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October 2010

October 2010

Physicians lack confidence to counsel patients on lifestyle

This article from HealthLeaders Media is a perfect example of what we found in our research, self-caring must come first. The study done at the University of Wisconsin concluded: “personal behaviors [of physicians] including regular exercise and better training in counseling techniques may improve patient counseling.”

While this research only focused on diet and exercise, it’s a microcosm of the universe of self-caring. Personal practices at home (Dimension #1) and at work (Dimension #2) equip all of us to have more meaningful interactions with others (Dimension #3).

The top barrier for physicians not exercising: their work schedule. This gets to Dimensions #4 and #5. What does that say about our “healthcare” when our healthcare organizations don’t have processes and business models that support well-being and self-caring?


September 2010

September 2010

“Broken” left us wondering how could an organization that is supposed to be based on care, not have processes to care for their caretakers

Posted on Health Beat by Maggie Mahar, this article relates the story of a third-year medical student witnessing her obstetrics chief resident’s teary response to both a mother and baby not surviving a traumatic emergency after the mother was stabbed to death. The sad events that unfolded in the ER left the chief resident sobbing, alone, in the nurses station, with no support.

If self-caring was the focus of the experience strategy, support structures would be in place when medicine breaks the care-givers. What experience would be most supportive? Rather then the doctor left to cope, on her own, crying in the nurses station, would there be a “safe space” to go for a while, and would this time alone be encouraged and expected? Would there be someone dedicated to talk with those involved immediately after the trauma? Perhaps there would be a universal “code lavender” chime so everyone pauses to send healing intentions, even if most of the staff is unaware of the particular circumstances. The opportunities are endless when viewed through the lens of primarily caring for the caregivers first by weaving self-caring into the fabric of the “beinginess” of the organization.

The author of the story concludes that her experience is that at some point most doctors experience being “broken” by similar experiences, and “how we started out suffering with our patients, but ended up suffering from them.” We cannot give what we don’t have. A health”care” system requires self-caring first.

The numbers are in: companies that operate from core values of care and compassion far surpass returns on the S&P500

This article from IONS, “The Evolutionary Imperative for Business” brilliantly explains how managing people from the perspective the industrial model of attempting to mold behavior so people operate as if we are machines doesn’t work. Managing a company like a living organism results in empowering people with an adaptive spirit necessary to respond to uncertainty and complexity of our modern world. Living systems require care and compassion to survive and thrive. Jay Braydon’s LAMP index demonstrates that companies that “operate with integrity (where the means align with the ends), value their employees, and follow the principles of nature” actually make more money than companies that do not operate from values of care and compassion.

EIM’s 5 Dimensions of self-caring provide a road map to curate the experience so all aspects of the organization, and the people within that living system, experience a state of “beingness” of healing and caring.

Hospital CEO leads on-site fitness classes

Showcasing the inconsistency between Dimension #2, personal practices at work, and Dimension #5, the business model

This article from USA Today starts out looking like a model to emulate. The CEO leads a fast-paced workout in the hospital fitness room. Talk about bringing personal practices into the workplace and leading by example. Evidence of changes in processes (Dimension #4) appear as we read about juice replacing soft drinks in vending machines and meetings being conduced while strolling the hospital campus.

Then read the comment from “hoomatt.” He was a nurse at this same organization. When he needed surgery, he elected to have it where he worked. A “botched” (his word) gall bladder removal left him in month-long coma. After 2 months in the hospital, the day before he stumbles home his supervisor tells him he’s fired. He relates that no one apologized or offered any sort of support;and he felt the organization failed to live up to the Catholic Values that were “plastered” all over.

Business models involve 3 aspects: values & mission; culture & stories and practices & policies. The juxtaposition of these two different experiences of the same organization, demonstrates the role and value of each of the 5 Dimensions.

This CEO recognized the connection between her passion for fitness and her career, understanding that when people feel better, they do better. It’s equally important to recognize the connection between all the dimensions of self-caring.

