Ever wondered why Healthcare lacks CARE?

I have a theory. Healthcare is like a pressure cooker. There is evidence that suggests if you ever wanted to replicate the conditions of a battle field, you’d walk onto a modern, busy, hospital ward.

It’s a battlefield

According to a US report into work-related stress in nursing published some years ago, if you wanted to create the optimum conditions for stress, “many of the factors you would include would be clearly recognised by nursing staff as events which they encounter in their daily routine. These include an enclosed atmosphere, time pressures, excessive noise, sudden swings from intense to mundane tasks, no second chance, unpleasant sights and sounds and standing for long hours.” The report asserts that a “situation which is typically experienced as stressful is perceived to involve work demands that are threatening or which are not well matched to knowledge, skills and ability to cope of the nurses involved, work which does not fulfil someone’s needs, particularly where nurses have little control over work or receive little support at work or at home.”

It is not a new phenomenon. Way back in 1984, Hingley explained that

“Everyday the nurse confronts stark suffering, grief and death as few other people do. Many nursing tasks are mundane and unrewarding. Many are, by normal standards, distasteful and disgusting. Others are often degrading; some are simply frightening…”

And while the stressors may have changed somewhat – the expectations on health care workers, and managers have increased, and often exceed their ability to meet – the experience of incompetence, fear and frustration, has not. And this stress extends to every level from the floor to the highest levels of government where policy and funding decision, and the cut and thrust of politics and issues management, ‘feel’ like life and death.

Fear and flight hijacks our capacity for higher order thinking

Under these conditions, people tend to default to their least evolved selves. Under this pressure, our psyche feels under threat, we snap into survival mode and we can lose our ability to think clearly and rationally, and our heads go into self-protection mode. We become more concerned about our-selves – our survival, and less concerned about others and the bigger picture.    Our thinking then manifests as defensiveness, offensiveness, abrupt and snappy tones, and an inability and unwillingness to be empathetic and listen to what others think or feel. We become consumed with the need to be right, to get our points across and win – or, to be liked, forgiven, or validated.

And it does not matter how ‘high’ you go up the food chain, when you start feeling threatened and frightened, you stop thinking like a self-empowered, self-actualising human being, and you start thinking and behaving like someone who is just in the trenches, waiting for the next barrage or onslaught.

This then becomes the culture of the unit, the organisation and even the whole sector, which creates its own stress – and you have a vicious cycle.

How to put the CARE back into healthcare

To change a culture, every single individual must take personal responsibility for how they are being, even in the moments of great stress. So to put the care back into healthcare, you – yes you – must:

• Understand how you think and behave under stress – do you default to being right or being liked?
• Notice what situations trigger this in you?
• In these moments – breath and tap into how you are feeling, thinking and for extra points, ask yourself why? That immediately stops you ‘losing it’, and, ironically, helps you maintain a broader focus of the situation.
• Decide whether and how you want to respond?
• And have the courage to be completely COUNTER CULTURAL! Be that person who does not get aggressive, defensive, snappy or withdrawn. Be you on your best day.