Work Hard, Rest Hard

I have worked in healthcare long enough now to see my fair share of burnout and compassion fatigue. It is difficult to watch talented, compassionate caregivers lose their edge, wither back, and harden their shells. Especially since it’s preventable. A few days ago I facetiously posted on my Facebook wall about how doctors had discovered the proverbial fountain of youth in basic diet and exercise, but that the general public rejected it because it didn’t come in a pill. I think it would have been funnier if it wasn’t so true. It is remarkable that even minor changes in these things really are the most effective way to not only prolong life, but to make it better as well.

The same is true with our emotional and spiritual health. Even the smallest adjustments can exponentially improve our wellbeing. Multiple studies have revealed that mindfulness and meditation can help reduce anxiety, tension, and depression, control metabolism, and lower blood pressure. Research also demonstrates that we can improve our attention, memory, conscious perception, awareness, and overall functioning. Virtually all the literature supports the position that peak performers are able to achieve wildly ambitious feats largely because, in addition to working hard, they rest hard. In other words, if your team isn’t a top performer, it might not be because they don’t work hard enough. It very well might be that they haven’t developed or been allowed to practice the skill of respite and self-care.

The crazy thing is that this is not a secret! There are books upon books about this stuff. And it’s not because folks don’t have a methodology either. There is a multibillion dollar industry around how to take good care of yourself. Just try and count the number of blogs, books, DVDs, articles, and audiobooks on the topic. At our hospital the leadership team has offered an entire room specifically for the practice of self-care. They know the cost, both financial and human cost, of burned out Team Members. So, why is it still happening? If it’s not an education or resource problem, what is it?

I think it’s a cultural problem. I think that our poor self-care is merely a symptom. The disease, if you will, is embedded in our ethos. Westerners are largely independent. We take great pride in hard work, pulling ourselves up by our bootstraps, and blazing the trail. These values have become so important to us that we have social pressure to always be on, giving our all. We simply don’t celebrate rest. We barely celebrate innovation or creativity that make things easier. I’m convinced that if the pulley was invented in the United States today the poor inventor would be run out of town for trying to cut corners. We have very little empathy for struggling persons and we give badges of honor to individuals who martyr themselves and their families under the banner of hard work.

I know because I’ve been there. When I was in grad school the second time, it was not uncommon for my schedule to be full from my 4:30 wake up to my 10:00 bed time. Each week I ran nearly 25 miles, worked more than 40 hours, was at my internship for 10, attended several classes, completed my coursework, stayed engaged with my faith community, and remained a devoted husband and father. It was rigorous to say the least and I am proud of how hard I worked in each of the arenas to which I had committed. Most of the time people would affirm my efforts and applaud all that I was able to dependably accomplish, but every once in a while they would ask how in the world I had that kind of energy. I was always happy to share that it wasn’t magic and it certainly wasn’t that I am any more special than anyone else. I was excited to let them know that it was intentional self-care and boundary setting.

What my peers often overlooked was that my early wake up time was to exercise in a supportive, encouraging community. They might have missed that I kept a regular coffee appointment with a good friend who would attend to my challenges and pray with me before I went to work. They probably didn’t know that I was listening to inspiring, informative audiobooks during my 30 minute commute or taking that time to quiet my mind and pray. Surely they missed my daily commitment to 20 minutes of meditation and scripture reading. I religiously practiced self-care as if my life depended on it because, quite frankly, it did. Everything in my life that was not moving me toward my goals or was preventing them from being realized, was reduced or removed; I didn’t watch TV, I ate well, I took out toxic things, and I invested in relationships that were empowering.

When I tell people about the importance of self-care they kind of chuckle. Some will take it to heart and others will put it into practice in their own lives, but far too many roll their eyes and get back to the grind as quickly as possible. I hope they make it, but I know some of them will not. I don’t think we will have an award for “most well rested” any time soon. For now, the reward will have to remain uncelebrated mental health and longevity. However, I do hope that we can feed into a culture that honors others who honor themselves and make space for self-care. Perhaps we will slowly see a shift where hard work is in balance with hard rest

I Guess This is Good-Bye

FF8C1CF2-11EB-4904-97B5-1B03FA83808E.jpegWhen I was nearing the end of one of my chaplain residencies my supervisor asked me how I was planning to say goodbye to my colleagues. “I don’t know,” I responded, “I kind of thought that residents just sort of disappear into the sunset without telling everyone that they’re leaving.” My response was met with some funny looks from my peers and in true CPE fashion, I was encouraged to explore if I might be avoiding the discomfort of a goodbye.

