The Value of Clarity

It’s January, time for a fresh start. I am personally engaged in a book-writing project and it is my goal for the year to complete it. I have chosen clarity as my self-guiding word for the year, my compass as I embark on this giant endeavor.

One of my passions is evolving healthcare in a direction that allows everyone involved to be fully human: patients, nurses, physicians, administrators and executives.

I recently read an op-ed piece written by an academic hematologist, lamenting the lack of balance between what he distinguishes as patient vs. professional time, and I wanted to respond. If you would like to see the original piece it is here.

He described how he sees manifestations of this conflict between what he calls “professional” time (academic time) as opposed to patient time (clinic time).

It occurred to me that nurses can learn quite a bit from observing how physician respond to the recent changes in healthcare. Everything this physician wrote has parallels in nursing.

Criticizing another person is not something you do in front of other people, if you have good people skills. It’s an unspoken rule in nursing to not criticize physicians out loud, either. I empathize with this physician, I understand he is thinking about self-preservation in the interest of doing a good job in whatever he’s pursuing, whether academic or patient care.

One thing I do know about physicians is that they work extremely hard and long hours. As an outsider to physician culture, I recognize frequently that physicians are trying so hard to treat diseases that they lose sight of the individual patient as a person. Perhaps it’s because physicians often don’t allow themselves to accept the limitations of their own human qualities, making it difficult to recognize the needs of their patients.

People skills are an asset in any profession. We call them “communication skills” and they are wonderful to find in a physician. These days, with physician burnout more commonplace than ever, I often find that people skills are the first thing to disappear when the physician is overworked.

Mixed-academic and purely clinical practices both place an unreasonable workload on physicians. Being constantly under pressure to do more and more with fewer resources, you draw the line somewhere. It is not in your patients’ best interests or your own professional longevity to drive yourself into madness.

Physicians rarely stop to acknowledge that they are human and can only do so much week-in, week-out, for years and years without it taking a toll on them physically, emotionally, socially, and professionally.

As healthcare professionals, nurses, physicians, and in other roles, we have a responsibility to take care of ourselves.

I suggest that professionals demand some “me” time: step away, clear your mind, and don’t DO anything. This is also done in meditation; one of those things dismissed as unproductive time, an intangible. But the only way to start fixing the problem you have, is to get a clear picture of it.

Ask yourself, why am I doing this? What is my own personal mission statement? Do the demands of my work align with my own values? If you are finding discordance between your personal values and professional demands, it’s time for some decision-making.

We are headed down a dangerous path when we don’t attend to our own needs as healthcare professionals who are, first and foremost, human beings.

Too many of us perform robotically. We don’t stop and think, we just do. We never get a chance to be the humans that we are within the giant healthcare factories in which we work. Right now healthcare is suffering from many crises, rising costs, overworked and burned out providers and staff, and it can be hard to find a safe place, an employer whose staff are not burdened with these crises.

We all need to be doing this periodically: step away, clear your mind, don’t think. Don’t be surprised if thoughts start to creep in. When you get some clarity in your mind, ask yourself the following questions:

• What does health mean to me?
• How do I define quality of life for myself?
• What are the human qualities most important to me, what do I value most?
• Does my work align with those values?

If it doesn’t, you must decide if the internal conflict is doing damage. And is it time to move on?

Clarity must come first, so that we can see the path ahead of us, to make sure we go where we intend to go. Let’s not get lost by taking a dangerous path.