Published on : October 22, 2010

The Heart of Sustainability: Self-caring as the Keystone of the Experience Strategy

The Heart of Sustainability: Self-caring as the Keystone of the Experience Strategy

“Patients first” is a frequently heard mantra these days. People working in healthcare are expected to demonstrate compassionate care every minute of the day – that’s their job. This is expected despite being immersed in cultures that are often less than caring, as demonstrated by the range of what is collectively labeled as “disruptive behaviors.”

The inconsistency between the expectation and desire to deliver compassionate care and the daily work environment creates a workplace in which staff seemingly swim against the tide to both be healed themselves to then be able to compassionately serve others.

What happens on a human level when our interior resources deteriorate? That crumbling of ourselves, our souls, compromises the ability to be present – for ourselves and others. It’s the math of the experience: we can’t give what we don’t have.

Expand self-care to five dimensions of self-caring

New research conducted by Experience In Motion (EIM), “5 Dimensions of Self-Caring that Heal Healthcare: The foundation of an experience management strategy,” reveals the need for a paradigm shift from primarily caring for others first to care for self first. Staff that is healed and experiences well-being on all levels is a fundamental requirement to care for others. According to research, making self-caring the keystone of an organization’s experience strategy provides the means to accomplish this shift.

The word “self-care” brings to mind the familiar list of things we know including: eat right, exercise, and engage in mindfulness practices like yoga or meditation. The EIM research reveals a much more multifaceted perspective, leading to this definition:

“Self-Caring: A dynamic of shared responsibly and accountability between individuals and organizations encompassing decisions, actions and attitudes that nurture the mind, body and spirit; resulting in resilient people, resilient organizations and a culture that actualizes healing and well-being on all levels.”

While personal practices on “the list” are important, this is only one dimension of self-caring. The other four dimensions relate to the “being” of organizations. The five dimensions of self-caring are:

  • Personal practices at home
  • Personal practices at work
  • Interactions with others
  • Clinical and business processes
  • Business model

Become aware of how our experience of our environment shapes our well-being
“It’s the environment, stupid,” says Bruce Lipton, Ph.D., author of “The Biology of Belief.” As a cellular biologist, Lipton discovered that when he provided a healthy environment for cells, they thrived; when the environment was less than optimal, the cells became “sick.” When the environment of the “sick” cells was adjusted, they revitalized.  The lesson we can all learn from Lipton’s work is that our environment, especially our daily experiences at work where we often spend the most time, is what has the most significant impact on our well-being.

Imagine for a minute that the healthcare organization is like giant version of Lipton’s Petri dish. What experience are staff enmeshed in within their environment each day? Joy Longo in “Combating Disruptive Behaviors: Strategies to Promote a Healthy Work Environment,” cites numerous studies detailing the extent of emotional-verbal abuse in healthcare organizations.

Longo notes that while physicians are often the main focus of attention in regard to disruptive behavior, all groups of healthcare workers can be involved. Nurses are frequently associated with the phenomenon of “eating their young.” Disruptive behaviors include: abusive language, degrading comments, sending nasty emails, refusing to mentor, ignoring attempts at conversations, physically assaulting team members, and intimidation.

The consequence of disruptive behaviors is most often measured in terms of threats to patient safety and medical errors. Studies also support Lipton’s conclusion about the tremendous impact our surroundings have on our well-being. In environments of disruptive behavior, human beings become like Lipton’s sick cells. Sick experiences result in sick people. Healthcare workers suffer from tiredness, headaches, and sadness. Nurse retention and satisfaction, as well as home life, are negatively impacted. Concentration, collaboration, and communication are reduced.

Know caring is good for people and good for the bottom line

According to Jay Bragdon, investment advisor and author of “Capitalism as Human System,” companies that operate from core values of care and compassion have significant bottom-line results. His LAMP Index screens companies to include only those that operate with integrity (where the means align with the ends), value employees, and follow the principles of nature. In 2009, LAMP Index companies returned 44.56 percent, exceeding the S&P 500 at 26.46 percent.

The EIM research echoes Bradgon’s measurements. Research respondents identified numerous improvements to business measures which result from a healing, self-caring experience for staff:

For practitioners:

  • Improved competency and confidence
  • More energy

For colleagues and staff:

  • Less stress
  • Greater job satisfaction

For the organization:

  • Less emotional burnout
  • Less turnover

For patients:

  • Hope and connectedness
  • Reduced fear and anxiety

Shift perspectives from being against disruptive behaviors to curating a caring experience

Most current solutions to address disruptive behavior follow a linear “command and control” approach; however, we don’t live in a linear world. We live, and therefore work, in a world quantum physicists have determined is composed of energy, in which everything is connected, entangled, and uncertain. In this quantum world, organizations are living systems and transformation requires a living systems approach.

An experience management strategy that organically aligns people, processes, and the sensory environment is an example of a living systems approach. This approach starts by focusing on what matters: moving beyond surviving to well-being and thriving. That requires a strategy grounded in self-caring.

Behaviors and attitudes are shifted when the experience, and one’s experience of the experience, shifts. In other words, changes in behavior are the natural result of consciously changing the experience.

