The pen is mightier than the pin.....

Something happened at work today...., a difficult conversation with a challenging member of the nursing team. As a senior nurse and service manager this is not an unusual occurrence although, to date, I have usually been able to deal with and resolve uncomfortable situations without the residual feelings of acute anger and frustration that I feel now.


Obviously, this is not the first time I have felt like this. I have several ways of resolving or dispelling such feelings, and these usually include tobacco and alcohol plus interchangeable items including play-dough, pins, an evil cackle and/or a pen.

I have spent many an enjoyable evening fantasising about nasty, unpleasant, painful events befalling my antagonist and have even made plasticine effigies and stuck pins in them. However, whilst these remedies were fun while they lasted, the only one which had any lasting effect was the use of pen and paper. Yes, I have written many an un-delivered letter to my boss over the years and have started many reflective diaries, sometimes following a model, other times just letting rip and writing what I thought without any guidance whatsoever from Mr Gibbs, Mr Johns or Mssrs Palmer and Burns. Somehow, all those toxic emotions and thoughts have just dispelled as the ink flowed.

I just have one problem with reflective diaries and other such writings; you either have to shred them, hide them or risk a member of your family finding them and contacting the local police/psychiatric hospital/your ex-boss (this last one actually happened, but that’s another story). However, I don’t want to have to curtail my therapy on the off-chance that someone will stumble across them, so blogging seems the perfect answer.

Considering how much potential damage a blog can cause, and the fact that I hold a clinical caseload and manage a team, I intend this to be anonymous.  After all, whilst many of them are infuriating at times, and all are a bit bonkers in their own way, I do love them all. Mostly.

So, back to today, this individual seems to rub everyone up the wrong way. This became evident quite soon after she joined the team several years ago, and resulted in a great deal of time and energy being invested in friendly chats, critical feedback, coaching, mentoring, supervision, academic teaching and plenty more. Despite all this, she has continued to upset patients and intimidate her colleagues on a daily basis. Initially I concluded that she had absolutely no insight into how what she said, her tone of voice and body language affected those she came into contact with, hence all the supportive interventions to help her gain some self-awareness.

However, following today’s events and a recent conversation with one of her patients, (who also happens to be a member of the PCT’s senior management team), I have come to believe that she has full insight into her behaviour; It seems that once she realised that her patient was actually a ‘VIP’, she dropped the patronising and dismissive approach; became courteous, charming and amenable, and eagerly handed over a script for antibiotics which she had been denying the patient to treat the ‘virus’ she had diagnosed until, that is, their identity became evident.

Today, during a debate about another patient’s management, she momentarily forgot who I was, allowing me to experience being on the receiving end her alter-ego for the first time. Her alter-ego is not a nice person, her nostrils flared, her eyes became wild, her hands balled into fists and her language became very controlled and articulate. Very few people have intimidated or frightened me at work, until today. Feeling quite vulnerable, I managed to hold my nerve and pointed out that the patient was waiting, and asked that she come back later to discuss this once she had calmed down. “I don't think so” was the response, followed by my office door slamming. (personally I would have added 'Sonny Jim' to the end of this response, c/o Halfwit of Big Brother fame, but maybe that would have made it less venomous)

Once I had done a spot of deep breathing, lifted my head out of my hands, walked around the block for a breath of fresh air (sneaky fag) I ventured to the toilet. There I was, a slave to my nervous bladder, when I heard a couple of people enter the toilets. We all know the girls’ toilet is a good place for a gossip. Let me tell you that it is also a good place to find out what people are saying about you. Especially when they don’t know you are there. It appears that this individual had certainly reflected on our encounter and her behaviour, and used the ensuing time productively. Word on the block is that I turn into a mad, swearing woman with a fondness for chucking small bits of office equipment around her desk if anyone dare get on my wrong side. "How unprofessional...", then the door closed, and I was alone again.

Suffice to say, the suggested discussion didn’t happen, or I may well have turned into that mad, swearing woman I had been depicted as. Instead, I did what anyone else would have done, and came home to get my plasticine and pins out......

Having had a good pin sticking session and a therapeutic vodka and tonic, I think I know how I am going to manage this situation, however, if any of you out there have any sensible (or insensible but satisfying) suggestions, then please let me know ................. I would love to hear what you would do in this situation.