You're in the Driver's Seat: Taking Control of Your Nursing Career Trajectory with Damion Jenkins...

Thank you for joining me for another episode of the Nursing Strategies for Success podcast with yours truly, Damion Jenkins of The Nurse Speak. In this episode, I will be discussing ways that you can take complete control of your nursing career trajectory. So if you're kind of stuck out there, not sure where you want to land, what skills you need to develop, or what you need to do to find satisfaction in your career, This episode is for you. Thank you for joining me for another episode of the Nursing Strategies for Success podcast, brought to you by The Nurse Speak, a show where we rally some of our nation's greatest nurse leaders, educators, experts, and advocates to tackle some of the greatest challenges that the nursing profession faces. My name is Damion Jenkins, and I'm your host for the show. So sit back, relax, and get ready to learn that nurses can do anything. Hey everyone, and welcome back to the Nursing Strategies for Success podcast. I am your host, Damion Jenkins, and today we're talking about something that's going to change the way that you look at your nursing career. Here's the deal: you have way more control over your professional trajectory than you think you do. I know that sounds bold, especially when you're dealing with difficult coworkers, challenging patients, families who treat you like you're invisible, or leadership that seems to have forgotten what it's like to be at the bedside. But I promise you By the end of this episode, you're going to walk away with tangible strategies that take your career into your own hands. We're gonna talk about professional development that actually matters, not just checking off mandatory education boxes, but real growth in your knowledge, skills, and confidence. We're gonna discuss how to improve your communication and teamwork so you become the person that everyone wants to work with And most importantly, we're gonna talk about how to reduce those toxic, hostile interactions that drain your energy and make you question why you became a nurse in the first place. Whether you are a CNA just starting out, an LPN looking to advance your career, if you're an RN trying to figure out your next move, or if you're in nurse leadership who wants to create better outcomes for yourself and your team, then this episode is for you. Let's get into it. So let's be real for a minute. The nursing profession can be brutal. You know it, I know it, we all know it. For those of you who are not privileged to know of Dr. Renee Thompson from the Healthy Workforce Institute, I highly recommend that you familiarize yourself with her. I will have ways to connect with her in the show notes of this episode. But Dr. Renee Thompson has spent over 30 years studying workplace bullying and incivility in healthcare, and here's what she found. Disruptive behaviors in healthcare aren't just annoying, they're dangerous. They affect patient care, they destroy workplace and professional morale, and they cost organizations billions of dollars annually. But what Dr. Thompson also says is that when disruptive behaviors go unchecked, bad things happen to patients and employees. The key word there is unchecked. That means that someone has to check them. And oftentimes, floor nurses, CNAs, and other members of the interdisciplinary team kind of look at each other or maybe look at just leadership to be the ones to check those bad behaviors. But really, it needs to start with you. Now, I'm not saying that you need to become the workplace police. I say it all the time in my place of work, um, I don't want to be the police. But what I am saying is that you have more power than you realize to influence the culture around you. To set boundaries, and to model the kind of professionalism that makes healthcare better for everyone. Someone else, if you're not familiar with and isn't in your professional network, is one of my favorite inspirational nurses, and that is Donna Cardillo. She puts it in a way that makes it very simple to understand. Florence Nightingale said, that nursing should not be a sacrifice, but one of the highest delights of life. But let's be honest, a lot of us are not feeling delighted right now. We're feeling burned out, undervalued, and often stuck. But the good news is that you can learn tools and strategies to help you get back to that delight. And another person that I would like to introduce to the listeners, if you are not familiar with him, and that is Keith Carlson, who is a holistic career coach and host of his own podcast, The Nurse Keith Show. He talks about it all the time on his podcast. He interviews hundreds of nurses who've created non-traditional careers, who pivoted from toxic environments, who've taken control of their professional destinies. And the common thread is that they decided to stop being victims of circumstance and they started to become architects of their own careers. And that's what we're doing on this show right here, right now, right today. We're talking about personal agency. We're talking about how much control you have starting right now. You don't need permission from anyone to be the best version of yourself. The only person that can prevent you from doing that is you. So start changing right now. All right, so let's get practical. If you want to level up your career, there's 3 things that you need. You need knowledge, you need skills, and you need confidence. The beautiful thing is that when you work on the first 2, the third one will come naturally. For those of you who have been out there in the workforce for more than 6 months, a year, 5+ years, you know that the more you know, the more you're able to do effectively, timely, and without interruption or mistake. It builds your confidence level. So it's really important that you start owning the fact that you are responsible for your own knowledge. You're responsible for your own skills, and you're responsible for clarifying and seeking out the additional information that you need to make good choices for yourself, your coworkers, and the patients in which you serve. Now, here's what I see all the time as my role of Director of Education and Staff Development. Nurses who think professional development means showing up to mandatory inservices sitting through a PowerPoint on fire safety and checking the box, signing a signature sheet and asking me, "How long is this in-service gonna take?" I'm sorry to say it, my friends out here, but that is not professional development. That's just compliance. Real professional development is about intentionally expanding what you know so you can do your job better and position yourself for opportunities. So how do you do that? A lot of you are probably thinking, oh my God, we don't even have time to focus on the tasks that we're assigned. How are we possibly going to dedicate additional time to grow our knowledge and skill set? Well, first of all, you have to identify the gaps. What are your gaps? What do you wish you knew