Self-caring in one area (juice or exercise) can’t make up for organizational ways of being that aren’t founded on self-caring.


August 2010

Sobering findings from Robert Wood Johnson Project illuminate challenges of inter-professional integration


This article talks about the challenges of having a collaborative healthcare environment – from truly integrating what gets labeled as “CAM,” to relationships between doctors and nurses. In our research, collaboration was mentioned as a key ingredient of self-caring. If the lens for what is done and how it’s done was first “what is self-caring in this situation?” and knowing collaboration is key, does that create a shift to allow collaboration to occur? Most human beings benefit from collaboration. That’s self-caring to seek it out and find ways to create it.


How many times a day can you identify opportunities to collaborate? Do you reach out to hear other views? Do you include others in processes and decisions? How do you feel when people reach out to you to collaborate? Feel good? That’s self-caring. Pass it on.

Could better corporate ethics have prevented BP oil spill?


Have you heard of triple bottom line economics? This is new to us, and we find it inspiring. Imagine instead of just measuring money, business success required measuring the well-being of communities and the environment. That’s what business professors are saying is needed. And they use the BP spill as their example of what not to do. Triple bottom line economics reflect self-caring in both processes (4th dimension) and the business model (5th dimension).


Surely, if self-caring was a guide, information BP workers reported would have been acted on differently; surely there would have been multiple backups for the valves that failed; and surely, even if all of that still resulted in a spill, the technology to clean it up would be vastly different – because preserving the environment would have been key in all aspects of the business processes. We can’t have healthy human beings without a healthy environment – that’s self-caring.


The ethics of gold


What caught our attention in this article isn’t about gold, or even the financial industry melt down. What captured our attention was this statement: ” . . . as organizations they implemented policies over the past several decades that knowingly—or they should have known—would eventually lead to great financial and economic hardship.” While one may argue that self-caring is the pursuit of financial gain at all costs, that’s not what our research revealed. As as evidenced by what’s happening in the economy, short term gain doesn’t lead to a longer term positive impact that would reflect self-caring.


If people within an organization collectively make decisions and create processes based on the act of self-caring (at a deep level), will the result ever be policies that they know or should know eventually lead to great financial hardship? We think not. Perhaps this is an example of how making decisions based on the impact 7 generations out would serve all living beings well.


Consider what you do within your organization on a daily basis. Is it in alignment with self-caring? From the tenor of the conversations, to perhaps not “allowing” a customer service representative to do the right thing to fix a customer issue, to processes that drain souls; what do you experience? Is being in a challenging environment self-caring? What can you adjust to create self-caring experience for yourself? That might just mean taking a walk or changing your own language choices.


The impact of LEAN on human beings and healing

The Minnesota Nurses Association created a video on their take on applying Toyota’s processes to hospital processes. View the video here.


It is time for leaders to embrace a new form of efficiency – human efficiency – especially in healthcare and it starts with the awareness that the best healing agent we have is within each of us. We need to switch our focus away from DOing more toward BEing more of who we are in each and every interaction and bring our whole selves to the healing experience. When we take time to connect with ourselves and others as the conscious, compassionate human beings – that we all are – we promote healing which improve outcomes, reduce the costs, and creates meaning. I wonder how many organizations are now addicted to LEAN and use it as the prescription to every symptom and disease plaguing their organization. Interesting enough, numerous studies show that the focus on LEAN in healthcare over the past 12 + years, has not alleviated many of the symptoms such as: safety, errors, turnover, burnout, and dissatisfaction, and in many cases things have gotten worse. Isn’t this our wake up call? Or have we, as some suggest, not hit bottom yet? Perhaps it’s time for a 12-step program to break this addiction to LEAN in healthcare and first, acknowledge we have a problem and then second, make a conscious decision to look at not only what we do and how we do but also who we are in the moment so we can all be agents of healing. —Nancy