Category: Being Yourself

In October 2019, The National Academy of Medicine released the widely anticipated report, Taking Action Against Clinician Burnout: A Systems Approach to Professional Wellbeing, a culmination of the research conducted by The Action Collaborative on Clinician Well-being and Resilience since 2017. Their findings indicate that more than half of all clinicians, most prevalently nurses and physicians throughout the United States, experience symptoms of burnout, depression, and suicide; now widely recognized as a public health epidemic that is having adverse effects on the quality and safety of healthcare.

Burnout is manifested by symptoms of emotional exhaustion, feelings of ineffectiveness, cynicism, no longer finding work as meaningful, and a tendency to view patients, students, and colleagues as objects rather than human beings. Burnout leads to lower job satisfaction, increased rates of alcohol, drug abuse, and suicide, in addition to higher rates of medical errors and decreased patient satisfaction. And although nurses and clinicians desire to provide the highest quality of patient care, they often fall into neglect of their own self-care, leading to increased physical and mental health problems. The NAM report identified there are multiple causes of burnout in clinicians, including both personal and workplace system factors. Personal factors include not engaging in good self-care and healthy lifestyle behaviors such as exercise, healthy eating, adequate sleep and not paying attention to daily stress-reducing activities. Workplace factors can include poor staffing, long shifts, inadequate leadership support, challenges with EMRs, less time with patients, and pressure to increase patient caseloads. Toxic and negative work environments, relationships, and lack of connection and trust with co-workers are shown to all lead to cynicism and burnout. (Melnyk, 2019 American Journal of Managed Care)

As a nurse and clinician, what measures can you personally engage in to build your resilience against stress and burnout, fuel your best self, and increase your personal and professional well-being?

Let’s explore “best self” – Martin Seligman, the founder of Positive Psychology, identifies three areas of human functioning:

1.  “Flourishing” describes people who maintain an “optimal level of functioning”, aka “your best authentic self”, showing characteristics of goodness, generativity, growth, joy, hope, and resilience
2. “Languishing” describes those who are showing up day to day, watching the clock at work, and collecting their paycheck but ultimately feel like something is missing in their lives.
3. At the far end is “Dysfunction” leading to depression, anxiety, and loneliness.

He found five factors shown to be essential for achieving authentic happiness, optimal functioning, and well-being known as PERMA: Positive Emotions, Engagement, Relationships, Meaningfulness, and Accomplishments (Seligman 2011). Ryan Niemiec, PsyD, of the Via Institute, has recently revised to add a sixth domain – PERMA-H – reflecting on health and wellbeing. (Niemiec 2019)

Individuals who are “flourishing” (aka best self) are passionate about pursuing goals, know and honor their core values, are able to engage in meaningful relationships, are able to proactively respond to challenges by using their strengths versus reacting negatively, are able to maintain their energy reserves and build resilience versus burning out and leave a legacy by empowering themselves and others to make a meaningful difference.

Thomas Muha, Ph.D., developed an evidence-based program specifically designed to increase clinician well-being helping one to increase resilience to stress and burn-out, and if in a state of burn-out, steps to rise above and learn how to flourish in your personal and professional lives. The PROPEL program has been shown to have proven efficacy and sustainability for raising nurses’ and clinicians’ engagement, retention, quality patient outcomes, and overall satisfaction both for the clinicians and the patients. PROPEL is an acronym for six steps guiding you to learn how to elevate your level of satisfaction and success. (Muha, 2018) Major themes of the PROPEL Principles:

• Passion is the source of your inspiration and motivation. Enhancing your passion for doing excellent work empowers you to perform at the highest level. There are two types of Passion:

Harmonious passion occurs when you choose to engage in an activity on your own accord and you are in harmony with your core values and all areas of your life – you are your best self. People who have harmonious passion can inspire others and remain resilient.

Obsessive passion occurs when a task is done solely for the motivation of an external reward or recognition. The obsession with perfectionism and attaining your personal goal leads to overcontrolling your own and others’ behaviors which leads to conflicts, negative emotions, and frustration.

Several studies have shown that nurses and clinicians who demonstrate obsessive passion have decreased life satisfaction and burn-out whereas harmonious passion protects the nurse from burn-out, detachment, and irritability.

Identification of your core values is the first step to realizing your passion(s) and recognizing what is important to you. Then visualizing what it would look like if you achieved that outcome. Becoming clear of your values guides and empowers you to make decisions and life choices that will fuel your inner passion and provide you with a level of sustained inspiration and motivation.

• Positive psychology studies show that individuals who have the highest levels of success in life also have a large circle of friends, coworkers, and others who provide abundant support. They are far more likely than the average person to be satisfied in their Relationships at work, in their families, and in their social activities which fosters well-being.