more of? Is it wound care? Is it medication management? How to de-escalate conflict when you have coworkers arguing with each other? Whatever the knowledge gap is, don't wait for your employer or your director of education or your nurse manager or your preceptor to offer up that training. You have to look for it yourself. You have to ask for it. There's tons and tons and tons of free and accessible resources that will help you to gain a better understanding of how to handle certain situations or how to develop a skill set that is gonna benefit you to make your job easier so it's less stressful for you in the long run. YouTube videos from credible sources. There's nursing professional organizations that offer resources. Every single one of you listening to this show has access to these resources, or else you wouldn't be listening to this show. You have access to the internet, data, cell service, whatever it may be, use it strategically. You want to incorporate weekly lessons as you move throughout your career. You don't wanna just become stagnant in one spot. Look, we're all guilty of doom scrolling on the internet and spending hours and hours and hours of looking at cute dog and cat videos. Or listening to some of the drama that exists out there in the world. But if it's not helping you grow, then it's not doing anything for you except keeping you stuck. The second thing is that you have to be able to read beyond your comfort zone. For example, if you're a med-surg nurse, read about behavioral health. If you're a long-term care nurse, you should start learning about some of the more acute care practices and skills. If you're in leadership, you should be more familiar with frontline challenges, workflow barriers. What are some of the resource issues that are slowing down the efficacy of patient care delivery on the front lines? The more you know, the more valuable you become and the better equipped you are to speak intelligently about your field. The third thing is, is that you really should seek out opportunities to gain additional education and possibly additional certifications. Now look, extra degrees, extra certifications, all of that take time and money. And often our organizations that we work for are not willing to dedicate time or money to help us achieve those accolades or that better insight and skill set. But it's really not up to our employers to do that. They're already established. They already have done their work to get credentialed, to be accredited, to be licensed, to have the light bill on, to keep the doors open, to provide the patient care services that they provide. They don't need your professional development in order to do that. But what does require your professional development is your success for your future. For your development in your career. If you really have a hard time dealing with bedside for whatever that reason may be, it could be physical ailments, emotional stress, maybe you don't like the work balance, maybe it's too, um, demanding for you. Well, you're not gonna be able to advance into a position that might remove you from the bedside if you're not seeking out opportunities to gain that additional skillset and knowledge. Your employer is not going to train you on how to become an entrepreneur. That would be counterproductive to their mission. Their mission is to make sure you're proficient in the role in which you are currently. They're not interested in promoting you out of that position. So keep that in mind. If you want to be promoted out of a position, you have to be the one to do the work to get there. So Whether it's wound care, diabetes management, gerontology, leadership, entrepreneurship, um, education, whatever aligns with your goals, you gotta go get it. That's what's gonna set you apart from others. So when we talk about skills, knowledge without skill is useless. You can know everything there is to know about nursing. You can have ICU-level experience in your head. But if you're not able to take that knowledge and apply it to the circumstances that you are facing in the moment, then it doesn't matter. Skills are where rubber meets the road. This is what gets the cars to move. If the manufacturers of these vehicles do not create the parts according to the design of the engineers who develop those parts, One screw is missing, one turbine doesn't turn, the vehicle will not move. So you have to really see it through from the beginning. You have to develop that knowledge base, you have to be comfortable utilizing that knowledge base, and you have to be able to take that knowledge and apply it to various situations that might even expect for you to use it in unconventional ways. And that's truly what makes nursing so amazing and what's— what makes the best nurses the best. The flexibility and in— the ability to really take that skill and use it in a variety of different ways. So practice deliberately. If you're weak in a certain skill, You wanna ask to shadow someone who's strong in that skill. You wanna volunteer for the toughest assignment. You know, ask if you could have additional time to practice. Competency doesn't just come from avoiding challenges. It comes from leaning into them. You know, I can remember very, very, you know, very vividly when I was a new nurse. And my nurse educator told me that I need to become proficient in IV management, that I need to learn how to start and manage peripheral lines in the long-term care subacute rehab setting. We get lots of elders who need hydration or antibiotics, and it doesn't make sense to have to wait for someone else with that skill to come and provide the service when I'm there with the patient The skill takes a matter of minutes, and then I could be implementing an intervention that would possibly keep this person from going to the hospital or even saving their life. And although all of that sounded really great to me, I was still very nervous. I was very nervous about making a mistake, about harming the patient, about blowing the, the vein and ruining the vein and You know, there's a lot of things that run through your head about what may go wrong, but you never really know if you could do it unless you try. And so she encouraged me and she allowed me an opportunity to be nervous, and she demonstrated a couple of times. But then the tough love had to come around. She had to say, okay, I'm done showing you. Now it's your turn to, to demonstrate. It's your turn to do everything that I showed you how to do and do it on this next person. And so after 2 or 3 attempts where I successfully managed to insert the peripheral IV, secure it, and then utilize it to give IV fluids or antibiotics, my confidence level immediately improved. I was no longer scared to try. I would get frustrated if I didn't, you know, get it, or I would be annoyed if I put it in and 10 minutes later it blew blew or, or came out or infiltrated, but my confidence in getting it in was already much improved. So you really wanna make sure that you take the time to practice those skills, not run from them. The