We All Need to Slow Down

We All Need to Slow Down

Michael B. Grossman, DM, MSN, RN, NEA-BC, CNML 

Hummingbird Yesterday my daughter made a slow motion video of Lucy, her Rhodesian Ridgebacks puppy. I was  fascinated to discover that they don’t run like a horse, but more like rabbit; in terms of their back legs push off together. So I did a search on YouTube and apparently that’s where their energy comes from, which is also the way cheetahs and greyhounds run. Anyway, while viewing slow motion video’s I came across this one of hummingbirds, which I found interesting in terms of the concept of we need to slow down to appreciate our lives and work. When we’re always going at 100 miles an hour we miss a lot of life. If you can slow down for 2-minutes, check it out: Hummingbirds in Slow Motion

https://www.youtube.com/watch?x-yt-ts=1422411861&x-yt cl=84924572&v=Fouo6GKGBIM

What Happens When We are Constantly in High Speed 

            There are 1,440 minutes in a day. It doesn’t seem like taking 2 minutes to watch a video is that much time, when you put it that way. Likewise there are 168 hours in a week. Seems like a lot of hours, eh? But, when you start to break it down in terms of all the stuff we have to do, those 168 hours go pretty quickly. There are 720 minutes in a 12-hour shift, yet 60% of nurses are too busy to take a 15-minute break. They are willing to risk their license and own health by working fatigued, because they are too busy to take a 15-minute break. As an ethics professor I discuss the evidence based literature around 12-hour shifts and fatigue and what I have discovered is that most nurses are just not aware of the literature, because they’re too busy to slow down and read it. A colleague of mine told me recently, you know Grossman you’re the only one talking about 12-hour shifts. Nobody else sees it as a problem. See that to me is the problem. When we’re going at 100 miles per hour because we’re late for work, we don’t have the time to look over at the gas gauge and see that it’s almost on empty! Have you ever done that and then ended up stranded on the road and take an hour or two to get help…

The Impact of High Speed Change

White Water Rafting Peter Vaill (1996) is generally credited with introducing the concept of white water change in organizations. Vaill’s concept was that change in organizations has become like white water rafting, where we’re not even done with one change when another one gets piled on, like traveling through the rapids. Eventually, as Kurt Lewin (1997) suggested organisms can’t take anymore change and just shut down. Lewin called this re-freezing. My daughter’s puppy does this when we play fetch. After she chases her ball 15-20 times, she just shuts down and can’t do anymore. Even if I try to reward her with a treat, she’s just frozen and lays down on the sofa exhausted. Many nurses say they don’t get tired working 12-hour shifts. They say the work fuels their adrenalin and they actually become more energized, as long as they keep moving. But where is the point where they collapse? Is it 14 hours? 20 hours? Is it doing five 12’s in a row? The body, physically and emotionally cannot go on endlessly. Eventually it refreezes.

William Bridges (2004) another noted authority built his change model on the theories about grieving. When people are grieving loss they go through several overlapping phases of denial, anger, bargaining, depression, and finally acceptance (Kubler-Ross & Byock, 2014). Often a funeral serves as the time to slow down and incorporate what has just happened. The funeral often provides the time for reflection and symbolic closure of that chapter in our lives. Think of how often you leave a funeral making the promise to be a better person, spend more time with your family, and tell people how much you appreciate them. But, how quickly do we get back to our extensive to do list?

When organizations go through change they follow these same patterns. Most organizations are changing so quickly today there is no time to pause and reflect on what’s happening, let alone to review the evidence based literature on any particular topic. Like my daughters exhausted puppy most of us are so exhausted we can’t listen to one more speech about how this new program is going to revolutionize healthcare. However, Bridges message is that endings are more important than beginnings. Someone who just lost a loved one is not ready to appreciate the virtues of their death. Their focus is on how they’re going to live without their loved one. Likewise when the Joint Commission (2011) sent out a sentinel alert about the dangers of fatigue related to 12-hour shifts, the typical nurse couldn’t even listen because all she can think about is Oh no, they’re going to take away my 12-hour shifts. How will it fit everything into my workweek? How will I find a babysitter if I have to go back to working 5 days a week? What about my second job, and school? They are too busy to slow down long enough to hear the warning that 12-hour shifts don’t need to go away, nurses just need to take their breaks and the risk of fatigue disappears (Smith-Coggins, et al, 2006).

