I was recently in a meeting where nurses tearfully shared the burden that they feel in meeting (or failing to meet) the priorities and expectations set forth by leadership and healthcare in general. The underlying sentiment of their stories was, “my best isn’t good enough.” I could hear their disappointment in themselves, in addition to the disappointment they perceived from others. On the eve of National Nurses’ Week, a time of great celebration of nurses and all they do for patients, this was difficult to hear. In a time where society as a whole might be exhaling with a feeling of relief from making it through the pandemic, nurses are holding their breath, trying to muscle it through the challenges left over from the pandemic, primarily staffing and supplies. Rather than lamenting about the challenges, or offering suggestions about how to deal with it, I want to talk to you about you; about how you mentally and emotionally deal with your new ‘best’. I’m going to use an analogy about a fictitious trauma patient.
Sarah is in college, just finishing up her exams. She has a summer trip planned with her friends, and she’s packing up her dorm room, to stay with her parents for the summer. She’s in great health and enjoys an occasional run and plays tennis with her friends when she can. This is Sarah’s true physical, mental, and emotional ‘best’. On a trip home to take some things back to her parents, she’s involved in a head-on collision. She has multiple injuries, ranging from cuts and bruises, to a ruptured spleen, fractured pelvis, and crushed leg, requiring multiple surgeries. After a period of time, it’s time for Sarah to begin physical therapy. Sarah’s had a good breakfast, she’s had other needs attended to, she’s had pain medication, and she’s in good spirits. She’s nervous about what it will feel like to get out of bed for the first time but she’s ready to give it her ‘best’. She has a good therapy session, where she worked on walking, and though she’s exhausted, she feels accomplished. This is Sarah’s new ‘best’. Every bit of Sarah’s (and others’) expectations should be compared to her new ‘best’, because her true ‘best’ is an unrealistic expectation at this point. In a couple of days, it’s time for therapy again, and Sarah just doesn’t feel good. She’s in more pain than usual, she missed a well-wishing call from a friend, and she’s remembering the plans she had for the summer. The realization that this is going to be a long, hard road is setting in, and she feels discouraged. She attempts to engage in therapy, but she didn’t meet the same goals she hit a few days ago. She feels disappointed because she didn’t do her ‘best’. She’s worried that others will think she didn’t do her ‘best’. As her nurse, I bet you’d challenge Sarah’s mindset. You would tell Sarah that her ‘best’ is the most she can give/be, given the circumstances of what is going on with and around her. You’d tell her that she is going to have good days and bad days. You would tell her, her ‘best’ is a moving target – her ‘best’ isn’t going to look the same every day. And you’d be right.
It is so easy for us to encourage our patients and plan realistic goals and help them to achieve them. But when it comes to looking at our ‘best’, we are brutally hard on ourselves. We approach our calling with unyielding expectation of our ‘best’ and we have a clear-cut idea of what that looks like and we are unforgiving of anything less. The problem is, like Sarah, our world’s have changed. We have challenges to overcome that we didn’t have before. We look to our pre-pandemic physical, mental, and emotional ‘best’ and expect that we can still achieve it regardless of the challenges associated with staffing, supply issues, adoption of new technologies, inflation, financial pressures, mental fatigue, toxic cultural issues, and on and on and on. The reality is your ‘best’ is the best you can offer in spite of all those things. Some days look great – you complete every task, you meet every need, you eat lunch, you drink water, you take a break, you help a colleague, you make a patient’s day, you teach a new skill, you learn a new skill, you check all the boxes. The next day might pale in comparison. But both days, you gave your ‘best’.
“You have to accept whatever comes and the only important thing is that you meet it with courage and with the best that you have to give.” Eleanor Roosevelt