I just heard of an interesting orientation strategy being utilized by a hospital. On the day of orientation, nurse hires check in and are directed to go into the auditorium. They are told orientation will begin promptly at 8 a.m.
Then, those new hires sit. And sit some more. And 8 a.m. comes and goes. So does 9 a.m. Then 10.
Finally, after they sit in the auditorium for hours doing nothing, they’re told to move to a different room with a vague description of how to get there. The frustration and confusion is so thick you can taste it.
Then, the nurses are asked to sit again in their original seats and the secret is revealed; if there’s anything transparent about it.

See, the hospital WANTS those in orientation to feel bored, neglected, frustrated and confused. Reason being? They assume that is how patients feel. Now that nurses have had that experience, they can better empathize with patients and their families.

I see the point the hospital is trying to make. But, is it effective? You’d have to ask those nurses in orientation, but my guess is no.

Still, as a non-nurse, I wonder what you think. Is this an effective way to communicate the emotions of a patient? How do you think you might feel if you were a participant in this experiment?

Yesterday, my wife and I met with a HVAC professional about our home. If you’re not familiar, HVAC stands for Heating, Ventilation and Air Conditioning. This person is what the HVAC company calls “an energy geek.” His sole position is to discover ways to use lower amounts of energy, cleaner energy and, of course, to lower bills.

He also brought along a technician, Jimmy. HJimmy was the bearer of burden and got the task of climbing ladders into an attic where the temperature had to be at least 140 degrees. This is Florida, after all.

As soon as Jimmy’s head went up into the attic, the energy geek said, “Jimmy is one of our best. Whatever the problem is, he’ll find it.”

Is Jimmy really the best? How on earth should I know? But, when Jimmy’s co-worker tells me he’s the best, I believe him. Even if he’s lying, just taking the interest of the customer into account gave me comfort our home; our largest investment, is in good hands.

Is this any different than patient/caregiver interaction? We all have the ability to manage up. Nurses, especially. Simply telling a patient or family member positive things about another caregiver is managing up. It brings a level of comfort to those who are concerned. I’ve written about this in “I’m Here” and “The Other End of the Stethoscope”, but honestly, it wasn’t until years later that I even heard the term, “managing up.”

Please share a time when you have managed up by reassuring a patient/family member that another caregiver is quality and compassionate. Or, write about a time when you saw patients/families still concerned or frightened because a caregiver missed the golden opportunity to manage up.

As we discussed last week, I’ve been reading, “The Nurses” by Alexandra Robbins. In the first chapter or two, Robbins chose to highlight a nurse who is a recovering opioid addict. This nurse, upon having that moment of clarity when she realized she was an addict, immediately checked herself into rehab…at her own facility. She also immediately went to the director of her department to share this realization and to admit that she had been, for many, many months, been squirreling away leftover narcotics. The department director then told the nurse addict that the department had been aware of her stealing drugs and had been investigating her for nearly a year. The nurse then went through a rigorous two year program set up by the state board to keep a watchful eye on the nurse after she admitted her addiction. Luckily (and as far as I’ve gotten in the book), the nurse is clean and sober and has completed the protocol which will allow her to keep her license. I stand and applaud this nurse, as I do for anyone who has admitted there is a problem and who has worked the steps of recovery. Doing such a thing takes a great amount of humility and courage.

Have you worked with a nurse who is in recovery? Does the addict’s choice of substance relate to his/her job? What were your first feelings when you found out a co-worker is in recovery? Did your opinion change after working with this individual?

Robbins first caught my attention several years ago with “Conquering Your Quarter Life Crisis” and then again with “Pledge.” I’ve enjoyed her investigative writing and with a subject like nursing? I was certainly going to give it a read.

As a writer, I know the challenges of getting a point across in a story while trying to balance the facts. Robbins’ characters are, of course, conglomerations of different people, personalities and stories. I’m only about 10% through the book, but I’m already starting to witness a bit of a trend in Robbins’ storytelling. Mainly, the nurses are compassionate, heroic, hard working professionals. Yet, it seems the physicians and surgeons are egotistical, uncaring and aloof with both patients and employees.