more hands-on exposure you get to doing skills, the better you become at it, the more comfortable you become. And then when the abnormal situation comes along, you're going to be able to handle it much more effectively. And here's something people don't talk about enough: the essential skills matter just as much as the clinical skills. And I use the word essential because a lot of times people refer to these types of skills as soft skills, but I don't think they're soft skills. I think they're the most important skills, even more so than the clinical skill, because let's be honest, If you walk into a room, you don't knock, you don't introduce yourself, you don't get the patient's consent to touch them, it doesn't matter if you have a lifesaving intervention that you're about to provide to them. They're going to deny your service. They're not going to let you provide the care that they need, and then there's going to be negative outcomes as a result. So although clinicians or administrators may not consider that those types of skills are as important as the life-saving clinical skills. They are. They're— I think they're more important. So when we talk about essential skills, again, often called soft skills, we're talking about things like communication, conflict resolution, emotional intelligence. Time management, team building, right, organizational skills, prioritizational skills. These are the types of skills that are considered essential, and if you don't intentionally develop them, you're going to hit a ceiling in your career no matter how good you are clinically. My good friend Keith Carlson, who I mentioned earlier, talks a lot about the importance of career development beyond clinical skills. He coaches nurses on how to think strategically about their professional growth, how to network effectively, and how to position themselves for opportunities. And he's right. If you wanna move up, you can't just be good at starting IVs. You have to be good at working with people, managing your time, and presenting yourself as a professional. And with that professional presentation comes confidence. Confidence doesn't just come from being perfect. It comes from being prepared. When you've done the work to build your knowledge and skills, confidence follows naturally. But here's the thing, confidence also comes from owning your mistakes, being accountable when you're wrong, and learning from them instead of hiding from them. One of the most confident things you can do is say I'm not sure, I haven't had exposure to that information, but I'll be happy to find out. Or come forward and say, hey, I made a mistake and here's what I'm going to do to fix it. That's not weakness, that's professionalism. And people respect you way more when you own up to your mistakes and speak the truth all the time than when you try to pretend that you know everything, make excuses for why it occurred, and then blame other people for your mistake. Donna Cardillo talks about this in her work when she works with new nurses. She emphasizes the importance of self-care, assertiveness, and mindfulness as tools for building confidence in navigating the interprofessional dynamics that are so critical to nursing success. You can't pour from an empty cup, and you can't be confident if you're running on fumes. So you have to take care of yourself so you could show up as the best version of yourself because your patients and your coworkers are depending on it. Now let's talk about the stuff that really makes or breaks your career, and that's how you interact with others. Again, it doesn't matter how clinically proficient you are. If you're an asshole, you have no credibility. If you huff and puff and throw your weight around because you're a big tough guy or you're the alpha female on the unit, you are worthless to the team and you're worthless to your patients. Now, some of you listening might start to feel some kind of negative emotions arise when you hear me say those words. But that's a universal truth that you're gonna have to learn from. If you ignore it and try to pretend that that's not the truth, you will continue to face a very stressful and negative career. Because again, if you're terrible to work with, you're not getting promoted. If you're terrible to work with, you're probably not getting information that you need to effectively do your work. If you're terrible to work with, people are not gonna go out of their way to help you when, when you need the help. You're not gonna get chosen for special projects. You're not going to get respect. You're not going to get more money. You are not going to get anything except the bare minimum. And you're making it harder on yourself than it needs to be. So really, you have to learn how to be receptive, be respectful, understand that when you do get frustrated, you can't just automatically go to a default of escalated behavior, unprofessional tones, aggressive body language. You can't do that because it immediately separates, um, the connection that you have with those other person. Those other people are going to immediately avoid you. And any successful nurse, CNA, LPN, RN, it doesn't matter, anyone in nursing, if you don't have the respect of the people that you're speaking with, then that also means they don't trust you. And then you are absolutely worthless at that point because our job is to get people to trust us so we can help them. And so we can lead them to a place of healing and safety and, um, growth, right? We want people to be the best versions of themselves just as much as we want that for ourselves. Um, but you can't do that if you're a jerk. Like, I'm sorry to say, it's just not gonna work. So, you know, we have to really start with communication. Most conflicts in healthcare happen because of poor communication. And it's not just a matter of the communication's not happening. In fact, I think we spend probably too much time speaking about things that don't matter, having conversations about our coworkers or about difficult patients or family members, or how the cafeteria food sucks, or how our benefits aren't great, or how the lockers don't work, or how the printer is broken again. We spend a lot of time focusing on the negative things in our workplace, and we speak that constantly. It seems to be like the daily conversation, um, at the nurse's station. And that is going to create a negative cloud over the unit from the beginning. So I don't really think it's about lack of communication. I just think it's about poor communication. We're saying the wrong things. For example, someone didn't say what they meant. Someone assumed something instead of asking. Someone got defensive instead of being curious. But here's how you fix that. You need to be direct. You need to be kind and you need to be clear. If you need help, say, "I need help with this patient." Don't drop hints and then get mad when no one picks up on them. If someone's behavior is affecting you, then you need to directly address it with them instead of complaining to everyone else. If you