- Email: [email protected]
Maintaining the creative edge during health care reform
NURSING EDUCATION Column Editor: Myrtle Williams, MSN, RNC, CNAA
Maintaining the Creative Edge During Health Care Reform Beth S. Martin, MS, RN, CS L L SECTORS within health care are engaged in measures to reshape the way work is done. It is more crucial now than any other time in our memories to stimulate creativity and to develop innovative practices in meeting the challenges of health care. But being creative in times of such dramatic change is not easy. The change we face is producing tremendous stress through all levels of health care providers and administrators. Our experience of this situation could be likened to being in the midst of chaos. How can we be creative under such conditions? Yet creativity is exactly what we need at this time in order to face and adapt to the demands of this era. The purpose of this article is to prepare the reader who is facing change or is needing to help educate others to manage during times of chaos. The article outlines steps to facilitate individual creativity during these chaotic times. The steps are assessing your values, breaking down barriers, and grounding yourself during change.
ASSESSING YOUR VALUES Creativity is an expression of our inner values. During times of dramatic change, these values are challenged. Being fully emersed in the change, we may not realize that what we are experiencing is a threat to one or more of our values.
From the Center for Nursing Development, Texas Children's Hospital, Houston, TX. Address reprint requests to Beth S. Martin, MS, RN,, CS, Texas Children's Hospital, MC 4-3250, 6621 Fannin St, Houston, TX 77030. Copyright 9 1996 by W.B. Saunders Company 0882-5963/96/1103-001253.00/0
200
Action Steps 1. Clarify values. Does it seem that your values are being tested by the changes that are being made? Is it the reality that needs realigning to your values or do your values need modifying to the changing circumstances? The answer to these questions requires knowing what impact you can have on the circumstances around you. 2. Test the reality. You will want to seek information from as many sources as possible. Read professional journals, attend professional meetings and conferences. Ask if what you are experiencing is happening to others? Chances are, much of what you are experiencing is being felt by many or most institutions. 3. Determine choices. You may determine that the values being affected are too important to you to change. In that case, you must decide to move on to another position or institution that allows you to express what is important to you. Be certain that by making this move you are not maintaining one set of values only to have another set challenged by your new situation. If you decide to stay in your present role, you will need to take steps to realign your value system to the new circumstances. 4. Allow time to grieve. In adapting to your new circumstances, you will need to give yourself time and the necessary resources to help you grieve the loss of what you held important. Values are deeply routed in our lives, we don't modify them easily. Seek support during this time, be gentle with yourself, and ask those around you for understanding. 5. Old values in a new package. Explore the possibility of maintaining your values but expressing them in a new way. Patient care providers are positioned to move into new areas to
Journal of Pediatric Nursing, Vol 11, No 3 (June), 1996
MAINTAINING THE CREATIVE EDGE
provide care. Will your core values of providing care to pediatric clients still be allowed expression in one of these new arenas? As you move through the above action steps, you may be able to discriminate whether you are experiencing an actual or perceived threat to your values. If it is a perceived threat, it will not hold up under closer scrutiny. There is pain involved in the change process. The intensity of distress often causes people to resist or avoid changes they face. We need to review our values every now and then to see if they need redefining when the circumstances of our lives and environments have changed.
BREAKING DOWN BARRIERS To tap into our creative capacity, we must be willing to break down the barriers we have established over time that inhibit us. We need to examine blocks to creativity and review the habits under which we are operating. When we act or think habitually, we are closed to new possibilities. This limits our growth potential and capabilities.
