Learning how to say, "yes, sir!" (and staying myself in the process)

November 3, 2008 7:49 PM

How did you get through prolonged periods of doing something you didn't believe in or agree with?

I'm shitty at compromising myself. This trait is often a strength, but at the moment it presents difficulties. I just started nursing school which I knew before I started would be a challenge since I'm not a fan of Western medicine, arbitrary rules make me crazy, and I generally fail to keep my mouth shut when I disagree with my 'superiors'. I figured when I signed up for this that if I can just make it through school and my first couple years of work, I'll have the flexibility to find a job where I have a degree of autonomy and where I'm promoting a type of health care that I feel good about (I'm thinking some kind of health education work or possibly hospice). But the problem is making it through the next couple years.

So far I've already had some head butting with the instructors and administration at my school. Worse is when I go to the hospital for my clinical shifts: I feel unhappy, depressed, defeated. I hate seeing how things are done there - the ways that hospitals fail to promote health (shitty food, waking people up all night to take vitals, a million students poking and prodding, docs who don't remember or have time to get to know patients, etc)

So what are some strategies for making it through someone else's way of doing things when you think that way is wrong? How do you maintain your own sense of self while sticking with the program? How do you jump through hoops without feeling like a circus animal?

posted by serazin to religion & philosophy (23 comments total)

Could you, or would you have time, to volunteer with a group promoting the things you do believe in?
posted by MadamM at 8:01 PM on November 3, 2008 [1 favorite]

Find ways to aggitate for change while doing the work required. For example, does the hospital have an ombudsman that you could express your patient concerns to?
posted by hworth at 8:17 PM on November 3, 2008

Keep a diary. Use it later when you have a point to prove. It will be very valuable ammunition.
posted by amtho at 8:22 PM on November 3, 2008 [1 favorite]

I'm sure you're not the only one in your nursing school who shares similar concerns of the state of healthcare. Perhaps you can look into a bioethics class? It will address many of the issues you are dealing with, revealing the problem of a teleologically ordered healthcare system clashing with the deontological rights of patients. Getting this perspective may change your attitude and who knows, may lead you down a path beyond nursing into administration where you can change some of the things you take issue with.
posted by ageispolis at 8:23 PM on November 3, 2008

I resign.
posted by turgid dahlia at 8:36 PM on November 3, 2008 [1 favorite]

seconding amtho.
not only will it help to vent your frustrations by getting them off your chest on a daily or weekly basis, but writing them down for later reference may help when you are able to make changes or do whatever it is you want to do.

i can understand your frustration.
i'm in my final year of an undergraduate program that i detest. this year, i am doing my practice teaching and i am counting the seconds until i am finished. it's so hard to jump through the hoops day in and day out.

the thing that works for me is planning fun stuff for weeknights/weekends, to keep my mind off of the frustration and bitterness.
posted by gursky at 8:37 PM on November 3, 2008 [1 favorite]

I found spending time doing the thing I enjoyed made it easier to do the thing I hated.

Of course, it can't just be something mindless, like playing video games.

MadamM gives a good suggestion. Anytime you can spend developing skills in the area you want to be in eventually will help you. If not a group you can volunteer with, then maybe setting up a student organization for people who share those values.

Also, talking to people and seeking their advice in the areas and practices you want to be in. When I mean talk, I mean the networking type of talk, and not the complaining kind. If you hit it off with someone, then you can commiserate.

Finally, exercise and group sports helps for many reasons. It helps get you physically tired so you can sleep. Keeps you in shape and keeps energy up. Helps you make friends outside of school.


If, in your mind, you are making genuine progress to your goal and you just need something to ease this pain, then a productive distraction will help you the most.
posted by abdulf at 8:53 PM on November 3, 2008 [1 favorite]

third to amtho about keeping a diary for ammunition.

i would add that in my experience of entering a very frustrating place called 'academia' i sought the counseling services included in my student fees and got me a little anger management. if you are sure that what you're doing is for you then don't be dissuaded by not fitting into the mold, by having these radical ideas (even if you don't know where to place them right now). i don't think humans are wired for grin-and-bear-it so much, but that we need outlets for frustration. take these issues to a trained professional if you think you are at risk of venting all over the people in your life - your loved ones deserve better than that!
posted by tamarack at 8:53 PM on November 3, 2008 [1 favorite]

I do a half ass job. Not the best strategy probably, but it got me through years of formal education.
posted by fshgrl at 8:54 PM on November 3, 2008

I once had a job in IT at a large publishing company where I was shoehorned in with the soulless sales department.

I kept a diary, wrote lots of emails to friends describing my hell... I was sometimes there after hours so I would occasionally put up strange, vaguely motivational subversive sayings on the notice board.