don't understand an order, that a doctor put in the system or that a nurse manager put in the system, you need to ask that individual who put it in directly for clarification instead of guessing or assuming that they meant something that's not actually written there. Dr. Renee Thompson teaches leaders how to set behavioral expectations and hold people accountable for behaviors. But guess what? You don't have to be a leader to do this. And I know from experience, not every leader has the skill set, but you need to set your own standards for how you communicate and hold yourself accountable. You can model respectful communication even when others don't. That's how you become a person of influence. There's lots of opportunities to learn in how you handle yourself when there is a conflict or a conversation that didn't go the way you wanted. For example, just yesterday, um, I had a meeting with a couple coworkers, um, some CNAs who knew about a situation where a patient needed to be assisted with incontinence care, but the assigned CNA was a male and the The patient kindly asked for a female to assist with that, that task. The male CNA reported directly to the nurse. The nurse then asked the other female CNAs on the unit if they could assist with that skill, and it wound up being nearly the entire shift until it was addressed, and it was not addressed by those CNAs who were asked by the nurse to do so. So, in a leadership position, it's my responsibility to make sure that they understand the rules and regulations regarding, you know, incontinence, timely incontinence care for patients, that they understand that although that resident or patient is not assigned to them directly, that they are still responsible for ensuring timely care. Because we work as a team, and leaving their shift or getting ready to leave their shift knowing that that resident still has not received the care was just completely unacceptable. But it wasn't just on the CNAs, right? We also have to consider that the nurses are also responsible, if not more so than the CNAs, because it is the nurse's responsibility to ensure that all care rendered or not rendered by CNAs is managed effectively, that we evaluate for effectiveness, that we make sure that the skills and tasks that we're delegating are carried out appropriately and timely and safely. So I had to have a conversation with these individuals, all of them involved, and not only make sure that they understand that that should never happen again, but I had to kind of humanize the situation. I had to speak in a way that they understood that I know why it was so challenging for them to get in there and get the work done despite everything going on. And that I also understand the sense of unfairness in being asked to pick up additional work for an already heavy assignment. I get it. I've been there. I know what it feels like. But we can't willingly allow patients, residents, clients, whoever we're caring for, we can't let them go extended periods of time without receiving the proper care. We have to, we have to prioritize our tasks and get in there and take care of that more so than a med pass or more so than, you know, cleaning the unit or more so than routine vital signs. Like that is an immediate need that needs to be addressed. We only have, you know, a short period of time from the time that that urine or feces touches the skin before skin breakdown will start to occur. So, you know, after explaining all of that, then here comes the hardest part, and that's the accountability piece, right? It's easy to educate. It's easy to explain why things need to be done the way they are. It's easy to point out the flaws and, and the, the inconsistencies with the, the work of the team and where the breakdowns were. But what's very difficult, the most difficult thing to do is to issue out that accountability, right? Here we have at least 4 female caregivers and that spans through nurses and CNAs who knew that the situation was going on but didn't prioritize or shift around their tasks to ensure that it got done. And so here it is, we have to hold them accountable. So that, you know, that, that could look very different from situation to situation, but in this situation, you know, there had to be paperwork, unfortunately. We had to document the incident. We had to ensure that the education was done and documented and that we received, you know, signature confirmation from all parties involved that they fully understand and that it will never happen again. And there was some, you know, debate initially, some blaming, some redirection of accountability from self to others that tends to be a natural defense when people are being held accountable for things that they fail to do effectively. But you can't let those types of things be a distraction, right? Because that's exactly what it is. It's like, oh, well, what about this person? That person didn't do this and they didn't do that. And I was having to go behind them and help them with their assignment, which therefore, when this was brought to my attention, it was just the last straw and I just couldn't do it because I was already doing too much. But again, it comes back down to how did you handle that situation? Were you effectively communicating? Were you effectively, um, challenging the other person to help maybe do tasks or skills that weren't going to be refused by other clients, right? So you have to attempt the, the conflict head on. You can't just ignore it and hope that it's gonna go away. 'Cause that's exactly what happened. Everyone ignored the issue, and it wound up turning into everybody being held accountable and receiving progressive disciplinary action and reeducation, which never feels good to have, and it's now part of their record. So it's like, that could have been avoided just by using good communication, explaining the the barriers that are going to be allowing you to handle whatever task is being delegated. And, you know, just a lack of teamwork is really what that was. It was just a lack of teamwork. And that leads us into the next section, which is teamwork, right? It's not just about helping your coworkers. It's about creating an environment where everyone can do their best work. It means showing up on time, pulling your weight, being reliable, and not creating drama. I can't emphasize how important this is. Here's the hard truth: if you're the person everyone dreads working with, that is on you to fix. It is not anyone else's responsibility to fix that. That is your problem. If people avoid partnering with you, if you're always the last one picked for shifts, if no one wants to be on your team Pay attention to that. That's feedback, even if no one says it to you directly. On the flip side, if you're someone who consistently helps with others, you stay calm under pressure, you don't throw people under the bus when things go wrong, people are going to notice that. And when opportunities come up, guess whose name is going to get mentioned? Yours. Donna Cardillo talks about the importance of promoting