Action Steps 1. Determine if any of these blocks fit your patterns of behavior (Miller, 1992): 9 Accepting conventional wisdom 9 Lacking time to explore new ideas 9 Satisfying only the perceived needs of others 9 Compartmentalizing problems 9 Looking for the quick yes or no answer 9 Fearing rejection of ideas 9 Being afraid to make a mistake 9 Expecting others to be the creative ones 9 Being unwilling to question others 9 Being unwilling to accept others' input 9 Being unwilling to collaborate If any of these blocks are characteristics of your behaviors, take action to transform them. They are old patterns of behaviors that will not work for you in these times. 2. Do something different. Habits are only helpful when we need quick responses to routine circumstances. See different possibilities to the everyday tasks you perform. Take a different route home from work. Do something different around your colleagues and see how you feel. Use your imagination. 3. Shift the context. Look at things in a new way. When you see A B C . . . X Y Z what do you
201
think of? Can you imagine that these 26 letters comprise all the great masterpieces of our written language? Talk to someone with a different point of view, role, or focus from yours to get their perspective on things.
GROUNDING DURING CHANGE Today, things seem anything but routine, even in the most routine part of our day. During dramatic personal and institutional changes, you must balance your habit-busting activities with grounding behaviors. Grounding gives you a sense of continuity, certainness, consistency. It is what makes you feel secure and stable even in the midst of chaos.
Action Steps 1. Keep Focused. We are here because of the patient and we must not lose the patient in the chaos. But if each one of us keeps that foremost in our minds as we move through the pain and struggle of the changes, the patient will come through this better than before. 2. Know the facts. Look for the facts not only in what you are doing and why, but also in what your institution is doing and why. What are the internal forces creating the change? What are the external forces (outside the institution) pushing for change? 3. Look for familiarity. Not everything is changed. You can look to your personal life, your relationships with your colleagues, or various aspects of your work environment for varying degrees of stability. You may begin to see that there is more familiarity than you thought in the changes, once you begin to look a little closer. 4. Plan. What do you want out of the change? The Chinese symbol for chaos means both danger and opportunity. Are you only protecting yourself from the danger, or are you taking the opportunity to plan for new possibilities in the change? It may be learning new skills, returning to school, or taking on a new role. Going forward through change is not risk and pain free, but if we do not take the responsibility to be a part of change, we will be its victims rather than its participants.
REFERENCES Miller, C. (1992). The Creative Edge: Fostering Innovation Where You Work. Reading, MA: Addison-Wesley.
Maintaining the Creative Edge During Health Care Reform Beth S. Martin, MS, RN, CS L L SECTORS within health care are engaged in measures to reshape the way work is done. It is more crucial now than any other time in our memories to stimulate creativity and to develop innovative practices in meeting the challenges of health care. But being creative in times of such dramatic change is not easy. The change we face is producing tremendous stress through all levels of health care providers and administrators. Our experience of this situation could be likened to being in the midst of chaos. How can we be creative under such conditions? Yet creativity is exactly what we need at this time in order to face and adapt to the demands of this era. The purpose of this article is to prepare the reader who is facing change or is needing to help educate others to manage during times of chaos. The article outlines steps to facilitate individual creativity during these chaotic times. The steps are assessing your values, breaking down barriers, and grounding yourself during change.
ASSESSING YOUR VALUES Creativity is an expression of our inner values. During times of dramatic change, these values are challenged. Being fully emersed in the change, we may not realize that what we are experiencing is a threat to one or more of our values.