Research has shown that when an individual is able to maintain a 3:1 positive-to-negative ratio with their thoughts they are more able to actively engage in courageous communication without negativity, defensiveness, anger, and hostility. They ask questions of each other and can understand what is going on in each other’s world which brings forth empathy with challenges and enthusiasm for their successes.

• Optimism and Pessimism are both learned ways of thinking:

Pessimistic thinking comes from having a fixed mindset and leads one to suffering and burn-out whereas Optimistic thinking leads to a growth mindset and hope.

When you experience a setback a fixed mindset presents problems because the story you tell yourself focuses on not having what it takes to reach the next level. Your pessimistic explanation will likely focus on your weaknesses, leaving you feeling too discouraged to continue to even try to make an effort. A fixed mindset automatically assumes you’re not good enough and leads you to conclude it’s best to just give up.

A growth mindset, however, assumes: “I can change. We can improve.” In addition to having better mental health, optimists perform better in their personal and professional lives. People who practice optimistic thinking when facing challenges have been shown to be healthier physically and live longer than pessimists!

• Choosing to be Proactive when facing challenges is the opposite of being reactive. People who are most successful at achieving their goals proactively play to their strengths – consciously deploying their best attributes in order to perform at their best. Proactively playing to your strengths empowers you to remain optimistic and resilient when facing challenges. Inner Character Strengths align with your values which align with your actions. Developing your inner strengths promotes personal well-being and is intrinsically motivating. Visit the VIA Institute website to take a free Character Strength Assessment: https://www.viacharacter.org/

People who use their strengths at work are six times more likely to be engaged in their jobs and have lower turnover, higher productivity, and greater patient satisfaction. (Sorenson, S. 2014)

Studies have shown that if you practice using your strengths for just 11 minutes a day, you will become a more Proactive person – and can respond to challenges with your best qualities: www.michellemcquaid.com/strengths-habit/

• Just like batteries, we are not all like the Energizer Bunny – especially healthcare providers caring for the sick, injured, or dying. It is imperative that to ward off stress and burn-out, healthcare providers need to have adequate physical, emotional, and mental Energy.

Recent research has shown that not everyone suffers adverse effects from stressful situations. In The Upside of Stress, Kelly McGonigal points out that “the most common effects of stress include strengths, growth and resilience”. With the proper mindset, stress can create positive changes: a sense of personal growth, increased appreciation for life, spiritual growth, enhanced social connections and relationships with others, and identifying new possibilities and life directions. How can you change your mindset? Every time you become aware of feeling stress, reframe your thinking to “I have energy available for dealing with this situation.” (McGonigal 2015)

Neuroscience research studies have shown that embracing a healthy diet, exercise, mindfulness, meditation, expressing gratitude and EFT tapping can all help to measurably decrease stress, increase your resilience and enhance your emotional and physical wellbeing.

• Leaving a Legacy; empowering yourself and others to bring purpose and meaning to the workplace and bringing out the best in each other, brings us the highest level of life satisfaction and optimal functioning; aka flourishing.

Try using the PROPEL Principles to give yourself an optimal growth mindset: Envision outcomes that honor and align with your values and ignite your passion, nurture and engage in positive relationships that provide support, embrace optimistic thinking that enables solutions, and deliberately practice using your strengths to remain proactive in your responses to workplace challenges. These practices will enable you to be your best self and you will flourish in your personal and professional lives! (Muha 2018) 

I was born in Redding, California. After my parents divorced, my mom moved my sister and me to a small town. Growing up, my sister regularly spoke for both of us. While this played a significant role regarding my shyness, I was invariably a happy kid. After the move, I developed a tight-knit friend group, consisting of 3 girls and me. Life was good, and we were content, aside from the occasional drama. However, as the years passed, things started to change. Little did I realize that that happy, shy girl would soon be gone.

Fast-forward eleven years to the beginning of ninth grade. I was at home sitting on my bed crying to my mom. I couldn’t process my sadness, nor did I know how to react. I felt numb and was unaware of the tears rolling down my cheeks. My heart was mentally breaking. Salty tears stung my eyes and my throat tightened. I felt my mom’s warm embrace as she sat beside me, assuring that things would be alright. Her cool hands wiped my tears, and she kissed my forehead. I wanted an explanation of why they were choosing to treat me in such ways. How could eleven years of friendship be forgotten?

While I may never understand, I can explain my side of the story. Unlike myself, these girls thrived on drama. They were the popular breed that needed attention to survive. Whenever problems occurred, they always revolved back to being my fault. My insecurities were thrown in my face and used against me. There was a never-ending competition, in which there was no finish line. I got broken down and was purposefully made to feel bad about myself.

Sadly, I started to believe these things and allowed myself to change. I was the girl who refused to walk on stage when her name was announced at award assemblies. In photos, I would hide in the back and pray not to be seen. I was the kid who chose not to dress up for Halloween because they didn’t want attention. I was embarrassed and didn’t want to give my friends another reason to take shots at me. They made me believe I was too fat or too stupid to experience these things. Being the butt of every joke became exhausting. Cutting me down only fed their starving insecurities. Yet, I constantly found myself apologizing.