Someone had posted a sign that read, "Sales people are the gears that turn the machine of commerce." I took and down and replaced it with one that read, "Sales people are the coal that fires the furnace of profit." What? I was going through my Fight Club phase back then...
posted by wfrgms at 9:02 PM on November 3, 2008 [1 favorite]

Serazin, if you voice your dismay and abhorrence, for your own sake, do it privately. Your instructors are watching you, and there's a fair chance they can decide you're unsuitable. Something that I learned, while in the same situation that you're in, was to focus on doing it their way... perfectly. You may have an opportunity after you have your degree to do things differently, but as a student, you do it their way, and you don't agitate in the classroom or during your clinical rotations.

Nursing students do not suggest alternative treatments or policies to the patients, the staff of any facility, or the attending physicians. Not if the want to stay in the program.

You may indeed be able to work as a nurse in a way that feels more in tune with your beliefs, but you'll need a good deal of nursing experience in the down and dirty before you qualify for work with hospice patients, or as an educator. It took me several years.

Become active in your Nursing Student Association. Learn, as i said.. perfectly, their way, because at this point in your nursing education, it's their way or the highway.

Become a patient advocate without criticizing the interventions and treatments ordered. Help your patients to really understand what is happening to them. Help your patients and their family to communicate with their physicians. Document the patient's response to things like being awakened in the night for vital signs. Document with the idea of communicating to other members of the health care team what your patient is experiencing. Help your patient or their family to write down concerns or questions, so they can discuss their care with their doctor.

You are only seeing a small part of the picture.

Yes, do what you can to stay sane while in nursing school, but let me repeat.. do not question authority at this stage in your education.

You could possibly be a great nurse one day. Don't blow it, ok?
posted by reflecked at 12:33 AM on November 4, 2008 [4 favorites]

What hworth says:
Find ways to aggitate for change while doing the work required.

For example, in planning school, I joined the Planners Network ("the organization of progressive planning") so I could not feel like I was just learning to make nice enclaves for rich people or helping developers get rich (what city planning can be at its worst).

Then, figure out how to be that person who always brings up the progressive issue in class without being a jerk about it. A lot of change in people's views and awareness happens when someone brings something up repeatedly but pleasantly, without getting a chip on their shoulder. Think of it as an exercise in tact, persistence, and patience. You don't usually see politicians butting heads; you mostly see them being pleasant while trying to figure out how to get people to see things their way.
posted by salvia at 1:09 AM on November 4, 2008 [1 favorite]

reflecked:You are only seeing a small part of the picture.

For me, this seems like the critical thing. You are a student. You have a lot of idealism, but very little knowledge about a large, complicated system of Why Things Are The Way They Are. It may be that your superiors are completely aware that certain practices are less than perfect, but they accept (at least in the short term) that those imperfect practices are the best they can do for the moment, because they are restrained from improving things by forces outside their control. You may be butting heads because you're telling them about the obvious and asking them for changes they can't give you, painfully rubbing their noses in their own limitations and shortcomings.

Instead of being the annoying newbie who thinks he/she knows best, do your job, learn what you're there to learn, and once you've established some goodwill with your 'superiors,' ask questions about why the system is the way it is, why certain practices persist. Focus on wrapping your head around the big picture. If you don't gain this sort of understanding, you'll never learn what buttons to push to get what you want.
posted by jon1270 at 2:47 AM on November 4, 2008 [5 favorites]

Yeah, to add to reflecked and jon1270, you can't have it both ways. You want something (formal educational and job qualifications) that very few people (teachers, bosses) have the authority to grant you. Where do you get the idea that it's to your advantage to put your goal in jeopardy?

I mean no snark here, but for most of us, "prolonged periods of doing something you didn't believe in or agree with" is also known as adulthood. The "sense of self" you cling to is not the static thing you imagine it to be-- it will come under attack, and be redefined, many times over your lifetime. Do what it takes (which, likely, is to keep your mouth shut), achieve your goal, and put it to use the way you want.

The coping mechanisms recommended here (balancing work with more fulfilling activity, half-assing it, low-level sabotage) are good ones, but they won't address a more fundamental issue: sometimes it's hard to admit we want something (in your case, a nursing degree) more than something else (to straighten out that backward faculty) that seems more honorable. Are there times when it actually is more important to do the honorable thing? Sure. But ask yourself this: if you dropped out today, would you still make it your business to "butt heads" with the teachers and doctors you disagree with?
posted by Rykey at 3:42 AM on November 4, 2008 [1 favorite]

Serazin I hear you. I could have written this same AskMe when I was in nursing school. It was so annoying in so many ways. I wanted it to be about education and find it intellectually stimulating. I was so disappointed. Everyone was so narrow minded, judgmental! Many of the professors seemed like burnt out old nurses who couldn't hack floor nursing so they taught nursing school instead. I still believe that about many of them. A few were so bitter and mean I swear they were trying to actively flunk people out for spite. They acted as if they were doing nursing a favor, filtering out the so-called unworthy. They did not care if you complained. They did not care if the test questions made no logical sense. Nothing was going to change. The attitude was - you're not the first to complain, and there's a line outside the door waiting to replace your spot if you'd just get out of the way.