I personally don’t like to paint with these broad strokes, though I do understand crafting a story. Even though each narrative may not be factual, this still, I feel, exacerbates the divisions of a care team.

Lately, patient experience professionals (like myself) have been emphasizing professionalism and teamwork. It would seem obvious that everyone on the care team would work in tandem to take care of patient needs. I know this cannot be accomplished 100% of the time, but as an ideal for patients, it’s a no brainer.

Do you feel that, in your facility/clinic/job that such striking divisions are true? Why or why not?

Don’t cling to a mistake just because you spent a lot of time making it.

Read that again.

What are the first feelings and thoughts that come to your mind?

Does it make you think of a regret you need to forgive yourself for?

Maybe you remember an event you need to move on from?

Are you moved by the concept of being gentle with our past and embracing the future?

Or is your response more along the lines of, “Yup, that’s true!”?

Whichever way your heart and mind go – just write about it.

Walking through the local Target I heard the unmistakable wails of a toddler breakdown. Followed closely by the inevitable, “It’s not fair!” and of course, “You’re so mean!!”

If I’m honest, there have been a time or two (or twelve) in my adult life, I’ve silently (or loudly) uttered those words. Some times it just is not fair.

As mature adults we know this. And we can quote this to others.

But still… it sure sucks when we are the ones life isn’t being fair too.

How do you respond when you have a patient who is in the midst of a melt down, feeling overcome with life and perhaps justifiably lashing out about how life is not fair? What emotions does that bring to the surface in you? Have you found a way to handle your own sense of dealing with the “fairness” question?

I spoke at a large hospital recently. After my presentation a young woman hung to the side until most every one was gone until she approached me quietly with a question.

She works in the NICU. She loves her job and treats each baby with tender care. She recently found out she is pregnant and while both her and her husband are thrilled, going to work has become difficult. Not because she is worried about all that can go wrong – she says she knows the odds and has dealt with that before she conceived – what more caught her off guard is how she is feeling so much joy – and holding the hand of people in so much pain. She wants to continue to offer them comfort and stay in her position, but she is afraid that as her tummy gives away her condition it will cause parents increased grief.

How do you deal with the difficult balancing act of holding both joy and sadness? As humans we have a huge capacity to rip open our heart and feel love and sorrow and grief and peace all at once – but it’s confusing. And at times overwhelming. How did you first deal with processing your own pain or joy – in the face of others loss?

My stepdaughter is in Nursing School. She came home from clinical telling us about her day and how she worked with a client in a nursing home, and the difficult job of giving an unwilling person a shower following a “major explosion.”

She has had several years of experience in other aspects of healthcare and has moved up into the Activities Department at a Nursing Care facility. She noted, “I’m back at the beginning!”

After commiserating for a moment, in an attempt to encourage her I said, “but when you’re finished with school you won’t have to deal with this type of situation as much.” To which, her already experienced self replied, “Oh yes I will. It might be different – but I know the truth – I’m in the Poop Profession. And I’m okay with that.”

That is certainly not one of the glamorous aspects of the healthcare profession! But it is an undeniable fact of many day to day operations.

How do you deal with some of the “ugly” parts of the job requirements? Do you keep a sense of humor? Do you keep a stiff upper lip? Do you have advice for the student nurses out there?

We think of this as the time of year to do away with the dusty, the smelly, the no longer needed. We long to throw up our windows and free our homes of the “junk” that has accumulated throughout the colder (or at least cooler!) months.

I like to do this mentally. I have found, left unchecked, negative, harmful, and often untrue beliefs tend to harbor in the corners of our psyche until we recognize them, acknowledge they are no longer welcome, and begin whatever process we need to do to “disinvite them” from our home.

When you think about this concept – what are some of the first thoughts that come to your mind that you need to rid yourself of. List them in any order, simply as they appear to you. Then choose something and write a note to it – explain to that negative belief why it is no longer welcome. Remember when it pops up again in your daily life to notice it, and remind it why its of no use to you – and send it on its way. It may not go quickly or easily – but acknowledging its presence will go a long way in removing the power it holds in your life.