to work another weekend or holiday.
There is more to medicine than just working clinical shifts, and this month I want to explore some options and ideas around an emerging idea: hedging your professional identity.
Working in healthcare is different. We are technically in a service industry, and I stand by my “hot-take" that waiting tables or bartending is the best experience to prepare for a career in nursing. That said, the relationships we have with our coworkers are very different from most other places. Whether you are working in a clinic or a hospital ward, it truly takes a group effort for things to run safely and smoothly.
It's natural that close bonds and friendships form when working in high-stress and high-stakes environments where outcomes really matter, but it's also easy to let those relationships blur the line between friend and professional, which seems fine until it isn’t.
Working as a clinician carries a responsibility of leadership, whether you realize it or not. You set the tone that the medical assistants, technicians, and nurses will follow, and your actions and attitude have a tremendous impact on the unit or clinic. Because of this, maintaining professional relationships is critically important, as well as avoiding several pitfalls that can set you up for failure:
Remaining fair and objective also means that when issues arise, your staff will feel comfortable coming to you with them. If an MA doesn’t feel safe telling you they are feeling overwhelmed by the volume of the clinic, or the nurse worries about questioning one of your orders, ultimately it's the patient that is at risk, as well as the overall wellbeing of the clinic/unit.
When I was first starting out as a night shift RN at a busy community ED, we would often go out to eat at a local breakfast spot after our shift was over. Occasionally some of the nurses from the ICU and float pool would join us. One person who was notably always absent was our night shift house supervisor, who was universally liked and one of my first mentors.
One night I asked him why he never came to our post-shift breakfasts, and his response was very blunt:
He told me that he had worked very hard to be seen as balanced, fair, and unbiased. He had to make difficult decisions about where to allocate resources from the float pool, and settle arguments between various units about patient admissions. Part of his success, he told me, was the fact that he never socialized with any hospital staff outside of work. His work was his work, and his life was his life. He never crossed those lines, and it was part of his personal mantra of what makes a successful leader.
Years later, when I stepped into my own role as a low-level administrator in a much larger ED, I quickly realized the wisdom he had tried to impart to me. Objectivity and trust are hard things to earn, and it's easily lost. Once it's gone, it's gone for good.
I try to write these blog posts about topics that go along with our collective experiences as nurse practitioners, the common issues we all face regardless of the clinical location. I welcome your feedback, stories, and suggestions. Shoot me an email at NP@hippoeducation.com; I would love to hear from you!