I’m so busy, I hardly have time to breathe!

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Does this sound familiar?

Joe: “How are you?”

Busy as usual, not even time to take a breath.  How about you?” Jane says with pride.

“The same” Joe proudly responds.

Why are they both proud of this?  What has happened to bragging about the time you have for family, fun, golf, travel, or just plain reading?

Are you rushing from one activity, one task, to another?  How much do you have on your plate?  With all the things you are doing, do you see what is happening around you?  What about those changes you have been trying to implement at work; are they actually taking place, but you just haven’t noticed, or have they been totally ignored & you haven’t followed up?  What is happening with your spouse, partner, children – do you really know?  Of course you know, all activities are on the big home calendar that everyone uses so the family knows who is where & what each member is doing.

My husband & I have lived very busy lives for many, many years.  He continues to have a very busy life; but, due to health issues I have been forced to slow down.  When this first happened I was upset that I could not carry on with all that I was doing.  Friends said to me, “there’s always something good in everything; so there must be something positive for you in this”.  I agreed, but to be honest, it took quite a while before I found that being forced to slow down was actually a blessing.  As I slowed down I started to feel better physically & enjoy life again.  Now l just need to convince my impatient, curious self that I cannot say “yes” to everything I am interested in or want to do (I am learning, but am a bit slow at times).  I am learning I have to make choices & set priorities.  If I don’t take care of myself – physically, mentally, emotionally, & spiritually – someone else is apt to have to make those choices for me & set my priorities.  I don’t like being told what to do, so I must listen to my body (husband, friends, & physicians) & do what is best for me.  Doing what is healthy for me has actually allowed me to do many things I have been wanting to do for years – like writing a blog, offering life coaching, & writing a book.  And, I am finding time for my spiritual, mental, & emotional health in addition to my physical health.

What are you missing with your busyness?

  • Are you running the kids from one activity to another, but not having time to stay & watch them – unless you have your laptop with you so you can work?
  • Are you running from one activity to another but not really enjoying the activities?
  • Do you peak in on your staff & because no one tells you about a problem, you dash on to your next activity?

My husband is a diver.  He has often commented to me how many divers stop briefly, see a fish or two & then swim off to see what else is lurking beneath the waves.  He hangs out a bit longer, hovering silently in one spot & sees more fish & other underwater creatures that come to him, that come out of hiding when all is still.  What if we did that in our day-to-day lives?  Can you be still & silent for a minute.  Give it a try.  How hard was it?  If we can do this for a little longer what might we see & learn?

 

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I am doing my best to share what I have learned & experienced to promote self-care; especially self-care of my nursing colleagues through my blog, web-site, life coaching, & HeartMath®.  I have seen that what we are taught in nursing, about wellness being made up of physical, mental, emotional, & spiritual health is true. And, while we remember to take care of our physical health we forget the rest.  When did you last do something for your mental, emotional, or spiritual health?  What is that little inner voice of yours saying?  Are you sleeping well? Do you have too much stress and/or worry in your life.  Where do you get support?  Do you go to church, meditate, pray, or take time to reflect on your day, your life, or those things for which you are grateful?  Do you just sit outside & enjoy the beauty of our world? I challenge you to take just five minutes each day for one week, to sit outside still & silent; then reflect on what you saw, heard, & what you feel (maybe even write down your reflections).

I would love if you would share your experiences so we can maybe learn from each other.

 

Conflict: The Role of Nurse Leaders

 

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We are surrounded by conflict.  Teenagers & parents are frequently in conflict about curfew time or dating choices.  Husbands & wives have conflicts related to finances, raising children, where to vacation, whose job is more important, whether or not to move, or how to squeeze the toothpaste tube; the list is close to being limitless.  Then, there are conflicts at work.  Workplace conflict is generally caused by poor communication or poor ability to control emotions.  Obviously, lots of areas for professional development.  However, not all conflicts need to be negative; in fact, some conflict is good.  No, I have not lost my mind.  I’m going to focus on work conflict.  Productive conflict is necessary for strong, healthy relationships (Patrick Lencioni).