Pausing Long Enough to Listen 

            Years ago a friend of mine was going through a career crisis and could not decide what to do next. It was in the summer and he realized not many organizations were hiring anyway. So he decided to just take 3 weeks off to reflect. By reflect he meant not doing anything concrete, so he could actually reflect. Ken Blanchard (1988) told and interesting story about a guy he had take a train from California to Chicago to meet with him to discuss a major decision. He told the man to book a berth on a train and not read or speak to anybody for the 3 day journey. Just reflect on the topic. Basically he encouraged him to slow down. Einstein suggested that his greatest discoveries did not come from working endlessly in the lab long into the night. Instead he said his best ideas often came from putting down the research, taking a break, and then the ah ha insight would happen in the shower or out in his garden. Jim Loehr (2004), psychologist for the US Olympic team teaches athletes that the secret to peak performance is not managing your time as much as managing your energy by working in 90 minute blocks of time, followed by strategic breaks to rest, meditate, do yoga, or just pause to reflect. It makes sense when you think about it.

Don’t Wait Till It’s Too Late

             I once had a nurse give a patient the wrong unit of blood. She was in a hurry and violated the hospital policy by picking up two units of blood, for two different patients at the same time. She was trying to save time! Another nurse asked a charge nurse if she was reading an order correctly. The charge nurse was too busy to slow down and listen to what she was saying. That patient died. Mary was rear ended at a traffic light by one of her co-workers on the way home after working a 12-hour shift, that had morphed into a 14-hour shift. Her co-worker fell asleep at the wheel. A plane crashed in France a couple of years ago because both the pilot and co-pilot had fallen asleep and the autopilot computer landed the plane, but someone still had to put on the breaks. So the plane coasted off the runway. People died. I can go on and on with stories, but the bottom line is this:

The most valuable result of all education is to make you do the things

you have to do, when it ought to be done, whether you like it or not.

It is the first lesson that ought to be learned. And however early a

man’s training begins, it is probably the last lesson that he learns

thoroughly (Thomas Huxley, 2001).

Why must we experience tragedy pause, reflect, and develop our personal meaning and approach to life? Try something today. It will take you just 30 minutes. Go to a co-worker at the beginning of your shift and offer to relieve them for a 30-minute break in the middle of your shift. Agree to take their patients. Then ask if they will do the same thing for you. Don’t take your break with anyone. Just push yourself to do some quiet reflection. I worked at a hospital in California last year that had a beautiful contemplation garden. You may not have that, but perhaps you can put some quiet music on your phone and listen to that for 30 minutes, in a quiet spot with earphones. Give it a try, don’t try and make a value judgment. Just take 30 minutes out of the 10,080 minutes you have this week. Think about slowing down the hummingbird in your mind and see what you come up with. Afterwards, you might even end up telling someone how much you appreciate them.

For further information go to: http://www.nurseleadershipbuilders.com/Dr. Michael Grossman, DM, MSN, RN, NEA-BC, CNML has over 35 years of nursing leadership experience and is a nursing leader, consultant, academician, and career coach. As a professor in the graduate schools of nursing at both University of Phoenix and Walden University, he specializes in healthcare ethics, leadership development, career coaching, mentoring, teambuilding, motivation, change, communications, and dealing with “difficult” people. He also teaches nursing leadership certification review courses and time management for busy clinicians. He can also be reached at 610-331-8470 or Mike@NurseLeadershipBuilders.com

References

Blanchard, K., & Peale, N. V. (1988). The Power of Ethical Management. New York:

William Morrow and Company.

Bridges, W. (2004). Transitions: Making Sense of Life’s Changes, Revised 25th Anniversary Edition. Cambridge, MA: Da Capo Press.

Huxley, T. H. (2001). Collected Essays of Thomas H. Huxley. Bristol, UK: Thoemmes.

The Joint Commission. (2011). Health Care Worker Fatigue and Patient Safety. The Joint Commission Sentinel Event Alert(48), 1-4.

Kubler-Ross, E., & Byock, I. (2014). On Death and Dying: What the Dying Have to

Teach Doctors, Nurses, Clergy and Their Own Families. New York: Scribner Publishing.

Lewin, K. (1997). Resolving Social Conflicts: And, Field Theory in Social Science.

Washington, DC: American Psychological Association.

Loehr, J., & Schwartz, T. (2004). The Power of Full Engagement: Managing Energy, Not

Time, Is the Key to High Performance and Personal Renewal New York: Free Press.

Smith-Coggins, R., Howard, S. K., Mac, D. T., Wang, C., Kwan, S., Rosekind, M. R., . . .

Gaba, D. M. (2006). Improving Alertness and Performance in Emergency Department Physicians and Nurses: The Use of Planned Naps. Annals of Emergency Medicine, 48(5), 595-604.

Vaill, P. B. (1996). Learning as a way of being: Strategies for survival in a world of

permanent white water. San Francisco, CA: Jossey-Bass.

 

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