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I work in risk management and am having difficulty adjusting to the way my department works. I'm feeling depressed with no sense of accomplishment. What should I do?

Tuesday February 12, 2013
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Dear Donna,

I have been working in the risk management department of a hospital for 10 months. I have an MSN and a background in regulatory issues. I thought I would be a great fit for Centers for Medicare and Medicaid Services and Joint Commission surveys, but I am having a difficult adjustment. There is arguing when my department identifies deficient issues. Our most recent commission survey resulted in multiple direct citations for areas that were clearly identified as deficient prior to the survey and are now being corrected. I’ve been told I need to become more politically savvy and learn to understand the hospital culture. Each day I come to work depressed with no sense of accomplishment. I have tried to speak with my manager, but she doesn't understand why I feel so depressed. She said that I needed to realize our department does not do enforcement — we only report the issues. How do I address my problem?

Regulatory Nurse

Dear Donna replies:

Dear Regulatory Nurse,

I can relate to your post because I was once in a similar situation in including a similar specialty. I was responsible for regulatory things including Joint Commission and CMS (Medicare and related regs) — others saw me as the enemy. I even had some department managers report me to my supervisor for what I perceived as just doing the job I was hired for.

By the same token, I had a lot to learn about my own personal style including verbal and nonverbal communication, choosing my battles and even defining my role in the process. I learned many hard lessons that have served me well in my life and career. Although they were painful at the time, they have helped me to teach others today. Because the culture of every workplace is different, it is possible that a combination of many things is making life difficult for you there.

My best advice to you would be to find a mentor (in or out of your place of employment) and work with that person to better understand and address the issues you are faced with. Read “In search of the right mentor” (www.Nurse.com/Cardillo/Right-mentor).

I was not aware of the concept of mentoring back then. In hindsight, I see that there were several people who showed an interest in me and could have mentored me had I reached out to them. But I always thought I had to be strong and independent and do and learn everything by myself. As a result, I made more mistakes than I probably had to, learned the hard way and got myself into some very trying situations — I probably didn't get as far in that part of my career as I could have.

Also join (if not already a member) and participate in related associations such the National Association for Healthcare Quality (www.nahq.org). Attend local meetings and get on a committee. This will offer support, create a forum for exchanging ideas, information and best practices, and even provide opportunities for you to get feedback on your own style and approach. It’s a good place to network and eventually look for a better opportunity, if that is what you want to do. It may be the job that's not a good fit, rather than you.

Best wishes,

Donna Cardillo, RN, MA, well-known career guru, is Nurse.com’s “Dear Donna” and author of “Your First Year as a Nurse: Making the Transition from Total Novice to Successful Professional” and “The ULTIMATE Career Guide for Nurses: Practical Advice for Thriving at Every Stage of Your Career.” Information about the books is available at www.Nurse.com/CE/7010 and www.Nurse.com/CE/7250, respectively. To ask Donna your question, go to www.Nurse.com/Asktheexperts/Deardonna. Find a “Dear Donna” seminar near you: Call 800-866-0919 or visit http://Events.nursingspectrum.com/Seminar.