The type of conflict that is good is where people do not agree, discuss the differences, & weigh pluses & minuses during decision making.  Being nasty to one another is not good conflict & needs to be overcome – we are adults: learn to be respectful of others & their beliefs, or preferences.  But, how do you have good conflict?  First, you have to establish trust; I have already written a bit on trust, the foundation of a cohesive team (Patrick Lencioni).  Trust needs to be established prior to even thinking of encouraging conflict.

Conflict doesn’t mean that someone has to be right & someone else has to be wrong.  It doesn’t mean holding grudges, or not speaking to someone, & it definitely does not include bullying.  Conflict must focus on ideas & concepts, & must avoid mean-spirited accusations or personal attacks (Patrick Lencioni, p. 202).  Conflict means you have to act like an adult – I think – sometimes adults don’t act in a way to be recommended.  But, I think you know what I mean.  Politeness, respect, no yelling, no swearing; but, that does not mean you cannot be passionate.  But, you must keep an open mind.  “Seek first to understand” Stephen Covey; is a good phrase to remember & to heed.  What does the other person mean, think, & why?  Sometimes when you understand these things you will find you are not so far apart.

When planning a change someone needs to share all that could go wrong.  Someone needs to think about how to prepare for what could go wrong, & try to prevent errors.  Someone also needs to be able to share all the positive things that the change will contribute to the work environment.  Conflict is an opportunity to discuss new ideas, to use imagination, & creativity when change is about to occur.  Change is inevitable; but, conflict often goes hand in hand with change, so why not make the best of it & ensure the change will be positive & successful.

What do you do when you don’t agree with your leader?   Well, unless the leader/boss is dishonest, unethical, devious, or abusive you need to hang in & find a way to get along.  Stephen Covey, & Kouzes & Posner suggest “Seek to Understand”.  Of course we know this is easier said than done.  However, disagreeing with your leader/boss, or co-worker is an opportunity for you to develop your leadership & communication skills; after all there will always be someone with whom we do not agree.  Kouzes & Posner (2006) suggest that serious conflict gives you the opportunity to learn: to learn about yourself.  Considering that you cannot change anyone other than yourself, it is a good idea to learn about yourself.  Additionally, being open minded, non-judgmental, & respectful are characteristics you might also want to develop.

Nursing includes conflict.  Conflict with other nurses, with physicians, with other members of the healthcare team, with patients, with families, & with anyone else with whom you have contact.  Dealing with conflict is barely touched on in nursing education.  Nursing leaders need to be responsible for guiding nurses to communicate effectively, to learn to work as a team, & to deal with conflict in a constructive manner.  According to Patrick Lencioni (2002), one of the hardest things for leaders is “the desire to protect members from harm” (p. 206).  Encouraging healthy conflict requires members to develop coping skills.  As hard as it might be for the leader to not step in to resolve the conflict, he or she must allow the members to come to a resolution on their own.  This is a big, ongoing job for anyone.  However, the nursing leader, or any leader, must work with employees to establish what is & what is not acceptable behaviour.  Mike Myatt, Feb. 22, 2012 referring to conflict writes “It is essential for organizational health and performance that conflict be accepted and addressed through effective conflict resolution processes”.

Nursing leaders who are in formal leadership roles, such as unit manager, often have so many meetings to attend they have very little time to lead professional development.  If that is the case, maybe it is time to consider bringing someone in to do such training.  Maybe one of the nurses has an interest, or additional education, in team building & conflict resolution & would be willing to lead this professional development.  Regardless of how it is done, learning how to deal with conflict effectively is necessary.  Remember, conflict can be good.  Nursing leaders must learn how to model this practice & encourage good conflict within their teams.

