Negative to positive: current thoughts

There is something magical that happens when you surround yourself with positive energy, a team of creative people who look at situations in an altogether different way. It is contagious. By leaving the negative, hopeless, destructive elements behind, you free yourself to fly—‘flying with eagles, not strutting with turkeys.’ I have been privileged to fly with some eagles and a few condors, soaring above the landscape of healthcare, taking on a unique perspective and making change work. This is in a time when health care is under a great deal of stress: increasing complexity, strained resources, high expectations, new challenges. And the system we work in isn’t one that is receptive to improvement strategies: the plug and socket is often absent. New ideas, novel methods, a quality improvement idea that’s worth a try, adapting and adopting, listening to patients, sharing data, embracing technology—all in need of a champion.Read: The merits of maggot therapyBeing a champion in healthcare isn’t easy. As an infantryman in the trenches, one thinks twice before peeking ‘over the top.’ You can get shot. Maybe it is easier to sit down low, polish your rifle, write that note back home, or smoke a cigarette. Let someone else take the hit.I note that most of my day in the office is spent listening to patients unload their problems, concerns, woes on me. My job is to sort the important from the rest, adduce further evidence, make a plan of attack, and educate (or reassure) the person in front of me. To be a good doctor and nurse, this should be done with some degree of empathy—we call it caring—that is often built on a foundation of knowledge and experience. At work, positive energy comes in different forms. “I understand your concerns, but even with your family history factored in, this is almost certainly NOT angina.” Or: “There are new therapies out there that have completely changed the face of breast cancer.” Or: “Let me make a phone call and see if we can move that CT appointment forward.” The energy wave is shared with the spouse sitting nearby, and the family breathe a sigh of relief.Read: The cases you never forgetSo, what can we do to infuse positivism into healthcare systems? Firstly, acknowledge the value of, and encourage the concept of, change. Make it easy to suggest a better way, and give credit for engagement. The healthcare system should be responsive and reactive to the needs of those we serve: patients. Secondly, learn what it is to be a positive team player, whether through taking courses, or by example, or from patients. The healthcare industry is like other industries: agencies for the manufacture of well-being (preventative or reactive). CEOs are found within the administrative structure, directing the efforts of care providers through example and with enthusiasm. Generals and admirals might be easily recognised, but the captains and privates in the trenches are key to winning battles. Seldom do they get the recognition or reward they deserve.Good communication, respect, and facilitated learning are all ways of promoting a positive attitude in the workplace, wherever that may be. We can learn from our past to better understand our present, and shape a better future. That will not happen in an environment of negative energy. Thirdly, positivism is well known in Business Research Methodology. It identifies the positivistic approach as being independent, based on hypotheses and deductions arising from experience with large numbers, based on statistical probability and dependent on measurements to confirm causality.1 Studies have also shown the benefit of positivity on health: patients may be better protected against inflammatory disease or stress, and have stronger immune systems.2 Healthcare providers also benefit from positive psychology resources in sustaining mental and physical wellbeing.3I am optimistic. Where does that come from? Well, the alternative isn’t good. It leads us to a dark place. I want to live in the light, with colour and structure. I will need a highly functional team to look after me (and my family) when I am ill. I cherish positivism, and hope everyone working in my profession has the good fortune to become part of a great team. Those members who have yet to ‘taste nectar’ can be trained to be better doctors or nurses. The spread to others is—thankfully—free.*Addendum: I was asked to go one step further. What sort of change is needed to allow healthcare providers to excel? I came up with shortlist that included:Ask for patient input at all levels of health care (e.g., ER planning).Healthcare providers should have greater access to data dashboards.QI methodology training should be ubiquitous for all healthcare personnel.Serious Adverse Events should be reported, without delay, without any attribution of blame.Medications should be affordable, prices set by government (not pharma).Courses in positive psychology, like leadership and QI, should be subsidized.What are other countries doing to mitigate the death toll of opiates?Can we not do more for mental health, including inpatient beds?Physician/nurse burnout is real. ‘Look after those who look after others.’ Debrief critical incidents, assess impact of hi-stress work, provide resilience training (c.f. the military).Create mechanisms for new idea input and review—across the boardReferences:Positivism Research Philosophy. John Dudovsky. BRM https://research-methodology.net/research-philosophy/positivism/The Power of Positive Thinking. John Hopkins Medicine.Yanek, LR. https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-power-of-positive-thinkingPositive Psychology in Healthcare Professionals. Liu, L. Psychology 28Mar2022. Doi: org/10.3389/fpsyg.2022.883603 Further reading:Positive Psychology in Lifestyle Medicine and Health Care: Strategies for ImplementationLianov, L et al. American J Lifestyle Med (2019). DOI: 10.1177/1559827619838992

Negative to positive: current thoughts

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