It was very hard to adjust. You will see blatant misery in the hospitals during your clinicals that you will be powerless to change. You'll see angry, mean healthcare workers that make you wonder why they would ever choose to work the job they do - they hate so much.

My advice: just get through it. Nursing school is really about learning to pass your boards. That is what you are doing. You're not learning how to care, you're not treating patients, you are NOT nursing. You are learning how to pass your State boards. You're tests are practice to take your boards. Your real education in nursing will take place once you start working as a nurse. Don't let those bitches filter you out before you get a chance to start. Jump through the hoops. Laugh at the petty, shallow, out-right wrong behavior. You are above that. But you must play their game for a short while.

I should say my experience wasn't 100% awful. Every once in a while I'd have a great nurse educator. I'd try to get the most out of it that I could. It's a crap deck of cards, but you must finish the game, and every once in a while you'll get an ace.
posted by dog food sugar at 3:55 AM on November 4, 2008 [3 favorites]

Be true to yourself, just zip the lips for 4 years.

Smile and nod, but keep the dream.

Vent outside of work, inside the job learn the skill of a public persona, it's a skill like any other.

Goal fixation: The patients need your help, keep the goal that knowing how to work the system will be incredibly helpful to you in helping them.

Emotions, liking the job, hating the job aren't the main ingredients in doing the job. Less emotions, more observation.

Zen roshi pours the tea for a professor. The tea overflows the cup. The professor yells out, "Stop there's no room for any more tea in the cup." Zen roshi says "If the cup is full already, there is no room. Don't come to learning already full of yourself. Be empty."
posted by nickyskye at 3:55 AM on November 4, 2008

reflected really speaks the truth.
posted by dog food sugar at 3:56 AM on November 4, 2008

this happened to me during a time when I was learning some clinical skills in a nursing home. A truly God-forsaken place. I was forbidden to give a shivering man another blanket since he already had one. The stuff that went on there stripped my soul.

But, I needed to finish the hours and so I did what I could while I was there, and acknowledged that I was powerless over the inner workings of this business. That helped. Just knowing that I would do everything I could within the constraints I was given so that at the end of the day I could think, "I did all I could today".
posted by agentwills at 6:09 AM on November 4, 2008

If you are "not a fan of Western medicine", why are you choosing a career in Western medicine?
posted by TedW at 6:24 AM on November 4, 2008

I have a penchant for complaining about the "system" too. As it turned out, my aptitude for for complaining was so great that I actually made it my career: I am now a lawyer representing whistleblowers in employment lawsuits. What I have learned from my clients is that 1) great defects can indeed exist in systems, and few people are willing to challenge them; 2) in order to effectively challenge the system, you have to very carefully distinguish between your tendency to criticize everything, your egotistical belief that you know what's right and most everyone else is wrong, and the real problems at hand and the appropriate degrees of action needed to solve them; 3) you will be infinitely more effective if you build up a constituency -- if your coworkers like and respect you for your skills and your teamwork; and 4) even if you do all of this perfectly, you may still get fired or retaliated against if you make your views known (in which case, consult a lawyer, especially before you quit in disgust.)
posted by footnote at 7:44 AM on November 4, 2008 [1 favorite]

Well, you could look at it as many people won't take your critiques as seriously unless you are an "insider" and have been credentialed by the system.

Or you could find an alternative that is more in tune with your core beliefs, like acupuncture or some other non-Western medicine.
posted by min at 9:25 AM on November 4, 2008 [1 favorite]

Like TedW, I'm a little alarmed by the phrase "not a fan of Western medicine".

A nurse is the implementor of modern Western medicine. Even if you zip it for the next couple years, you'll still be in the system when you graduate. It'll still be your job to get bloodgasses and vitals at 0300h, whether the patient is asleep or not. It is your job to implement the doctor's orders, whether you like them or not, except where you can show that it will harm the patient--where the doctor makes a mistake, for instance.

My wife is a nurse, and my mother is a doctor. I can assure you that subverting your physician's treatment plan by whispering in the patient's ear about aromatherapy or homeopathy is going to get you a very poor reputation very quickly. Suggesting it to the doctor isn't going to go over very well, either--which makes sense, as most cardiologists don't study clinical Qi Gong.

If you don't like Western medicine, I'd really suggest that you find a different career path. Working in a hospital is all about Western medicine.
posted by Netzapper at 10:29 AM on November 4, 2008 [1 favorite]

I appreciate these suggestions folks. I'll try to incorporate most of them, at least to some degree.
posted by serazin at 1:48 PM on November 4, 2008