camaraderie, collegiality, teamwork with each other, right? The profession and the workplace. You don't have to be best friends with everyone, but you do have to be professional. When you create positive working relationships, your job is going to get easier and your career options will expand. And when you are viewed as a team player, that allows you more opportunity to demonstrate professional integrity. And so professional integrity is something that I consider to be non-negotiable. Your reputation is everything. If you're known as someone who cuts corners, shows up late, calls out constantly, talks badly about patients, coworkers, or does not follow through on your commitments, your reputation will follow you, and it's really hard to rebuild it once it's damaged. Trust me. I work and live in New York City, one of the biggest health systems in the country. So many different hospitals and health systems here, nursing homes, home health agencies. And I've only been here and working in these spaces since 2022. I've been here since 2020, but I didn't start working for other organizations in New York until 2022, with the exception of when I did a contract at one of the big hospitals here. Back in 2015. And what I've learned in just these few years is that this community is very small. These nurses know each other. These, these leaders who work in these organizations, they all talk. They have like this massive phone tree. They have everyone's numbers. And I promise you, we've had several situations where people have applied to come work at our facility or other facilities, and we get phone calls asking about them, and they get phone calls asking about them, and everyone seems to know who these people are. So once you ruin your reputation, unless you're completely moving in a different area or switching career paths altogether, it's going to follow you. So your job is really to have a good reputation. Professional integrity means doing the right thing even when no one is watching. It means speaking up when something's unsafe. It means admitting when you made a mistake instead of hiding it. It means treating every patient, resident, family member, coworker with dignity and respect, even the difficult ones that you might be working with. Keith Carlson often talks about aligning your career with your personal values. So, if integrity, respect, and professionalism are your values, then you have to live them every single day. Not just when it's convenient or when people are watching. That's how you build a reputation that opens doors. An example of that— it's just such a simple example, but I want to just share this for those of you who will understand this, and this goes down to professional integrity. For those of you who work in nursing homes or hospitals in urban areas like New York, during flu season, we know that the state issues mandates that anyone who does not have their flu vaccine must wear a surgical mask when in patient care areas. But that isn't just a blanketed term, meaning that you get to pick and choose when you want to wear that mask. It doesn't mean that all of the infection control protocols that surround proper utilization of PPE, like surgical masks, goes out the window. And so for those people who have high professional integrity and who are always doing their very best to do the right thing, they're going to be wearing their masks correctly. They're gonna be keeping their masks over their nose and covering their mouth. They're going to be exchanging those masks with every interaction for potential contamination, like going inside of isolation rooms. They're going to be taking the mask off by the straps, putting it in a trash can, washing their hands before they eat, drink, pull it down to have a conversation where they want to talk to someone who needs to see their lips, and then they're going to put on a new one, um, and make sure that they follow the same process throughout the duration of their day while they're caring for patients or in the care spaces. Right? But there's so many people that I would see just on a daily basis that are considered to be nice, considered to generally do a good job. Their residents enjoy working with them. You know, coworkers typically find them pleasurable to work with. But every time I see them, their mask is not in the correct position. It's under their chin. It's on their head. It's hanging off their ear. They don't have one on at all. And when they see me, they immediately react as if they know they're, they're follow— they're not following the protocols, but yet it remains a consistent problem. So for those individuals, I challenge them to lean into having a stronger professional integrity, because in my opinion, based on my evidence of seeing how they carry themselves, they don't value the importance of why the masks are necessary, which would be a, a strong indication that they don't have a very high professional integrity. Because if they're not valuing why it needs to be done, then they're not caring so much about the work that they're doing. The very core of what their job is for, and that's to protect and take care of people. And so if you're not following infection control protocols, then that tells me that you don't have a very high professional integrity, and I don't know what else to say about that. And, and that's your problem. You have to fix that problem. And if the leaders who determine your salaries and your pro— your pro— promotion abilities. Like, if they don't feel that you're a professional and that you deserve that promotion, then that's something you have to work on. All right, so then the next section that I want to discuss is really talking about the stuff that makes you want to quit, right? It affects us all. We all have the same conversations. You scroll through TikTok or YouTube for hours You'll find the same conversations. You can hear the conversations in the lunchroom, at the nurse's station, sometimes in the hallways outside of patients' rooms. You hear your coworkers talking about hostile patients, entitled family members, or family members who think they fully understand what's going on, but they don't really understand the, the intricacies of care delivery and You know, probably the worst part of it all, that's those difficult, toxic, negative coworkers who just make our jobs very unpleasant. But here's the reality. You can't control other people's behavior, no matter how much you try. You cannot make a family member be polite. You cannot make a coworker stop being passive-aggressive. You cannot make a patient treat you with respect, but what you can control is how you respond and how you protect yourself from letting their behavior destroy yours. So when you're dealing with hostile patients and family members, let's talk about that. First, you want to remember that most of the time hostility towards you or others comes from a place of fear pain, and feeling powerless. People in healthcare, especially patients and family members, typically lash out when they're scared, uncertain of