From the Center for Nursing Development, Texas Children's Hospital, Houston, TX. Address reprint requests to Beth S. Martin, MS, RN,, CS, Texas Children's Hospital, MC 4-3250, 6621 Fannin St, Houston, TX 77030. Copyright 9 1996 by W.B. Saunders Company 0882-5963/96/1103-001253.00/0
200
Action Steps 1. Clarify values. Does it seem that your values are being tested by the changes that are being made? Is it the reality that needs realigning to your values or do your values need modifying to the changing circumstances? The answer to these questions requires knowing what impact you can have on the circumstances around you. 2. Test the reality. You will want to seek information from as many sources as possible. Read professional journals, attend professional meetings and conferences. Ask if what you are experiencing is happening to others? Chances are, much of what you are experiencing is being felt by many or most institutions. 3. Determine choices. You may determine that the values being affected are too important to you to change. In that case, you must decide to move on to another position or institution that allows you to express what is important to you. Be certain that by making this move you are not maintaining one set of values only to have another set challenged by your new situation. If you decide to stay in your present role, you will need to take steps to realign your value system to the new circumstances. 4. Allow time to grieve. In adapting to your new circumstances, you will need to give yourself time and the necessary resources to help you grieve the loss of what you held important. Values are deeply routed in our lives, we don't modify them easily. Seek support during this time, be gentle with yourself, and ask those around you for understanding. 5. Old values in a new package. Explore the possibility of maintaining your values but expressing them in a new way. Patient care providers are positioned to move into new areas to
Journal of Pediatric Nursing, Vol 11, No 3 (June), 1996
MAINTAINING THE CREATIVE EDGE
provide care. Will your core values of providing care to pediatric clients still be allowed expression in one of these new arenas? As you move through the above action steps, you may be able to discriminate whether you are experiencing an actual or perceived threat to your values. If it is a perceived threat, it will not hold up under closer scrutiny. There is pain involved in the change process. The intensity of distress often causes people to resist or avoid changes they face. We need to review our values every now and then to see if they need redefining when the circumstances of our lives and environments have changed.
BREAKING DOWN BARRIERS To tap into our creative capacity, we must be willing to break down the barriers we have established over time that inhibit us. We need to examine blocks to creativity and review the habits under which we are operating. When we act or think habitually, we are closed to new possibilities. This limits our growth potential and capabilities.
Action Steps 1. Determine if any of these blocks fit your patterns of behavior (Miller, 1992): 9 Accepting conventional wisdom 9 Lacking time to explore new ideas 9 Satisfying only the perceived needs of others 9 Compartmentalizing problems 9 Looking for the quick yes or no answer 9 Fearing rejection of ideas 9 Being afraid to make a mistake 9 Expecting others to be the creative ones 9 Being unwilling to question others 9 Being unwilling to accept others' input 9 Being unwilling to collaborate If any of these blocks are characteristics of your behaviors, take action to transform them. They are old patterns of behaviors that will not work for you in these times. 2. Do something different. Habits are only helpful when we need quick responses to routine circumstances. See different possibilities to the everyday tasks you perform. Take a different route home from work. Do something different around your colleagues and see how you feel. Use your imagination. 3. Shift the context. Look at things in a new way. When you see A B C . . . X Y Z what do you
201
think of? Can you imagine that these 26 letters comprise all the great masterpieces of our written language? Talk to someone with a different point of view, role, or focus from yours to get their perspective on things.
GROUNDING DURING CHANGE Today, things seem anything but routine, even in the most routine part of our day. During dramatic personal and institutional changes, you must balance your habit-busting activities with grounding behaviors. Grounding gives you a sense of continuity, certainness, consistency. It is what makes you feel secure and stable even in the midst of chaos.
Action Steps 1. Keep Focused. We are here because of the patient and we must not lose the patient in the chaos. But if each one of us keeps that foremost in our minds as we move through the pain and struggle of the changes, the patient will come through this better than before. 2. Know the facts. Look for the facts not only in what you are doing and why, but also in what your institution is doing and why. What are the internal forces creating the change? What are the external forces (outside the institution) pushing for change? 3. Look for familiarity. Not everything is changed. You can look to your personal life, your relationships with your colleagues, or various aspects of your work environment for varying degrees of stability. You may begin to see that there is more familiarity than you thought in the changes, once you begin to look a little closer. 4. Plan. What do you want out of the change? The Chinese symbol for chaos means both danger and opportunity. Are you only protecting yourself from the danger, or are you taking the opportunity to plan for new possibilities in the change? It may be learning new skills, returning to school, or taking on a new role. Going forward through change is not risk and pain free, but if we do not take the responsibility to be a part of change, we will be its victims rather than its participants.
REFERENCES Miller, C. (1992). The Creative Edge: Fostering Innovation Where You Work. Reading, MA: Addison-Wesley.