In a hospital setting there are a lot of people coming and going. The reality is that most of our contact with others is temporary. Students and contractors come for a season, ambitious leaders continue up the career path, burnout and fatigue are common, and perhaps the most obvious, patients are discharged. As a result, many hospital employees arent great with goodbye. I don’t think this is isolated to healthcare however; avoiding goodbye is a human thing, the hospital just makes for a good excuse.

If I’m honest, part of why I didn’t announce my departure from the unit where I served was because I was afraid that no one would say anything. My negative self-talk had caused me to wonder if perhaps my absence wouldn’t even be noticed. Furthermore, as an introvert, any kind of event with me as the center of attention also sounded quite uncomfortable.

What I was missing was an incredible opportunity to connect. Saying goodbye in an exercise in trust and intimacy. It is a chance to grieve and have our grief absorbed by relationship. It’s funny that I missed this. After all, I am in the grief business. As a chaplain I sojourn with others every day in their grief and as a counselor, I specialize in the topic. In my professional role, termination is intentional and mandatory. When done well, it is healthy and part of the therapeutic process.

It would be selfish of me to allow my ego to prevent others from having the opportunity to say goodbye if they chose to do so. Because my mission is to courageously live an authentic life that influences others to do the same, I have been open with my own process and practiced vulnerability, even in things that seem silly or mundane. This post is no different.

So, my Appalachian friends, this is goodbye. My wife and I have placed our house on the market and begun the process of loosening our tent stakes so that we can move back West to be closer to our families of origin. We have done this once before, when we moved here from California, but this time is harder. We have sunk roots deep into this community, purchased our first home, and watched our children grow out of diapers here.

The last eight years have been chock-full of relationships and personal growth that is really quite daunting when I reflect back.

I have obtained two graduate degrees, completed internships and residencies at several facilities, and participated in hours of continuing education which built my skill and self-confidence as a professional and a leader. I have partnered with several agencies and worked with various organized faith communities to address issues of poverty, addiction, abuse, and justice. I have joined multiple civic clubs to build relationships and serve others. The work has been rewarding, but the relationships move me to tears. From professors to peers and supervisors to clients, so many have poured into my family that I am overwhelmed with gratitude.

My circles of community are broad and make a diverse tapestry of beautiful humans doing beautiful things in the world. I was ordained and baptized all three of my children in front of First Christian Church, Johnson City. The members of Leadership Kingsport befriended and trusted me to tell our story. My CPE groups helped give me the courage to confront my inner demons and continue healing from my past. The professors at Emmanuel and Milligan opened my eyes to vast new areas of academics and poured into my excitement to learn and grow. My friends at Covenant Counseling helped expand my clinical skills. And the PAX of F3 Northeast Tennessee have held me accountable to rising up as a leader in all areas of life. I will dearly miss being in the immediate space of so many of these brilliant and compassionate people. I will especially miss my Indian Path family. I cannot imagine a better place to spread my wings. The leadership team has invested much in my development and the clinical team has received me with open arms. I am daily affirmed, nurtured, and encouraged in ways I cannot even begin to repay. Even more, these ones have trusted me with their stories. So many in this building have come to me and shared their deepest fears, hopes, pains, and tales of triumph.

It has been an incredible honor to minister to this community. I appreciate the hospitality and each person who has welcomed us to these mountains. May you be blessed ten-fold what you have given to me.

Know Thyself

“Know thyself” is a beautiful aphorism that is often attributed to the ancient Greeks. One can also find early inscriptions with a similar phrase created by the Egyptians. Personally, I believe it is one of those universal concepts written on the souls of all humankind, so its origin is not really important. What is important is the sheer vastness of philosophy that can be crammed into these two little words. Volumes upon volumes have been and will continue to be written about our search for self, but I would like to zero in on one specific piece that might just be the key to unlocking some of what is holding you back from your greatest potential.

First a little background. Early Western concepts in psychology began with the idea of psychoanalysis, which is basically examining the conscious and unconscious roots of our thoughts and behaviors. The theory was that insight would produce change. One of the major criticisms of psychoanalysis is that insight alone does not actually cause transformation. This is pretty straight forward- I can be aware that running makes me healthy, aware of how to obtain the necessary gear and the proper technique for going on a run, and I can even be fully aware of all my excuses for staying on the couch, but if I don’t get up, all that insight is useless.