what's coming next, when they feel they lost a sense of control or autonomy. And although that doesn't make their behaviors okay, it does help you to not take it personally. When you're dealing with a difficult patient or family member, it's so helpful to just stay calm, set professional boundaries, and do not escalate the situation. It is not your job to argue with them. It is not your job to try to tell them that they don't have a right to feel how they feel. It's not your job to avoid them and not render care services because it's uncomfortable for you. To be treated the way that they're treating you. But what is your job is to try and use de-escalation techniques. You need to lower your voice. Some of the people that I work with have naturally loud voices. When someone's upset, that's going to trigger them. And, you know, some of these individuals I feel just don't have a desire to learn. To change the way that they speak. And it does make everyone's job harder when we're constantly getting complaints about the way that people are speaking to them. But again, ultimately, that's not anyone else's responsibility. It's the individual's responsibility to learn how to control themselves. And if they can't, then unfortunately, they have to face the consequences that comes thereafter. But you really should lower your voice. You wanna give the person who's upset some space. You wanna acknowledge their feelings without agreeing with them. And you could say things like, "I see you're frustrated. I'm here to help you. Let me know when you're ready." Or you could say things like, "I wanna help you, and I'll do the best that I can once we can speak respectively— respectfully to each other." Something that I say all the time is, "I can see that you're very upset. If there's anything I can do right now to help you feel better, please let me know. In the meantime, I'll give you some space. You have your call bell, you have your water, your remote, everything you need. Just please call me when you're ready and I'll help you. If you need us before that, press your call bell, I'll be right in." You just have to let people know that you acknowledge that they're upset, you're respecting their autonomy and their individuality as a person, you're gonna give them space so that they— that way they can decompress in their own way, but you're also reassuring them that you are there and you are available to help them once they're ready. It is never appropriate for you to make excuses, to try to deflect their behavior, to say things like, "Well, I'm just here to help you. I don't know why you're being disrespectful to me." Like, that's not going to help the situation. Or telling people to calm down or telling them, "Oh, I don't know why you're so upset. It's just protocol. Everything will be all right." Like, that's dismissive and that's just going to start a fight. So, if someone does get to the point to where they're crossing a line, like they're being verbally abusive, threatening, or inappropriate, Your job, again, is not to retaliate. Your job is not to escalate it and to make it worse. Your job is to acknowledge it, tell the person that's inappropriate, let them know that you are acknowledging that their behavior is inappropriate. That's all you have to say. And then you're gonna go report it to your superiors. And you're going to document it. You're not going to just suck it up. You're not going to ignore it. You're not going to allow it to happen and not do anything about it. But what you're not going to do is engage with the person who is being verbally abusive, threatening, or inappropriate. You can say to them, that's inappropriate, and, and please don't do that or speak to me like that, but you're not going to say anything further. You're going to leave You're gonna go report it and you're gonna document it 'cause your safety and dignity matters as well. Dr. Thompson's research shows that when organizations don't address disruptive behaviors, it becomes normalized, and we don't want to let it become normalized. We wanna speak up and do something about it. So if you're in a facility and you have abusive patients or residents or family members, It's, it's harder for facilities to deal with family members because they're not the patient that we're caring for, but we can certainly call the police and we can certainly ask for police involvement because we have a visitor in the space where we're supposed to be providing therapeutic care for people creating disruption and creating harm towards our staff. That should be something that leadership is willing to do. Yes, it's going to require additional paperwork documentation. Yes, it's a headache. Yes, it might open up attention to the state, the media, whatever, because police had to come into the facility, but it's just a part of supporting your team. Like, we wanna be able to support the people who need the support and not just take up for bad behaviors because it's just easier to do so. So when we talk about dealing with toxic coworkers, for instance, this one's a little bit trickier because you have to work with these people every day, but the same principles apply. You don't want to engage in the toxicity. You wanna set those boundaries and you want to address issues directly and timely whenever possible. So if you have a coworker that's undermining you, spreading rumors, being passive-aggressive, you have a few options. The first option, which I always recommend, is to address it directly. Hey, I noticed you said XYZ in the break room. If you have an issue with me, I'd rather you come to me directly so we can work it out. The second option, which is helpful if you're afraid of approaching the person directly, is that you can document patterns of behavior and then take it to leadership if it's affecting patient care or creating a hostile work environment. But keep in mind that anyone can document anything about anyone. So, a full investigation has to take place. All parties involved have to be interviewed, and often I find it's helpful when all parties involved are brought together so we can have a discussion as a team so we can identify assumptions, biases, misrepresentations, or misunderstandings. And so then we can also all agree on what the actions will be moving forward. I don't think it's appropriate for a leader to hear one side of the story and then act on it. I think it's actually really damaging when that happens, especially when a person is being a victim of bullying behaviors. And the leader takes the bully side of the story, cuz they might be the one who's been there longer, or they might be the one who's more dependable to fill the schedule. And then what that does is it isolates, undermines, and makes those other folks feel unsafe to be in that place. And they wind up quitting, um, which is one of the reasons why we have a lot of turnover in healthcare is because just lack of follow-through and proper investigation from leadership. The third thing that you can do when you're dealing with toxic coworkers is you can choose not