Saturday, July 2, 2011

Nurses, Who Says You Have to Smile?

Nurses, Who Says You Have to Smile?

I do not think of myself as a smiler.  It’s not that I am unhappy all the time, or that I dislike smiling, I just don’t make a conscious effort to do so.  I have other things which I consider to be a priority, but I do laugh easily and quickly. Even at work.  Apparently the fact that I don’t have a smile or any variation thereof plastered on my face all of the time earned me the nickname “Nurse Frowny Face” from one of my patients, who was offended by my lack of smiling.  Well, that wasn’t the only problem, as I had asked her to please keep her voice down in a hallway that has acoustics better suited for a concert hall than a psychiatric unit, when she wanted to know if everyone had gone out to smoke without her.  Sigh.  This earned me a meeting with a supervisor about being rude…
I am all for maintaining a professional demeanor but I absolutely refuse to put a smile on constantly for anyone, including the patients.  I believe that if you maintain such a demeanor all the time and without variation, you come across as superficial, annoying and insensitive to patients, among others.  It is ok to cry with them, to feel anger and annoyance for (and even with) them, and definitely ok to laugh with them.  However, to insist that a nurse be smiling and sweet all the time to “cheer up” the patients, especially depressed ones, is asinine.  We are not robots who are programmed by those around us to function at what they perceive to be an optimal level; we are only human.  Having been a patient, I would not want a bubbly nurse when I am in physical or emotional agony.  I want one who can introduce him or herself, look into my eyes, and empathize with me without being swallowed up by my pain.  If he or she can “mirror” my emotions, I am convinced that he or she is following how I feel without taking on my problem.  I believe that, above all, being genuine and kind facilitates the healing process, not the expression on my face.
Being a good nurse requires excellent psychosocial skills, in particular mastery of your interpersonal skills.  “Enhancing your calm” is essential.  It is also important to not be a doormat, as you are an individual just as worthy of kindness and respect as the next person.  You have the right to ask to be treated as such.  But, there are also going to be times when you slip, times when you let ‘er rip and say something which you may regret later.  All you can really do then is apologize and acknowledge that you were out of line.  In the meantime, and hopefully prolonging this event until your very last working day before retirement, I believe it is important to spend some time reflecting on what or who pushes your buttons.  Come up with some strategies for coping with these.  It might be a matter of taking a course in assertiveness to help you communicate in a way that is both pleasant toward others and protective of your feelings.  It might also be a matter of knowing when to stop trying to be Super Nurse on the Unit, asking for help, and/or taking a break when things are particularly rough.  Sometimes you should just let things slide, as we have a lot to worry about as it is.  Either way, setting limits with patients, co-workers, physicians, and families is important.  I find that when I can strike a balance with this, the expression on my face doesn’t matter.  My eyes sparkle, my voice is warm and pleasant, and I am able to remain totally enthralled with the growth I witness within my patients because I can help nurture it.
About the Author: Rachel E. Clements is one of those "second winders" who began training in one career field and chose nursing instead; she has been a nurse for 5 years in May.  Rachel lives and works in Boise, Idaho, and is currently enrolled in Montana State University's online Psychiatric Mental Health Nurse Practitioner program.  In her spare time, Rachel enjoys hiking, savoring the sunshine with her two kitties, and tending to the yard of her relatively new house!


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