As the field of psychology evolved, behavioral models emerged, which are action oriented and approach pathology from a completely different perspective. Overtime, practitioners have developed hundreds of approaches with varying focus on thinking, feeling, and behaving. Technology and advances in neuro science have opened new doors to better understanding, but the field remains in conversation about how best to help humans function at higher levels. The funny truth is that the tool we choose to help us get better isn’t nearly as important as just grabbing one and getting to work!

In the world of personal development and performance psychology, one of the major theories that undergirds coaching is psycho-cybernetics. Developed by Maxwell Maltz in the 1960’s, this theory is all about changing self-image and examining the messages we replay over and over in our minds. There are dozens if not hundreds of excellent books out that were clearly influenced by Maltz and his school of thought. In fact, you probably apply some of his theories without even knowing it.

One major component that has come from Maltz’s work is confronting “self-limiting beliefs.” This is where knowing thyself comes back into play. The idea is to examine the beliefs we have about ourselves, our abilities, our value, etc. and then to change the negative tape or re-record a new message. There are many effective techniques for how to do this. One on one coaching or counseling is very useful in this process. Truthfully, you can do much of this work on your own without even knowing what you’re doing.

I would like to offer a word of caution before you jump in head first:  many people might encourage you to go in guns blazing to wipe out the enemy. But, what I have found in my own journey and when working with clients is that the expression “we have met the enemy and he is us” holds true. While we are not our beliefs and what we believe about ourselves might indeed be inaccurate, there is a part of us holding on to that belief. Don’t let this part of you become collateral damage. Instead, approach with curiosity and compassion.

You can start a dialog with this part of yourself. For example, when she says to you, “you’re not good enough,” you might simply remind her of your innate value and state the reasons why you are lovable. If you merely beat this part of you down and shame it into submission, you will likely expend a tremendous amount of energy. Even worse, the shame will likely produce more inner distress and symptoms. I have found that when I treat my own inner bullies like I would treat an angry youth, I make more progress. That is, these parts are hurt and scared- not evil or even looking to harm me. They are working hard to protect my ego and keep me safe from the perceived threat of vulnerable relationships. Once I acknowledge their efforts and assure them that everything is going to be OK, they calm down and I can move on.

I will give you a real life example. For a long time public speaking has been tremendously uncomfortable for me. This is terrible news for someone called to preach and speak regularly. There is a part of me who remembers embarrassing public blunders. Every time I get ready to speak this part reminds me of previous mistakes. And I hear things to the effect of, “you’re a phony. You’re unoriginal. You don’t do this or that well enough. You don’t deserve an audience.” This part of me is simply trying to avoid embarrassment by talking me out of taking a risk. Instead of ignoring this voice, every time I get ready to speak I thank him for what he is trying to do. I also remind him that others have helped me up every single time I’ve slipped. After all, here I am. Standing. Then I remind him of the times things went great and the wonderful affirmations others have offered. It is only after this whole process that I move on to my visualizations and inner rehearsals. I always make peace with myself first. This is a win-win because even if I do bomb, I have shown compassion to myself and instead of an “I told you so,” I am given compassion in return.

Knowing thyself is some scary stuff. It takes tremendous courage and resolve to confront yourself, but it is liberating in indescribable ways. You will be more present, more at peace, and more effective. I hope you take the time to get to know you a little better. You’re pretty great.

Pain is Inevitable. Suffering is Optional.

Pain is inevitable. Suffering is optional.

Recently a friend and I were having a conversation over a cup of coffee and this enduring adage came up. If I remember correctly, we were talking about exercise and how some people erroneously believe that once a person reaches a certain level of fitness, he or she won’t ever get sore after a strenuous workout again. We were laughing about how “it never stops hurting; you just get used to it.” As our early morning musings are apt to do, this turned into a much deeper theological conversation, ripe with the sort of existential quandaries best served in the early morning hours with a cup of joe or late into the night in the corner of a pub.

As our conversation went from aches and pains to pain and suffering, the topic of my role as a Hospital Chaplain came up. I shared with him that I believe one of the biggest problems in the Western World generally and healthcare specifically is that there is a pervasive expectation that we can and should live with no pain. This too is an erroneous belief; there is no such thing as a pain free life. Even the very best practitioners and the most powerful medicines cannot prevent all pain. Part of the human condition is that we will all experience varying degrees and manifestations of pain throughout our lifespan. In other words, pain is inevitable. Thankfully, the latter half of our adage is also true: suffering is indeed optional.