to engage. Just simply refuse to participate in their gossip, refuse to retaliate, and focus on being the professional regardless of how they act. If you show up and do your work and engage with your coworkers and your clients and patients and everyone else with dignity, respect, uh, an upbeat attitude, and you are not letting others faze you, they're eventually gonna stop. I promise the hostile, um, behaviors towards you will stop, or they might escalate, but then that person's gonna wind up getting themselves in trouble because everyone's gonna see that you are doing the right things and they're the ones causing the trouble. Dr. Thompson teaches that you don't have to be friends with anyone, but you have to maintain professional behavior. And when you consistently do that, even in the face of toxicity, you will protect your reputation and your mental health, and people are going to trust you. They're going to really take note when you're able to deflect someone who is trying to come for you. When you're able to still focus on your patients, your residents, your coworkers, yourself, you manage yourself with poise and grace, you don't buckle under the intimidation tactics that someone else is throwing your way, you can talk to them directly and, and still manage patient care and not allow your emotions to make you make bad decisions, then everyone is going to see that for the truth that it is. They're going to respect you for it, and you're going to be untouchable when it comes to others trying to sabotage you. So let's just be very clear here. If you're in a genuinely toxic environment, I'm talking about hostile, physical or verbal threats constantly, you know, evidence of people sabotaging your work. Trying to pin stories against you or place blame on you, where you've addressed it multiple times and leadership is not addressing the issues, it might be time to leave that job. But before you do, you wanna make sure everything is documented. You wanna submit everything via email to HR, and you wanna keep a copy of all of these situations for yourself. In the event that the organization or leadership tries to blacklist you or, or tarnish your reputation professionally. It's really sad to say that sometimes we have to do this, but I've worked in so many different places and have seen so many different things that it's never a bad idea to have all your documentation and protections in place just in case someone is silly enough to challenge someone who has high professional integrity and who values their reputation tremendously. It's just, it's unfortunate that sometimes people act that way, but just make sure that you submit everything to HR, that you make formal grievances, and that you have all of your documentation in place for when you leave your job. So that way, if they do try to file any kind of grievances against you, whether it's professionally or legally, you have all of that documented. And it might even help you in legal suits later if it needs to go that far. All right, so don't try— don't sacrifice yourself trying to fix a broken system, right? If, if you're just in a place that's not working out, Despite your efforts to try to help improve the system, and your efforts just seem to not be improving anything, um, your wellbeing matters more than any job, always and forever. So please, you have to do what's best for you. All right. I've never had to do that before, right? And I, I don't know too many people who have, um, but I have seen some circumstances where it was just best for the good people to get out of that place. And then those places wound up getting into major trouble with local agencies, um, government agencies, DOH, things like that, because they just weren't doing good business at all. It was just bad all around. Um, and I'm a strong believer in karma and universal truths, and eventually the light shines through and people will be held accountable for their wrongdoings. So it's always important to make sure you don't fall in that category. All right, next section I wanna talk about is leveraging your resources to level up, right? You wanna be able to position yourself as someone who's desirable for promotions, special opportunities, and better offers. So you have to use what's available to you, right? There's so many resources available to you that you're just simply not using. Depending on the organization you work for, there might be tuition reimbursement programs, leadership development programs, mentoring opportunities. Professional development funds, in-house trainings. If you don't know what's available, find out. Talk to the educators in the building, talk to HR and discuss benefits, your manager. Look on the facility's intranet if they have an intranet. Look at resources in the community that can help you grow. Look for scholarships, volunteer opportunities, look for these types of things. You can also go to a lot of the different professional organizations like the National Nurses in Business Association, the ANA, um, or specialty organizations that are relevant to your area. These organizations typically offer networking, continuing education, conferences, and connections that will help you change your career trajectory. Or you can spend a little bit more time with someone like myself who has done a lot of these things and has a library of resources available to share with you so you can master the next thing that you think you need to get to the next level. And if you don't know what you need, talk to people like myself or other career coaches who can help you along the way. You should be really focusing on networking intentionally. It's not just about hanging out with the unit squad, right? Just the, the nurses who work with you in the facility. It's really about connecting with like-minded individuals who you don't know. Networking isn't just about being fake or using people to get what you need. It's really about building genuine relationships with people who can open doors for you, offer advice, advocate for you when opportuni— opportunities arise, and even help you get to the next level because they've already gone through that process. Conferences is a great way to do that. That's how I met a lot of my connections, and all of the people that I mentioned earlier in this podcast so far, I've met them all through one particular conference, which is the National Nurses in Business Association. Such a major contribution to my professional development, and I highly recommend that any nurse, no matter what level you're at, get involved with the National Nurses in Business Association. Become a member, go to their annual conference, The next conference that's going to be coming up this year is going to be in Scottsdale, Arizona in July. You want to make sure that you go to that conference if you're interested in anything business related, if you're interested in how to leverage your resources and knowledge to create a revenue stream for yourself that falls outside of collecting a paycheck at the hospital or nursing home. All right, you could