I found myself spiraling. All I wanted to do was scream. I wanted to throw a tantrum, bellowing from the top of my lungs how mad and hurt I was. I wanted to say they were bad friends. That that was not how friends are supposed to treat each other. How I had been their number one supporter as they took the light inside of me, while I watched on the sidelines. How what they said and did hit deep for me. I wanted to tell them how they didn’t even know the real me. How I wasn’t allowed to have feelings, and they knew close to nothing about what I faced on the daily. How girls should empower girls, not tear them down. But I couldn’t. I not only had too much pride, but was too mature to give them the satisfaction of seeing me broken.

However, at the beginning of ninth grade, I was done. It was time to end this eleven-year toxic friendship. I removed myself little by little. I blocked their messages that would try to reel me back in. It was lonely at first, but I started branching out. Having lunch with different people and making new friendships felt exhilarating. I found myself feeling and less stressed. I was able to talk with my old friends and create a resolution. While we are no longer close, they can accept what I want. By taking these steps I found myself. I had a newfound confidence and was proud of my ability to stand up for myself. Overall, I learned that doing what is best for you, can make you stronger. While it is hard at first, I can promise it gets easier.

“The individual has always had to struggle to keep from being overwhelmed by the tribe. If you try it, you will be lonely often, and sometimes frightened. But no price is too high to pay for the privilege of owning yourself” – Friedrich Nietzsche.

This quote is the proof that you cannot please everyone in your surroundings, even your closest friends and/or family relatives can judge you no matter what the circumstances are, but if you tried to ignore and not letting all those accusations, misunderstanding and misconception to your systems that came from your toxic society, there’s a possibility that the negative effects of it will burn into a wild fire that you cannot even imagine that all those acts are doesn’t give you a stress and anxiety because you choose not to think of it and tried to break all the ties that connects them from you. Giving yourself a break and freedom can help you to understand yourself.

Owning yourself don’t require any payment, because all you have to do is to love yourself, including your weaknesses, flaws and/or imperfections. Maybe you can be lonely and frightened because you already break the strings, connections and attachments towards to your surroundings, but the positive impact of it is to practice to understand and loving yourself without any further thinking and questions towards to your decisions.

Being yourself don’t need to please everyone just for you to be likeable by many, but more so being yourself is the way of letting your wings flying freely above and between the oceans and the sky without bangle to your feet, chains to your hands and tape to your mouth.

Lastly, it is true that, sometimes we live for the satisfaction of our family or of other people, we wanted to meet their expectations and to always wanting them to be proud of us. But we never considered that living for the whelming of the others could lead ourselves to frustrations and worst depression. It is one of the causes, why people ended their own life because they failed to satisfy their family, because they are afraid of what others would tell them, and because they felt worthless. And that is the worst a person could do while she is living.

We have to keep reminded that living should be for ourselves, not for themselves. Living is necessary, you have to face failures taste, the bitterness of agony, before living in joy and of sweetness. We must stop living to be accepted by others, we must be ourselves and live for ourselves to be loved.

Primary school wasn’t as eventful as it was supposed to be for majority of children, instead it felt like I was drowning in what the world perceived me to be instead of who I wanted to be. As a child growing up, I never really knew who I was and how I should act. All I ever did was try to impress people that didn’t even like me.

Coming into high school, I’ve learnt how to stay true to one’s self, and if people don’t like you, one shouldn’t change themselves just to get approval from other sources, “you do you” as my dad would say. The greatest key I’ve learnt to staying original is to surround myself with positive people, as well as people who know what their morals and values are in life. Family is also very important as they are able to support you during the hard times, as well as your victories.

Imagine living in a world full of people who act the same way that you do, without hesitation and discomfort. Imagine a world where every single person looks exactly like you. I for one would be scared to live in a world filled with people who look exactly like me as well as act like me. This is why originality is so important; not only are you being yourself, but you’re also sharing an amazing light that can encourage people to become themselves. God created all of us to be unique, and that uniqueness in us is what creates our many and different characteristics. Why would you as a human being want to change the way you look and act just to please others? Why have plastic surgery just to look like somebody else? Why beat yourself down for not meeting society’s standards? All this destroys originality. Being a copy of someone else will make you unhappy and the ultimate goal in life should be to find yourself and be happy.

The older I get the more I realize that being ourselves is the best thing we can experience. You’re not wasting your life on meaningless things that don’t define who you are, instead you are working on how to create a better you. Being the best you in this day and age takes a lot of patience as well as self-care.

“Be who you are and say what you feel, because those who mind don’t matter, and those who matter don’t mind” – Bernard M. Baruch.