Though somewhat difficult to fully articulate due to its conceptual nature, physical pain is basically a combination of biological and psychological responses to a stimulus. Suffering, on the other hand, is the physical, emotional, and spiritual distress caused by a dysfunctional response to that pain. In short, there is an automatic cause and effect with pain, but with suffering, we have room to intervene. Viktor Frankl, a brilliant psychiatrist as well as a Holocaust survivor who authored Man’s Search for Meaning wrote, “between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.”

Chaplains live in the space between pain and suffering. So do many other healthcare practitioners. It is where compassion and true healing takes place. This is how there is hope when the prognosis is hopeless and how faith remains when all seems lost. I tell clients every day that it is futile to fight against all our circumstances- it is much more productive to make a decision about how we will respond to them. That is not to say we are completely powerless and must allow ourselves to be tossed back and forth helplessly, but I do believe that we would do well to courageously step into the space between stimulus and response where we can claim our freedom.

My friend just switched jobs. Don’t make the same mistake his boss did.

9EA40959-48B5-4B09-BB0A-B03156142EE4Recently, a friend of mine was training for a GoRuck Heavy. Most of the training leading up to the event took place late in the night or very early in the morning so that he could maximize his family and work responsibilities. However, once his employer became aware of the grueling training plan leading up to the event he began to push back and demand more time from his employee stating that, “if [he] had time for working out so much, [he] had time to take on more projects.” It’s important to remember that this training was outside of scheduled work hours. In fact, the only time he requested off was the day of the event itself, which was approved months in advance.

In the end, my friend took a position with another firm. This is a huge hit for his old company and here’s why: turnover costs a lot. It costs so much that many companies desperately attempt to retain even low and moderate performers to help mitigate the expense. But, my friend isn’t a low performing team member. Chances are, your fitness minded employees aren’t either. Id go so far to say that if you have these type of folks working for you, you might even want to give them extra days off to train!

There are plenty of articles about how fitness-minded employees benefit companies. Not only do these team members have far less health issues of their own, studies have shown that the overall immunity of the company rises when a workplace is health conscious. This means less people are taking sick time, even the ones with unhealthy habits. More productivity with lower costs? Yay!

There are many additional reasons why it’s a good idea to hang on to those ultra-running, weightlifting, early morning workout connoisseurs.

  • They are more productive. Yep, even the ones who woke up at 5 am for a run.
  • They are happier. Oh yeah, love me some dopamine and serotonin
  • They have less stress (and more fun!)
  • They are safer, filing less than ½ as many workers comp claims

And these are just a few of the many, many reasons that I frequently see in fitness and management magazines. But, I’d like to focus on another, even though it is difficult to measure (at least in the way we can with insurance and healthcare costs).

Here is how I know my buddy’s old boss lost a good one.

Fitness builds community. It is a subculture all its own with various tribes and places to belong. For example, I currently workout with F3. But this is simply one tribe, just like CrossFit is another and community gym classes are another. We often overlap and join Spartan, GoRuck, and various running tribes as well. In these groups you will find interconnected networks of high achievers; People who are building their self-confidence, self-efficacy, and interpersonal skill. This goes way beyond retention and job embeddedness. It is where people have a high probability of thriving not just physically, but emotionally and spiritually as well.

The reason I know my friend’s boss lost a good one is because I was at the event with him. I saw him set an enormous goal and methodically work toward it for months. I saw him endure through pain without complaint and offer to carry the load of his comrades. I was there when he mustered the morale to keep going when his body was pleading for him to stop. I witnessed his integrity with every painstaking repetition, even when he thought no one was looking. I know because he and the others we were with made me a better man who wanted to do more.

More productive, longer-lasting, collaborative team players with high levels of integrity and grit? Isn’t that exactly what you want on your team? Try to keep these folks around! They’re worth it.

Playing For a New Team: Ballad Health

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I do not often make sports references, but in honor of the Super Bowl this last weekend, I decided this was a fitting metaphor…

From a very young age he was infatuated with the game of football. There are stories of him watching games and picking out plays as young as two years old. His father worked him and his brothers hard to fall in love with not only watching, but playing the sport as well.

This was in the days when Joe Montana and Jerry Rice posters covered the rooms of most little football fans in California. Growing up only a few hours north of The Bay, all he wanted to do was play for the San Francisco 49ers.  Throughout high school and during his time playing for Cal, I have no doubt that every time he envisioned himself playing for the NFL, he was wearing red and gold. And in 2005, it looked like that was going to be a real chance, but San Francisco passed him over on the #1 pick and he ended up being selected by Green Bay at the number 24 slot.