connect with people on LinkedIn. Lots of helpful things being shared on LinkedIn, lots of conversations happening, even invitations to join this podcast I put on LinkedIn, and I get to connect with so many amazing nurses and nursing professionals who have lots of valuable things to share. You can join nursing groups and actually participate in them. Don't just have them, you know, on a doom scroll list, but actually engage with these folks, start talking with them, start sharing ideas. And then learn from all of those connections. You wanna stay in touch with these folks. You never know when a connection you make, um, will lead to the perfect opportunity for you, right? Keith Carlson, for instance, built his entire career on networking and building authentic relationships within the nursing community. He's proof that who you know matters just as how much of what you know or how skillful you are. But the key word is authentic. People can tell when you're just trying to use them versus when you're genuinely interested in learning and connection— connecting. And I can tell you, I've met lots of folks in various capacities who claim to be able to do all these amazing things, and they have all these amazing resources, and they make all this amazing money. But every interaction with you is to get you to buy something from them. That's not a true connection. That's not someone that you wanna spend lots of time with. If someone is always trying to sell you something or get you to join their next cohort, or to try to convince you that you need their program to level up what you are already doing well, then they're not a true connection. But if they are someone who is genuine, genuinely interested in learning about your journey, offering assistance or resources at little to no cost to you, inviting you to collaborate and contribute towards their ongoing missions without really expecting a monetary investment, maybe just a little bit of a time investment. Which would be highly recommended by me and other people. If you want to learn additional skill sets, then you say yes to these opportunities and build those relationships over time, because eventually it could land you in a position where you're getting $100,000 contracts to, to do similar work with other people through learning that process, right? Maybe, you know, um, That contract was thrown your way by these individuals because they're too strapped to take on that client, but they know you are now in a position to be able to do that. So you can. The point here is, is that networking is not just about hanging around and meeting new people and then doing nothing with it. It's about connecting with those folks who align with what you inspire to be like so that way you can learn from them. Ha— also share with them what you've learned along the way, maybe offer some of your services and wisdom to help them along their way. And then we all just have this really nice working relationship where you do this for them, they do that for you. They actually want to know about your Christmas plans and how your family's doing. You guys get to meet up once in a while for cocktails or dinner without any kind of transaction, and then maybe some business transactions happen later. This is what networking is all about, right? You just never know who you're going to meet and how they're gonna help impact your future. So networking and connecting with people who you don't know, but who share the same mindset and values will really help you grow far in your career. And with those wins, as you're growing through your career, you wanna make sure that you take time to document them. You want to keep a running list of your accomplishments, certifications, projects that you've led, positive feedback that you received, and problems that you solved. When it's time for performance reviews, promotions, getting that new job, getting a loan for a business investment opportunity, you need to have that concrete evidence of your value. You don't want to rely on your manager to remember everything that you've done. You don't want to rely on letters of recommendation from prior employers. You need to be your own advocate. Donna Cardillo talks about the importance of building your personal brand and positioning yourself for success. That means being intentional about how you present yourself, what skills you're developing, and what reputation that you're proud of. You are the CEO of your own career, and you need to act like it. All right, so Here's where we land. You're not a victim of your circumstances. You are not powerless. You have choices every single day about how to show up, how you respond to challenges, and how you build your career. Can you control your patient load? No, you cannot. But you can control your staffing for yourself because you showed up that day. But can you control the staffing for the whole building? No. Can you control your coworker's behavior? No. But you can control how you develop your own skills, how you communicate, how you handle conflict, and how you position yourself for those positive outcomes and those additional opportunities. You can choose to be someone who adds value to every team you're on, You can choose to build your knowledge and skills here so you're indispensable and people will depend on you. You can choose how to handle different situations with professionalism and grace. You can choose to set boundaries to protect your well-being. You can choose to advocate for yourself and pursue opportunities that align with your goals. And when you make the choice consistently day after day, you build momentum. You build a reputation. You build a career that is fulfilling, sustainable, and entirely yours. You don't let toxic people write your narrative. You don't let difficult circumstances define your career. You don't wait for permission to grow. You've got everything you need to take control right now. The nursing profession needs more people who are committed to excellence, professionalism, and personal growth. And that starts with you deciding that you're worth investing in. So here's my challenge for you. Pick just one thing from this episode and take action on it this week. One skill to improve, one conversation to have, one resource to explore, one boundary to set. Just one. And then do it again next week. That's how you change your trajectory. That's how you change your career, and that's how you change the circumstances in which you live that you may not be happy with. It's one intentional choice at a time. All right, everyone, that's what I have for you today. So I hope this episode reminded you just how much power you actually have to shape your career and your life in nursing. If this resonated with you, please share it with another nurse who needs to hear it. We're all in this together, and the more we invest in ourselves and each other, the better this profession becomes. Thank you for taking the time to listen and to hang out with me, and until next time, take care, be well, and remember that nurses can do anything.