References

Lencioni, Patrick. (2002). The Five Dysfunctions of a Team. Jossey-Bass, San Francisco, CA

Myatt, Mike. (2012). Five Keys of Dealing with Workplace Conflict

http://www.forbes.com/sites/mikemyatt/2012/02/22/5-keys-to-dealing-with-workplace-conflict/#4ffef0ac15a0

 

 

 

LEADERSHIP & TRUST in NURSING

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Trust is a key component in all relationships.  Have you ever trusted someone only to have that trust broken by catching that person in a lie?  Or, had someone make changes related to the project you were assigned to lead, while you were away & not informing you?  How about sitting in a meeting & hearing an announcement about the project you were leading with no advance notice?  Other examples include someone taking credit for your work, someone making an error & not owning up, cheating, lying, or talking behind your back, just to name a few ways trust can be broken.  I’m sure somewhere along the line in your personal or professional life you have had your trust broken.  Now ask yourself that tough question – whose trust have you broken?

The Merriam-Webster Dictionary defines trust as:

a: assured reliance on the character, ability,

strength, or truth of someone or something

b: one in which confidence is place

Synonyms could include: integrity, reliance, surety, faith, dependence, belief, hope, care, protection…

 Antonyms could include: lie, cheat, steal, deceive, trick, fool, irresponsible…

When I was teaching first year nursing students we discussed how to establish trust with your patients.  Maintaining confidentiality; doing what you say you will do, when you say you will (keeping your promises); being a patient advocate (standing up & protecting). If you don’t know an answer, say so, then go find out: admit your weaknesses, be honest.  Establishing trust with patients is not different than establishing trust with anyone, except that you might need to do it more quickly.  Also, remember, patients & their family members may be frightened & distrustful depending on past experiences with healthcare.  One of the things not addressed in any depth in nursing courses is building trust with co-workers, other healthcare professionals, or team building.

Patrick Lencioni (2002) wrote the following about the trust needed in teams

“trust is the confidence among team members

that their peers’ intentions are good, 

and there is no reason to be protective or

careful around the group.  

In essence, team mates must get comfortable

being vulnerable with one another” (p. 195).

Being vulnerable means team members need to be comfortable admitting mistakes, making suggestions, admitting weaknesses, skill deficiencies, & asking for help without having these held against them.  In nursing there is another layer to trust; in nursing we want to be able to trust that our colleagues will always do the same things in certain situations (i.e. code blue) every time: this is the reason patient simulations are used & are important in nursing & healthcare.

Building the vulnerability portion of trust can take time to develop.  As a nurse I remember there were some colleagues I would ask for help before others, & only a few to whom I would admit my weaknesses.  Admitting weaknesses, & asking for help can be very frightening, especially to new nurses.  The statement “nurses eat their young” has been around for many years, & my guess is that most nurses have experienced it at some time, yet it continues.  When I was a nursing student we were told about this phenomenon & vowed when we graduated we would never treat nursing students & new nurses with contempt, or disrespectful.  The leader has a large role to play to ensure that trust is developed & maintained among team members, & among teams.  When you think about this the circle of trust it is huge (Figure 1).  Old customs, habits, rituals, & cultures are hard to change; but in this case it would be well worth the effort.

 

scan(3)Figure 1: Circle of Trust

The many roles of nursing leaders must include changing the “nurses eat their young” culture.   What can the leaders do to introduce these changes & see them through to fruition?  Kouzes & Posner (2016) stated

“Trust is all about openness, and trust building involves

creating an environment in which people can be open and honest

with each other” (p. 163). 

One thing that I noticed during my time nursing was the absence of openness & honesty from management; often just an extension of how they were being treated by the executive.  Strong leaders are a benefit to any organization.  Time spent nurturing & growing those leaders is time well spent.  Nursing managers can develop the leadership skills of their direct reports by being open & honest; setting the example & not accepting any less from herself or others.  This said, every person can start to build trust in their relationships by being honest & open.  Sounds simple, but it is something that must be worked on every day; it requires a lifelong commitment to leadership development.

References

Kouzes & Posner (2016). Learning leadership: The five fundamentals of becoming an exemplary leader. Wiley. San Francisco, CA.

