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Upstream or downstream, that is the question

I recently attended a talk about the latest research in fetal alcohol spectrum disorder (FASD). Initially I was intrigued by the physical and behavioural manifestations of the disorder, but quickly began to feel overwhelmed by the complexity of the diagnostic and management approach. Part way through the talk I was struck with this idea: The…

I recently attended a talk about the latest research in fetal alcohol spectrum disorder (FASD).

Initially I was intrigued by the physical and behavioural manifestations of the disorder, but quickly began to feel overwhelmed by the complexity of the diagnostic and management approach. Part way through the talk I was struck with this idea: The real problem isn’t FASD. The real problem is drinking in pregnancy, unintended pregnancies and the lackadaisical attitude about drinking in our culture. Why aren’t we talking about that? 

Why are we putting so much attention and effort into managing problems that shouldn’t happen?

That is the question.

There are a lot of us who believe our job is to work downstream, to help the sick and injured.

There are only some of us who believe it’s our job to work upstream. To see and prevent problems before they happen, to do what isn’t being done, to make connections, to teach, to lead, and to help people see risks and change what they can.

It’s scary to work upstream, against the current and venture into un-chartered waters. Guidelines are rare and the journey is fraught with uncertainty, vulnerability and risk for failure. I can’t think of a better way to work.

All I know is that I’m far more interested in changing the culture and preventing problems and unnecessary hardship than trusting in the belief that my job is to be constantly surrounded by suffering.

The reality is that trusting in nothing but downstream work is exhausting and dangerous. When we choose to work downstream, we’re essentially building our careers on a physical and emotional battlefield.

If that’s not how you want to live your life, or you’re tired of drowning, it’s possible to turn around and make your way upstream. Try seeing the real problems underlying the problems you’re faced with every day.

That’s the work that needs to be done.

It’s up to you.

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“It’s not my ideal job”

We do a great disservice to ourselves and the world when we get stuck in a job doing work we don’t like. When we reach a place and stay there, we miss out on opportunities and the chance to grow and make our best contributions. Starting something new feels risky and scary. But I must…

We do a great disservice to ourselves and the world when we get stuck in a job doing work we don’t like. When we reach a place and stay there, we miss out on opportunities and the chance to grow and make our best contributions.

Starting something new feels risky and scary. But I must tell you, the risks of staying comfortable (and dissatisfied) are even greater.

So here’s your permission slip to walk away from the comfort of certainty into the wilderness of doing work you care about. You’re entitled to do this work, but first you have to believe you’re allowed.

Wake an hour earlier than you need to. Work in the evening, on your lunch breaks, on weekends and in your spare time. Do something – anything – every day that will take you one step closer to where you want to be.

Dreams and goals only come true when we consistently show up and work away at them.

It’s never a good time to do something different. Do it anyway.

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Intentions

Ten years ago when I was applying to nursing school, I’m sure my family was confused about my motives to become a nurse: I didn’t like hospitals, shift work and being around sick people. The primary reason I became a nurse was that I enjoyed learning about the health of the human mind and body,…

Ten years ago when I was applying to nursing school, I’m sure my family was confused about my motives to become a nurse: I didn’t like hospitals, shift work and being around sick people.

The primary reason I became a nurse was that I enjoyed learning about the health of the human mind and body, and I felt that the opportunities in nursing would be limitless. In other words, I didn’t become a nurse solely because I wanted to help people.

Let me explain…

Throughout my life I’ve always struggled with doing work, tasks and jobs that aren’t meaningful to me. And, that every single time I’ve prioritized someone else’s agenda at the expense of my own values, beliefs and well-being, I’ve ended up doing mediocre work and feeling miserable.

I believe it’s true that whenever anybody does work solely for the sake of others – our employers, bosses, clients, colleagues, or our selfish egos – we inadvertently offer services, make things and create solutions that aren’t all that helpful to the people we hope to serve.

Consider textbooks. If textbook authors actually wanted to help us learn and apply what we’re learning, I don’t think they would write impractical, hard-to-read, five-pound, 2000 page books. But – if textbook authors truly thought about the kind of books they needed as nursing students, or the kind of book they want or need to write, then we might start seeing work that’s helpful to us.

