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Precision Vision: Empowering Innovation and Well-being

July/August 2020

 

Elizabeth CardElizabeth Card, MSN, APRN, FNP-BC, CPAN, CCRP, FASPAN
ASPAN President 2020-2021

There is an interesting concept of dualism. This “yin and yang” is rooted in ancient Chinese philosophy and describes how opposites or contrasting forces actually work in concert and are complementary.1 In the natural world, this interconnected, interdependent relationship results in an eloquent balance. The beauty resulting from this yin and yang balance of light and dark is evident in the astonishingly gorgeous Water Lilies paintings by Claude Monet.2 He famously painted series of the same object, such as the water lilies, at different hours of the day, an innovative demonstration of this delicate interaction between the light and dark evolving. Julia Child instructed how to pair food and drinks based on this same concept.3 By combining strong opposites, the quality of palate experience improves dramatically resulting from the degree of differences. A classic example, such as pairing sweet and sour with spicy, results in a combination with more structure, like the timeless pairing of margaritas with Mexican food. As perianesthesia nurses, we practice in an environment that is complex and full of this duality.

Experiences Make Us More Resilient 
During one of the most challenging days in my nursing career, both of my patients coded at the same time. We reintubated one, and, thankfully, he stabilized. However, with my other patient I brought in the family, the chaplain and eventually transported this patient to the morgue. That now empty room was also the only empty critical care bed in the hospital with an overflowing ER. I readmitted another patient who was struggling, but we got him through the night. I spent the entire shift praying and caring for these three patients. Today, I am a skilled nurse practitioner because of experiences such as these. 

There is an African proverb I love: “Smooth seas do not make skillful sailors.”This is so true. It is the challenges in life that smooth our rough edges. These experiences refine and shape us into something more resilient. My nurse friends in New York City, New Jersey and Maryland have had strings of those kinds of shifts this spring. Yet, what they talk about are the wins, the patients they discharged home, or the dignity and kindness they provided to the patients that died during their shift.

Was it Just Luck?
Recently, The Washington Post reported on a remarkable story that demonstrates the lasting impact of a positive attitude. Deirdre Taylor was a four-year-old rescued from her burning family’s apartment. She only knew the firefighter who carried her to safety that day through the black-and-white photos on the front page of The New York Daily News in 1983. For three decades, she longed to find the firefighter, to thank him in person. But, after the 9/11 devastation in the same area of New York City, she feared that firefighter may have perished. 

This spring, Deirdre, now a registered nurse in Virginia, answered Mayor de Blasio’s urgent call for nurses to respond to the pandemic.6 Deirdre took an 8-week assignment in a New York City emergency department in the same area of town in which she had grown up. She brought the faded and yellowing New York Daily News article with her, telling The Washington Post, “had he not been there, I would not be alive today.”5 Her luck came in the form of Ladder 20 firefighters delivering pizza to the ED staff. She explained who she was looking for and was connected to her rescuer, Gene Pugliese. 

Gene is now 70 years old and retired, but still came by the Ladder 20 fire station regularly. Gene confided to The Washington Post he had received a medal of valor for rescuing Deidre. It was the proudest moment of his long career, and he had dreamed about it as recently as two weeks before Deidre contacted him to thank him. What a beautiful story!

The Duality of Life
In the duality in life, the yin/yang, the good/bad, the light/dark, it is what we focus on and contribute to that matters. My dad likes to say: “The main thing, is to keep the main thing, the main thing.” Along these same lines, fellow ASPAN member Beth Cooper sent me a note which read, “Attract what you expect, reflect what you deserve, become what you respect, mirror what you admire.” Looking for the positive helps us focus and maintain our well-being. 

Focus on the Positive for Well-being
However, finding and maintaining this positive focus can be challenging. Psychologists Dr. Seligman and Dr. Csikszentmihalyi recognized this challenge and founded positive psychology, a guide to helping people achieve well-being.They created an intervention to improve happiness, establish well-being through individuals creating a new habit of focusing on three good things that happen each day for one month. Their follow up data six months later revealed the positive effects of this exercise were long lasting.8 

Another research study, based in part on positive psychology in 2017, sought to establish and test an easy method for neonatal ICU nurses to create this positive focus and maintain well-being.9 The researchers used "The Three Good Things" questions and had the participants answer them each day for a two-week period. Their findings again found individuals experienced improved well-being and happiness through this exercise. I found this fascinating. 

In the Vanderbilt and ASPAN Resiliency Programs, created from the findings from my ASPAN Burnout and Resiliency research study, we incorporate the Three Good Things exercise.10 This electronic Gratitude Journal is available for all ASPAN members, free of charge. It is available by scanning the QR code below to sign up:  

Or copy the link below… 
https://redcap.vanderbilt.edu/surveys/?s=M4H4TW97E4

The ASPAN Well-being Strategic Work Team (SWT) will be launching additional projects, collabo-rations and posting resources on well-being in the next 12 months. Austrian psychiatrist and Hol-ocaust survivor Viktor Frankl wrote: “When we are no longer able to change a situation - we are challenged to change ourselves.”11 We each have the capacity to shift our thinking, focus on the positive,  appreciate the duality of our lives, and create well-being.

REFERENCES

  1. Yin and Yang. Wikipedia website. Accessed May 28, 2020. https://en.wikipedia.org/wiki/Yin_and_yang
  2. Monet C. Water Lilies. Art Institute of Chicago website. Accessed May 28, 2020. https://www.artic.edu/artworks/16568/water-lilies 
  3. Accent on Beverages: Drinks Complete the Meal. Julia Child Food Pairing Guide. PBS website. Accessed May 28, 2020. https://www.pbs.org/food/features/accent-on-beverages-drinks-complete-the-meal/
  4. Weiss JP. Smooth seas do not make skillful sailors. John P Weiss website. Accessed June 8, 2020. https://johnpweiss.com/blog/115972/smooth-seas-do-not-make-skillful-sailors
  5. Flynn M. A nurse went to New York to work on the front lines — and to find the firefighter who saved her life over 36 years ago. Washington Post website. Accessed May 28, 2020. https://www.washingtonpost.com/nation/2020/05/28/nurse-thanks-firefighter-new-york/
  6. Mayor de Blasio Calls for Draft of Essential Medical Personnel. NYC.gov website. Ac-cessed May 28, 2020. https://www1.nyc.gov/office-of-the-mayor/news/218-20/mayor-de-blasio-calls-draft-essential-medical-personnel
  7. Seligman ME, Csikszentmihalyi M. Positive psychology: an introduction. Am Psychol. 2000;55:5–14.
  8. Seligman ME, Steen TA, Park N, et al. Positive psychology progress: empirical validation of interventions. Am Psychol. 2005;60:410–21.
  9. Rippstein-Leuenberger K, Mauthner O,Sexton JB, Schwendimann R. A qualitative analy-sis of the Three Good Things intervention in healthcare workers. BMJ Open. 2017. https://doi.org/10.1136/bmjopen-2017-015826
  10. Card EB, et al. Burnout and resiliency in perianesthesia nurses: findings and recommen-dations from a national study of members of the American Society of PeriAnesthesia Nurses. J Perianesth Nurs. 2019;34(6):1130-1145.
  11. Frankl V. Viktor Frankl and the search for meaning: a conversation with Alexander Vesely and Mary Cimiluca. Daily Good website. Accessed May 28, 2020. http://www.dailygood.org/story/1578/viktor-frankl-and-the-search-for-meaning-a-conversation-with-alexander-vesely-and-mary-cimiluca/ 

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