Lencioni, P. (2002). The five dysfunctions of a team (2002), Jossey-Bass, a Wiley Imprint, San Francisco, CA

Nurses! Self-Care is a Must: Stop Being Bullied by Your Workplace

As a nurse how many times have you told family members to go home?  Go home or you will get sick & not be able to help your loved one.  As a nurse, has anyone ever told you that?  Probably the closest you have gotten has been “don’t come near me & infect me with whatever you have”.  Nurses know that when they stay home sick they may not be replaced; therefore, colleagues will be left to pick up the extra work.  Working short staffed, you hope an extra coffee, maybe a chocolate bar or some donuts will provide extra energy to get through.  But, that only works for so long & then the next person gets sick & the cycle continues.  This is a familiar story that every nurse knows all too well.  You are not doing yourself or your colleagues any favours by continuing in this cycle of destruction.  As a nurse you are a leader: lead yourself by caring for yourself.

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As nurses we know what we need to do:

  • eat a healthy diet
  • get adequate sleep
  • be physically active
  • maintain a healthy weight
  • have a strong social support system
  • live in a healthy community
  • spend time with your family
  • make time for yourself
  • keep your brain active
  • embrace your spirituality
  • listen to your body

Of course this is easier said than done; the culture of ignoring self has been around for a long, long time. This is just the beginning; remember you are not selfish when you care for yourself.  If you do not care for yourself you will go from being a caregiver to someone needing care, & possibly be a burden to your family.  No nurse wants to be in that situation.

For two years I struggled with increasing fatigue, repeated sinus & other respiratory illnesses.  With prolonged physical problems, my mental status was slipping into the doldrums; I wasn’t depressed, but it was starting to seem that might not be far away.  I was prescribed time off work for ‘burn out’.  Though I felt much better after six months off, I did  not return to my previous state of health, & the amount of progress I made vanished within a very short period of time.  Eventually I was able to get back to work on a very restricted schedule, but within 4 months I had the same old respiratory illnesses, extreme fatigue, & body aches.  More time off, then a repeat of the same thing.  During this time – we’re looking at close to 2 years now – I was a slug at home.  I’d get home from work & collapes; no energy for anything.  My poor husband didn’t have much of a wife & was doing housework, shopping, & cleaning.

At about the one & a half year mark I finally got a diagnosis: I had an autoimmune disease (PBC) & it was responsible for the extreme fatigue.  Though I thought knowing the reason would help, & it did, mentally, it did not help my energy level, if I overdid I got quite ill.  This was distressing as I loved my job, loved being a nurse, but I could no longer work.  Unfortunately, I still couldn’t do much at home either, & was missing out on many of the things in life that I enjoyed.  If I had listened to my body & if I had taken better care of myself would it have made a difference?  Could I have prevented my autoimmune disorder, or could I have maybe felt better for longer?  No one really knows; &, that is the past & I am moving forward.

This is not about me, I’m doing ok & I have learned a lot; but, I hope my story inspires you to care for yourself.  I found out my workplace didn’t really need me.  My family managed, though they all had more work to do & none of them really needed that, especially because of me.  So what will you do?

My questions to you are these:

  1. Are you happy?
  2. Do you love your job?
  3. Are you happy with the amount of time you have for yourself?
  4. Are you happy with the amount of time you have with your family?
  5. Are you satisfied with your health?
  6. Do you feel you are missing out on anything?

You know what the answers should be: what changes do you need to consider?  How will you make these changes?

I believe every nurse is a leader; whether he or she thinks so.  But most important everyone must know thy self, must lead thy self.  Self-care is difficult: our culture puts so much pride in working too many hours, working too hard, not having time to eat well, or get enough activity, going to work when ill, not taking vacations, & not having time for self that we brag about these ‘hardships’.  I don’t think this makes much sense: do you?

What can you do?  Start with yourself, talk to your colleagues: can you support each other in a quest to be healthy & happy?  I am passionate about nursing & leadership: I hope to see the changes I have been championing come about in my time, but I need your help.  Let me see the initiatives demonstrating nurses caring for themselves.

“Be the change you wish to see in the world”.

-Mahatma Gandhi-