Pollyanna isn't naive, she is a badass.

Our current society seems to view robust and irrepressible optimism as a weakness, and dismisses it as coming from someone who is too silly, inexperienced or gullible to understand the “real truths”. 

But I think this is a fundamental misunderstanding of what optimism is. Optimism isn't about ignoring reality and living in a fantasy of rainbows and unicorns. In fact it requires great strength of will and of character. It isn’t always easy, and it certainly isn’t passive. Optimism is a fierce battle of consciously choosing the perspective that is going to best serve you in your life. 

I don’t think Pollyanna was simple and naive to reality. I think she was a badass who bent reality to her will. And here’s why:

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Boundaries Webinar Q&A: Part 3

During my recent webinar on boundaries I was asked a very good question.

As a care taker for a loved one, it is difficult to watch them make choices that cause more problems (pain, symptoms that cause problems, etc). But I will always be the care taker no matter what - even though poor choices makes my job harder. I can't figure out how to set a boundary about this. How can I not feel frustrated at the consequences of poor choices?

Many of us have probably faced similar scenarios, so though I'm using this question as a prompt, my suggestions are directed at all of us, not just the lovely person who submitted the question. :-)

Previously we have talked about giving up trying to control things which we cannot control, and how to powerfully control the things we can – ourselves – to help give us the results we want to have.

I've been trying to get across the idea that since we can't actually control the choices other people make, that basing our feelings on what other people decide to do is not the strongest strategy to ensure our own self care.

But, and this is a big but, this doesn't mean that we have to stop caring about other people and what they do.

It doesn't mean we can't have an opinion on which choice we would like them to make.

And it doesn't mean we have to just let everyone around us do whatever they want without there being any consequences when they are around us.

The good news about this is that no matter what others decide to do, we can always protect ourselves with a judicious use of boundaries.

Remember, boundaries are something we create for ourselves to protect ourselves from the actions of others. They are not something we create to control the behavior of others for our own gain. If you do X, then I will do Y.

If our patient wants to engage in behavior that is detrimental to his health, that is not a boundary violation for us. If he wants to ignore everything we say, that is not a boundary violation for us.

But if they want to make you endorse or ignore or approve of their behavior, that could be.

    - If you ask me to bring you a beer with your Xanax, then I am going to decline to do that.

    - If you stay in bed all day and refuse to do your physical therapy (which is your right to do), then I am going to tell you all about pressure ulcers and drop foot (which as your caretaker is my right to do).

    - If you start eating a box of Oreos while I am giving you an insulin shot, then I am going to speak to you about the importance of proper diet and blood sugar control.

This doesn't mean you are going to grab the cookies out of his hand and yell and scream and try to force him to comply with the recommended diet. It doesn't mean you have to be mad, or resentful, or in fact feel anything that you don't want to feel because you are not going to delegate your feelings to his behavior and choices.

But while he is an adult and gets to do what he wants to do, you are also an adult and can do what you want to do. You can make requests, you can tell him what you think, and you can ask him to see things your way.

You don't want to expect or demand that he change his behavior, because that immediately puts him in charge of you as you wait to see if he will acquiesce or not.

But as a nurse you can educate self-destructive behavior when you see it, calmly and rationally and with compassion, rather than feeling like you have to do it in anger or judgement or frustration.

The strategy of taking responsibility for ourselves, while allowing others to be fully responsible for themselves isn't always the easy way, but it is powerful because it keeps everyone focused on outcomes they can actually control.

So this is the time to ask yourself a lot of questions. When it comes to your patient, what really is important to you? Is your goal to drag him into health by any means necessary? Or is it to enjoy the time you spend with him, regardless of his health status?

These newsletters have been a little longer than usual, but I hope you've found them helpful.

Robb

P.S. If you have other questions/issues/situations you'd like me to respond to, just reply to this email and let me know.

Boundaries Webinar Q&A: Part 2

Happy Thursday nurses!

During my recent webinar on boundaries I was asked a very good question.

As a care taker for a loved one, it is difficult to watch them make choices that cause more problems (pain, symptoms that cause problems, etc). But I will always be the care taker no matter what - even though poor choices makes my job harder. I can't figure out how to set a boundary about this. How can I not feel frustrated at the consequences of poor choices?

