A few months ago I was asked to design and deliver a workshop on professionalism to a group of nurses. When I was thinking about what to talk about I was thinking about the challenges faced by nurses in an increasingly complex workplace. On the face of it, our workplaces do feel more stressful than they used to be. In reality the actual physical workload does not seem to have changed dramatically. What has changed though is the vast amount of data nurses receive and are expected to produce, during their working day. So on top of caring for patients, nurses now have to process data from a variety of sources, analyse this data to decipher what is useful and what is not. So there is no wonder they get make mistakes, miss things, get stressed, and in some cases burn out.
This is an issue that is high on the agenda of people who work in health care, and across the world healthcare professionals are finally looking at how we can look after each others well-being as much as we care for our patients. The emphasis very much is on how the resilience of healthcare professionals.
With that in mind I felt that a workshop on professionalism, must centre on the nurse’s responsibility to pay attention to their own well-being to the benefit of their patients. If you are going to pay attention to your well-being you need to reflect on your behaviours, actions, feelings. Showing compassion and empathy are the cornerstones of nursing, but are practically impossible to show if you are not compassionate to yourself. Therefore that is why I called the workshop Reflective Compassionate Practice with the aim of the workshop being, to encourage participants to reflect on why they react and think the way they do, and how that impacts on themselves and others, then to appreciate their uniqueness, and accept their perceived failures. The premise is that non-judgmental raising of self-awareness increases your ability to problem solve, increases your ability to show compassion and empathy as you are more willing to accept what causes you distress and pain, therefore it is easier to connect with others that are experiencing distress and pain.
So the workshop invites the participants to practice critical thinking at work and outside of work. Critical thinking takes practice, so therefore I introduce some simple concepts of testing the information they are given and not just taking it at face value. So encouraging them to delve beneath the surface of what they are being told:
Have I got all the information in need?
What assumptions am I making about what I am hearing?
What are the implications of this information?
Is it true, or factual? How will I test its accuracy?
Is the information consistent with what you already know?
Is there an alternative point of view?
Is my judgement of the information reasonable?
Now there is a lot more to critical thinking than these simple questions, however I want to encourage the participants to be curious and have a desire to get accurate information, to increase the chances of them making the right decision based on accurate correct information. We all know that often the real truth often sits just beneath the surface of the initial statement.
I then invite them to consider how they react to stressful situations, using the work of Professor Steve Peters and the chimp paradox. So we discuss that unpleasant memories can have an effect on how we react to situations, that we perceive to be stressful. On many occasions these memories are not ours but are folk stories that develop within the culture of teams. For instance during the winter hospitals are extremely busy. There is often more patients than there are beds available. This can create tensions between teams and between bed managers and teams. Despite all involved having the same goal in mind (caring for the right patients in the right place) things can get quite tense. Often this is because the nurses and managers are already prepared for a confrontation before it happens as their brains have told them that the people they are going to talk to will be difficult and will not want to do what they believe is required. So there is no surprise that arguments start. If their brains referred to memories that were generous to the intentions of those other teams and managers, then perhaps then row would de-escalate to a constructive discussion that is resolved in a more timely manner, allowing everyone to get on with caring for the patients. Steve Peters would call it turning your gremlins into autopilots, or making unhelpful memories, helpful memories. Again this takes practice so I encourage the participants to carry out this practice in all aspects of their life.
We then do a short exercise to determine how they prefer to behave and think. Whether they prefer get their energy from working with others or working by themselves. Generally most nurses are comfortable doing one or the other. Also whether they prefer to think things through and then act or whether they prefer to start to solve the problem straight away. So using Jungian theory I invite them to consider how they will show up at work and why people who show up with different behaviours might react towards you in a certain way. This is by no means meant to be an accurate psychometric test but, just to help the participants examine why they might behave the way they do and why they react to different people in different ways and how they can adapt how they connect with each other.
The participants are now beginning to get a picture of themselves and some tools that they can use to increase their self-awareness.
We now examine stress and why we all experience it at different times and what can trigger feelings of stress. We looks, examine, fatigue, hunger, and perception as they can all have an impact our stress levels. We then discuss strategies to manage our stress levels. For instance, taking breaks at work, taking on fluids and eating. I will invite them to suggest strategies to they use to manage workloads, such as list writing, briefings and debriefing. I also introduce them to an hour of happiness. I invite the group to come up with activities they do regularly that are just for them and make them feel happy. I then challenge them to make a commitment to allocate themselves at least one hour of happiness a day.
At the end of the session we discuss the importance of setting goals to create a sense of optimism and create a solution focus rather than concentrating on the problems they see. I introduce them to Miles Hilton-Barber who decided to become an explorer and adventurer when he was in his 50s. Miles had gone blind as a young adult, after 30 years of being limited by his circumstances he decided to concentrate on achieving his dreams. Miles is now in his 60s and has flown from London to Sydney, run across the Gobi Desert, and climbed Mont Blanc, to name but a few. There are a number of his talks on YouTube and I encourage you to seek them out. Basically his message is, start with your dream and not your circumstances. If you start with your circumstances you will never do anything.
I then invite them to write a commitment of what they are going to do over the next month with a deadline to encourage them to start thinking in terms of goal setting and being resourceful.
To be an effective Professional it is vital to self-aware and show yourself the compassion you show your patients.