Best-selling author Elizabeth Gilbert says she wrote her famous travel memoir Eat, Pray, Love to help her understand her journey in life. Even though it helped thousands of people around the world, her sole motivation wasn’t to change or help others. She wrote it for herself. 

This blog might seem like a self-help guide to some of you, and if it is that’s amazing. However, my primary intention with blogging is that it helps me make sense of my experiences in nursing. I need to learn, write and create, and this outlet is a great way to feed my soul and keep me sane. Helping others is a side effect of this work.

There’s no need to be embarrassed or ashamed of the reasons you do your work if helping others isn’t your first priority.  For the most part, your work should be enjoyable, healing, exhilarating or relaxing. These reasons are good enough.

If the thought of helping people doesn’t get you out of bed in the morning, that’s okay. In fact, it’s more than okay. What should get you out of bed in the morning is your desire to do work that matters to you.

Do what makes you the best version of yourself, because that’s what the world needs.

If you do what you love, eventually it will become help.

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Breaking the rules

When people tell us “we can’t or don’t do that ” it often means “we won’t do that”. The distinction is important: Won’t and can’t are not the same thing (not even close). A few weeks ago I received a brief phone call about some abnormal test results I had. I was away on vacation and unable…

When people tell us “we can’t or don’t do that ” it often means “we won’t do that”. The distinction is important: Won’t and can’t are not the same thing (not even close).

A few weeks ago I received a brief phone call about some abnormal test results I had. I was away on vacation and unable to be seen in-person for another few weeks.

It wasn’t until after I hung up the phone that I realized the information I needed to hear and provide shouldn’t wait another few weeks, and also that I didn’t need to be examined physically in-person to discuss the results and plan of care. A phone or video call would have been just fine. But they don’t do that. 

I recognize that when organizations get big, processes become well-established and people get comfortable in their roles, they start believing they can’t do certain things or they stop caring about doing things differently for the people they serve.

The trouble is, when we believe we can’t do something differently and when we stop caring long enough, we inevitably stumble down the path of frustration and despair. When it comes to health care, the consequences of this kind of thinking are disastrous.

I believe that our work is not always to do what we’re told. That our work is too important to protect against change, failure and criticism. If anything, we’re here to do the work that needs and wants to get done, whether we like it or not. Even if it means doing things differently.

The best work I’ve ever done has broken rules. Every project that has transformed me and the lives of the people I serve involved creating new rules and ways of doing things. The work I’m most proud of involved work that other people wouldn’t do. This kind of work scares me the most, but it’s also been the most rewarding.

The next time you see a colleague not do something they ought to, or say they can’t do something they should, you’ll likely find they are hiding beneath rules that need to be broken.

Please, go ahead and see the rules. Decide which rules people won’t change (but should), and then follow your heart and get to work on breaking them.

When we care enough to do what other people won’t, amazing things happen.

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Awful vs interesting

I once worked a job that destroyed a part of me for a few years. I was asked to do more than I could handle, but I was too afraid to admit I couldn’t do it. I was set up to fail, and it sucked. For years I looked back on that time in my life…

I once worked a job that destroyed a part of me for a few years. I was asked to do more than I could handle, but I was too afraid to admit I couldn’t do it. I was set up to fail, and it sucked.

For years I looked back on that time in my life and only remembered how awful it was. I felt physically sick just thinking about being summoned by my boss to talk about all my problems and how I was going to fix them.

As time has passed, I’ve realized that this awful experience is actually interesting. Isn’t it interesting how toxic workplace culture influences us? Isn’t it interesting how different people lead? Isn’t it interesting how people behave when they’re uncertain and afraid?

Rather than focusing on the negative, I started being more interested in understanding what happened and why it happened. And honestly, I believe that staying curious has made all the difference between feeling ashamed and feeling transformed and empowered by that experience.

I think the same is true for most things in life: The moment when something awful happens is usually the moment where interesting begins, as long as we’re committed to curiosity.

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