Many of us have probably faced similar scenarios, so though I'm using this question as a prompt, my suggestions are directed at all of us, not just the lovely person who submitted the question. :-)

Since there is much to discuss with this question, this is the second part of my response, you can see part one HERE.

Last week we talked about how trying to control something we don't have control over (such as another persons behavior) is an easy way to get ourselves feeling frustrated.

This week we are going to talk about what you can control – your own thoughts and feelings.

If you are thinking that the only way not to feel frustrated is for your patient to behave a certain way, then you are creating a relationship where you are the victim and you are just waiting to see what your patient does which will determine your feelings.

If he does X then you will be happy. If he does Y then you will be frustrated.

You are a strong and capable nurse, why would you want to sit around waiting for someone else dictate your feelings to you?

The stronger strategy is to take full responsibility for our own actions (i.e. how we are going to treat and feel about people who make “bad” choices), and to NOT take responsibility for the fact that they are making those choices, or to attempt to demand a particular outcome from them.

Our feelings in this situation are the direct results of the thoughts we are having about our patient. If our thought is “He is being so foolish and difficult! Doesn't he care about what I am trying to do here?” we are going to have a different set of feelings than if we think “He is so lovably stubborn, the old poop!”

Which thought is going to give you the feeling you want to have when you are caring for him?

All you have to do (don't you love how I make it sound easy?) is to think the thoughts that are going to make you feel the way you want.

  • “The rascal is sure lucky to have me.”

  • “This is not easy but I'm so glad I'm able to be here for him.”

  • “I feel good about the care I give him no matter what he does.”

  • “It's a good thing I am such a strong and capable nurse that I can put up with all of this nonsense and yet still enjoy myself.”

Even something like “It is a shame he doesn't take better care of himself” is probably going to feel better than “Why is he doing this to me?”.

Remember, his actions are not a reflection of your success or failure as a nurse, they are a reflection of his priorities and desires as a patient.

In the end, he is going to do what he wants. Relaxing our need to control him and giving him permission to do what he is going to do anyway just might end up giving you a lot of relief.

Giving permission doesn't mean you have to like what he does however, and next week we will talk about the choices you still get to make for yourself, even as you stop trying to make choices for him.

Robb

P.S. Did you know you can follow me on Facebook? CLICK HERE for the official Facebook coaching page, and be sure to like and follow!

You know this patient, don't you?

You know the patient. 

The frequent flier who comes in again and again. Nothing ever changes, except for the worse. They never follow directions. They don't want to do anything for themselves, they just want you to give them pain meds. Preferably given IV Q2 and in tandem with phenergan. And how could your forget the benadryl, you know they always take everything together! What kind of moron nurse are you??

What is your day like when this happens to you? How do you feel? 

You no doubt have lots of evidence of why that person is terrible, awful, and no-good. 

You no doubt can easily justify self-righteous anger, judgement and dismissal. 

But how do you want to feel?

I know, they are rude and arrogant and disrespectful, and don't deserve your kindness and humility and respect.

They deserve the punishment of your judgement, right?

But, how do you want to feel?

I'm not suggesting you have to be an angel, or a Pollyanna. (Not that there is anything wrong with that.)

But I am suggesting that you can decide to feel however we want. All the time. Regardless of how other people behave. This is a superpower you can learn.

Sounds crazy, right? But it isn't. 

“This patient is the worst, I can't believe how lazy and selfish and arrogant they are, how dare they talk to me like that, I am just trying to help and they are blatantly abusing the system and they just need to stop! I wish the doc would just discharge them already.”

or

“This patient is so lucky to have me, because I am freaking awesome at my job and I can take care of anyone no matter how much crap they throw at me. Since I am so good at taking care of myself I know my worth is non-negotiable, and that anything they say has nothing to do with me and everything to do with them. I know they won't realize or appreciate it, but I'm going to give them such thoughtful care that Florence herself would be proud of because that is just how I roll.”

Which thought is going to make for a very long shift? Which is going to give you the day you want to have?

And the best part is that you aren't choosing the thought for the benefit of an undeserving jerk. You are choosing it for yours. 

Watch yourself today. Take notice of what you are thinking when you feel bad. Notice what you are thinking when you feel great. That awareness is something powerful we can build on. 

Yours in self care,
Robb