I recently came across an article entitled “Managing the demands of professional life.”1 When searching through PubMed for scientific articles, titles like this pique my curiosity! This article discussed several concepts in interpersonal relationships that busy professionals often forget.
The article was written by a psychiatrist and cardiac surgeon. Most concepts are related to behaviors and relationships of surgeons but the concepts apply to all of us and the behaviors are common to many professionals.
The first concept is that of mindfulness. There is a lot in the literature now about mindfulness and it is often misunderstood by healthcare workers. Mindfulness, as defined by these authors, means simply being present in that moment. How many times have you caught yourself with wandering thoughts while caring for even a very sick patient? With more experience, we often go into auto-pilot and are thinking about what to do next instead of what is happening at this moment. The patient safety literature and experience show that it isn’t always the less experienced nurse who makes the errors.2 Because we get used to medications or equipment or even patients always being in the same place, always performing the same thing the same way, we begin to see the usual or expected without looking. We check ourselves less often. We lose our mindfulness. Dickey & Ungerleider talk about mindfulness as a personal mindfulness.1 A need to connect with our inner self. Instead of just going through life, we need to experience life! What a great message for a new year!
The next concept they discuss is intentionality. This is presented in relationship to our personal lives. Have you ever found yourself in a job you really don’t like, living somewhere you don’t want to be or thinking of something you want to do ‘someday’ but somehow you’ve ended up where you are physically or emotionally and don’t feel you have any choice but to continue? As Dickey & Ungerleider mention, the road we travel needs to be our own road.1 They quote a poem by David Whyte “In effect, if we can see the path ahead laid out for us, there is a good chance it is not our path; it is probably someone else’s we have substituted for our own. Our own path must be deciphered every step of the way” And yes, sometimes we make wrong turns but should always be encouraged to turn back, correct what turns out to be a ‘wrong turn’ for us and continue on. Also having the road “laid out before us” doesn’t allow for opportunities that arise that we would never have planned for. This has happened in my own career and I am so thankful for those experiences. When I graduated from nursing school so many years ago, I never envisioned the career I turned out to have. I could never have planned for the many opportunities that have come my way. Without the willingness to travel those roads and take chances, other new opportunities may never have come along.
The concept of intentionality also includes the often discussed balance between work and personal time. As they mention, this doesn’t necessarily mean the same amount of time for each of these areas but the proper amount of time. Do you feel so connected to work and validation of your performance that this almost becomes a competition? “Begin to believe that you are defined by your performance and at some point in your life, you may, having travelled far from who you are and the dreams that you held for yourself, become focused solely on the performance required for the next award (promotion or other type of approval). It’s as if you set out to be something and you forgot how to be someone” (pg 141).
Next, they discuss the concept of mindsight. This is about truly understanding another person and what is important to them. The ability to connect with their experiences. This certainly improves the relationships we have with our co-workers. Particularly in the NICU, we work very closely together. In many cases, our best friends are the folks we work with because we have taken the time to truly understand their point of view, their lives and what is important to them and they have done the same for us. We can probably also think of someone we have worked with at some point with whom we avoided taking the time to truly empathize and understand. Therefore, working relationships may be more strained. Respect for likenesses and differences build trust and trust builds teamwork. Teamwork is mentioned so often in relationship to patient safety. Every member of the team has something to offer. When allowed to offer it, they feel more valued and in turn, the benefit of what they have to offer is now shared by the team.
Forgiveness and shared meaning is the next concept. There is much in the nursing literature, over many years about bullying, nurses ‘eating’ their young, lateral violence and other terms for interpersonal ‘meanness!’ Why do we do this?? In many cases, it is simply to feel superior. It often occurs toward less experienced, less verbal individuals who will not or at least are assumed not to have power to change the behavior. This takes us back to intentionality. Is this behavior happening because of a need for recognition or other types of ‘awards’? In any case, it can lead to toxic relationships. Now the person on the receiving end of the bullying harbors ill-will toward the bully-er. This only leads to more resentment and even to physical stress as working relationships deteriorate. This too can impact patient safety. Perhaps at some point in your career or maybe even now you recognize some bullying in your own interpersonal communications. You feel bad about it and it causes you stress. But maybe the person just really pushes your buttons and you can’t help it in the moment. For either of these situations, forgiveness and shared meaning is important. Shared meaning simply means that you understand the other person’s point of view. It doesn’t mean that you agree with it. This means communication! Which is to say, listening to each other’s perspective without judgment. No one is more right or more wrong, just different. Improving communication increases trust and strengthens the team. Regarding forgiveness, it is important to forgive others as well as forgive ourselves. “When we don’t forgive, we create toxic relationships, both with ourselves and with others” (pg 142.)
Finally, Dickey & Ungerleider talk of managing stress.1 There is so much in the professional literature about managing stress. We know stress can lead to physical ailments. Our jobs are, by definition, stressful. And poor interpersonal relationships only add to the stress. Some of this interpersonal stress may be created by us. Becoming antagonistic toward someone because things are not going well, a situation in which our stress level rises for uncontrollable reasons, may reduce our stress level at that moment but leads to worse interpersonal relationships with the person or persons we yelled at which must be repaired later for good team work to occur. This takes work and time, not to mention the personal stress of confrontation that causes additional stress for many people. Working to repair what has occurred and avoiding future unnecessary confrontation will ultimately decrease your own stress and the stress of those around you. After all, more mistakes are made when we are stressed. I often talk about team concepts when helping folks learn pediatric advanced life support. Codes that are run by someone who is fragmented, stressed and therefore, randomly shouting orders creates additional stress in those trying to help out and ultimately, can lead to errors. On the other hand, what a difference a well-run code is where the team leader is calmly calling out orders and allowing input from other team members.
I found these concepts interesting to consider. The effects of mindfulness, intentionality, forgiveness and mindsight can be apparent in both our professional and personal lives. After all, these are both occurring in one person, therefore effects are overlapping. We don’t take off the effects of our professional lives like taking off our shoes when we go home. Good days at work and bad days at work effect how we behave at home so taking care of ourselves effects us, our families and friends, our patients and their families, and our co-workers. So, take care of yourself and be the best that you can be in the New Year!
1. Dickey J, Ungerleider R. Managing the demands of professional life. Cardiology in the Young. 2007;17(2):138-144.
2. Chang YK, Mark BA. Antecedents of severe and nonsevere medication errors. Journal of Nursing Scholarship. 2009;41(1):70-78.
Looking for additional reading from Sandy Beauman’s professional perspective?
View her blog entry, The Value of Leadership.