Editor’s foreword: I would like to introduce a completely unedited, unadulterated and unsolicited view from the world of a newly graduated Enrolled Nurse. I think horizontal violence within nursing is still far too common place. We can all learn something from the people that inhabit the roles that all funnel in to one key job – building patients back up again. This is a really insightful piece of self-reflection from a Nurse I am proud to call a colleague (Twitter Health Service). Over to you “Stevie”.
It started as an off the cuff comment. I referred to the (much analysed) chip on my shoulder. The (joking) reply was, “isn’t that the prerequisite chip on the shoulder ALL Enrolled Nurses have?” Which led me to thinking, do we really? Or is that just how others see us? What does it even mean? What do I mean when I bring it up? I decided I should ask Google this question, and depending on where you look, you get a few different answers. Urban dictionary tells me it is ‘to be touchy, to be easily provoked, or to harbour a grudge.’ Phrases.org.uk would have me believe it is ‘a perceived grievance or sense of inferiority’, and the free dictionary puts it like this, “to blame other people for something bad which has happened to you and to continue to be angry about it so that it affects the way you behave.”
What jumped out at me was ‘sense of inferiority’. Maybe that’s what’s actually feeding the chip, but to everyone else, the person with the chip comes across as thinking that they are superior, up their own arse, arrogant.
I’m not sure what I mean when I talk about the chip on my shoulder. As someone who is painfully self-aware, I’d like to think that I don’t blame other people for the things in my past & I don’t use what has happened in the past as an excuse for my current behaviours. I am not feeling particularly aggrieved right now either. I would however describe myself as sometimes touchy, somewhat easily provoked and although I am not quite in the league of my Spanish mother, I can indeed hold a grudge.
I don’t think my chip fits those definitions. Maybe mine stems from starting again in a new field at the grand old age of 32 at the bottom of the food chain, having previously been a line manager/trainer/mentor. And yes, let’s mention the food chain/hierarchy. Those who say there isn’t one in healthcare are normally fairly high up it already. I’m bright. I have ‘opinions’. I like to know the ‘why’. I ask questions. I’m confident in my abilities & keen to learn new skills. My tongue is firmly in my cheek & I do a great line in self-deprecating humour. I am cripplingly insecure. Is that my chip? Does it look like that to other people? Is it always there or does it just pop up like an air bag? Is it a defence mechanism?
Do ALL ENs have a chip on their shoulder? Well, a quick poll of 5 ENs (yes I know, tiny numbers, there needs to be more of us on Twitter) revealed no, we don’t think they all do, but we all independently named the same person who we think does. Awks. Not me. Phew.
Being an EN feels tricky. Our scope of practice varies from EN to EN, ward to ward, hospital to hospital, state to state. I never knew how much difference geography would make to scope of practice. In one rural ED Resus I am thinking of, with the appropriate annual training & supervision, an EN can pop in an LMA if required to do so. Down the road in the city as an EN you’d get to scribe & I doubt much else. Woo! It is of course about person not just role, however I think we are capable of more than we are consistently allowed to do.
I do feel I have something to prove, and I know the best way to do that is to quietly be really damn good at being an EN. But it’s hard to stop comments about ENs such as “your college needs to pull their head out of their backside and stop raising your expectations as an EN”, “you can’t do this in-service, you’re an EN, you won’t understand it”, “what’s the point of you?”, “you’re just the lackey”, “you’re not a real nurse”, feeding your chip. My personal favourite is, “you’re just an EN”. No one is just anything. I know of a ward where they like the ENs to eat their lunches next door with the students. I’d like them to try that with me. Is that my chip popping up again?
So what to do about it? If you think you’ve got a chip on your shoulder, maybe have a think about why it’s there. What makes it deploy? Are you inadvertently feeding it? When people think someone else has a chip on their shoulder, the instinct seems to be to knock it off, put them in their place, or just avoid/ignore them. None of those things seem very nice, and if insecurity is what feeds the chip, ‘taking them down a peg or two’, is probably just going to make things worse. I’ve been told (not in the healthcare facility where I’m employed), to keep students in check, to make sure they didn’t get too big for their boots. Which quite frankly, does not sit well with me at all.
Perhaps, gentle shaping as opposed to being bashed about the head with what someone else wants you to think, is the way forward. What works on my chip, (as lame as it sounds) is a little dollop of kindness. Someone taking the time to really listen to what I was trying to say, being interested, facilitating, encouraging and giving me a voice. Maybe, in a little while, the chip won’t be visible at all. I don’t think I’ll miss her.