I am sure that the next few years were tough for Aaron Rodgers. Not only was he wearing green and yellow and playing in the snow rather than on a beach, he was also playing backup to a superstar. Picture this for a minute. Up until that point, all the early mornings, late nights, the blood, sweat, and tears, all the sacrifice looked a certain way in his mind’s eye. He most certainly envisioned a very different picture.

During that period, Aaron had a choice to make. He was left to decide if the dream was about the San Francisco 49ers or if it was about stepping into his calling. Clearly, he decided that his gifts, training, and effort were for something bigger than a specific team. He understood that it doesn’t matter what jersey you wear when the game is excellence. Leaders give their all regardless of what team they are playing for because they are passionate about doing their best above all else.

I hope that we at Ballad Health choose to be just such a people. I hope that we focus beyond mere details and consider a bigger picture. I know I repeat myself, but I stand by my belief that we will do well to consider scriptures such as Colossians 3:23 which reads, “Whatever you do, work at it with all your heart, as though you were working for the Lord and not for people.” I promise you that if we live in just such a way, we have a much better chance of finding supreme peace and accomplishing so much more than we even know. No matter who may come or who may go, who our specific coach is, or even what color scrubs we’ve got on, if we play for the sake of excellence than we are sure to win.

 

Change, Mergers, and Leadership

just married

We’ve merged. Two large organizations, full of some of East Tennessee’s most talented, compassionate healthcare teams, tied the knot and have become one. For better or worse.  Some may think of it as a “happily ever after” story and others might be thinking more in terms of a shotgun wedding or a tragic drama. Being a constructivist narrative guy, I happen to believe that the genre is, and will continue to be, up to us, the storytellers.

I was not in the meetings when decisions were made about Ballad Health’s organizational structure. I did not participate in the business plan, marketing strategy, or legal process. I am not an executive spokesperson, so I cannot speak to such things with any authority. And I don’t specialize in business or finance, so I can’t say much about the economic ramifications of this union either.

What I do specialize in is people. My world is the human experience of interconnected systems and the behaviors that these relationships produce. My function is to place my finger on the heartbeat of our organization, analyze our spiritual and emotional health, and offer interventions that improve our ability to deliver compassionate services to the families of our region. This is what I can speak to.

I began with the metaphor of marriage because, as a Minister and a Counselor, this is also my world. Based on the work of Edwin Friedman et al., I understand teams in the same way I do families- systems that are more than the sum of individual parts. As we become this new, complex organism, there will be a lot of growing pains. Much like when two partners leave one way of being (single) and become something entirely different (married). It is exciting, confusing, scary, frustrating, joyful, and a whole gamut of other feelings all at once.

Our merger is similar to getting married in a lot of ways. We face learning new ways of doing certain things. We will learn a new language and develop a whole new culture. We will have a period of negotiating space and time. Unlike a marriage though, we are more contractual and less covenantal. This is business, after all. But, it is not just business. These are real life people with real life callings who are being negotiated! So now, more than ever, it is important that we keep our wits about us and take special care to honor one another in thought and deed.

Here are a few simple tips I’ve been sharing with Team Members to help ensure that our transition is ethical, respectful, and as healthy as possible:

1. Recognize and lean into your grief. Loss is loss and the best way to honor it is to talk about it. Some transitions will mean wonderful people shift out of important roles. This is painful and it is ok to feel whatever it is that you’re feeling and to seek guidance. It is not ok to sabotage or disrespect others.

2. Step up. Don’t confuse authority with leadership. Authority has to do with your role, but leadership is influence and everyone has a circle of influence.

3. Go with the flow. The current cares not which direction you swim, but you’ll get a lot further if you decide to travel downstream.

4. Pay attention. Consider where things were and monitor where they are going. You may just find new opportunities!

5. Celebrate and choose joy. Any lazy thinker can criticize. It takes courage and effort to find what’s going well and express gratitude.

6. Offer solutions. The world doesn’t need any more problem finders, we want solution makers.

7. Remember your why. I always encourage folks to do this. This is your calling- it is what will get you out of bed in the morning.

8. Pray for the decision makers. Lord, give our administration, our boards, and our managers wisdom and peace as they make difficult decisions. May these choices strengthen our communities and bring healing to our region. Provide us with just and fair solutions for complex problems and guide us to deliver health to all.