When viewed through the lens of consistently infusing self-caring into the core of the organization, disruptive behaviors present an opportunity to shift from a “problem to fix” mindset to an “opportunity to care” experience.  Here’s how the experience of disruptive behaviors can be reframed in three of the five dimensions:

Dimension 3 – Interactions with others

“A caring culture is where self-care is an expectation. Where love and compassion are part of the language, where we help people be the best they can be – it’s basically being kind to one another.”

An experience management approach identifies ways to weave kindness into the fabric of the organization. Each person has a role. Start observing what language is being used by others, and what you say and write. Decide to communicate kindly. This sets the tone for others.

This is a great example of how each person can “be the change” Gandhi spoke about and make a conscious decision to choose language that is kind. Everyone can do this, and it doesn’t cost a thing. We all know gossip isn’t positive for anyone. Don’t engage, walk away, or better yet ask the gossipers to stop the conversation.

Language guidelines (not scripts, but preferred emotional underpinnings of language choices) provide a way to do this across the organization. For example, rather than language that demands, use language that guides. Rather than language that excludes, use language that includes. At a shift change or the beginning of a meeting everyone can take a few important minutes for self-caring to comment on what this language shift means and honor peers that  exemplify the use of positive, kind language. This can be reinforced in the business model dimension focusing on stories of kindness.

Dimension 4 – Clinical and business processes

“We have LEANed humanity out of healthcare.”

Experience management often focuses on processes – how things work and flow, or how they don’t. The typical business processes for disruptive behavior of reporting, reprimanding, and counseling, assume a linear world, which remember, isn’t the world we inhabit.

Consider a complete reframe. Most people don’t consciously set out to do or say something mean (unkind/ disruptive) as a part of their day. What if as an organizational way of being “disruptive behavior” was viewed as a “call for healing?” Instead of processes to “control” the behavior, there are instead processes to support people to heal what’s underlying the behavior.

With this experience perspective, everyone in the organization is an active participant and called on to recognize outward behavior as an unmet need in someone’s interior landscape. This is in alignment with “physician [or nurse, IT staff, receptionist] heal thyself.” Maybe a physician is short with his/her staff because ultimately he/she doesn’t feel seeing patients every 15 minutes is nurturing for them. The physician may be passing their personal pain on to others in the form of outward behaviors.

Now, rather than being a problem, disruptive behavior  becomes a different call to action – a call to examine one’s life and heal the painful spots. The organization can support people to make adjustments for their personal benefit, which ultimately benefits the organization and patients as well.

Dimension 5 – Business model

“We have to break up the model that we have right now in healthcare, whether it’s in a clinical setting or nursing home or hospital. Our current ways that we have been delivering care are not working.”

Business models are composed of three interrelated aspects of organizations:

  • Mission & values
  • Culture & stories
  • Practices & policies

A business model founded on self-caring is an opportunity to examine all aspects of the business and identify how the organization supports each person to experience well-being on all levels throughout the work day. For every activity and decision ask: what component of this activity, experience, process, and/or decision results in each person involved feeling they are taking care of themselves and that the organization cares about each person?

For example, most physicians would not recommend to their patients that they work long hours. Working more and longer is not on that ubiquitous self-care list. So why is this seemingly the norm for healthcare workers? Where’s the role model walking the talk? How can any patient be expected to follow advice from anyone who isn’t exemplifying taking care of themselves?

If stressed nurses typically exhibit disruptive behaviors the last two hours of an 8 – 10 hour shift, shorten the shifts.  As part of the experience design process, suspend being tied to patterns and instead explore creating shifts that will most fit people’s natural rhythms. Rather than expecting people to fit into shift slots, like a manufacturing mindset of cogs in a machine, identify what type of schedule supports each person to be at their best, and organize schedules to honor each person’s well-being.

Experience the results: self-caring is the heart of sustainability

We typically think of sustainable in relation to the environment outside our doors. The definition of sustainability from the 1987 Report of the World Commission on Environment and Development is "meeting the needs of the present without compromising the ability of future generations to meet their own needs."

We’re all staff, patients, and families together in the Petri dish of the experience. For the healthcare system to be sustainable and meet current and future needs, and for each person to meet their own current and future needs, each individual must have a sustainable interior world. Each person must experience well-being and healing. That requires self-caring in all dimensions.

Organizations have the primary role in four out of the five dimensions.

Organizations must operate and “be” in ways that create, nurture, and cultivate the sustainability of our human interior landscape.

Sustain comes from the Latin word “sustinere,” derived from the Latin word citare, meaning to urge on, encourage, promote; and the Medieval Latin word “tenere” meaning to hold, keep, represent and support.

Making self-caring the keystone of the organization’s experience strategy is a return to the heart of sustainability ‒ encouraging, promoting and supporting each person to experience healing and well-being, in every moment of every experience.

About the author

Deb Andelt is co-founder of Experience In Motion, a customer experience tools company based in Scottsdale, AZ. She is the author and co-creator of “The Toolkit to Empower Healing” and the research study: “5 Dimensions of Self-Caring that Heal Healthcare: The foundation of an experience management strategy”. Her personal experiences with practitioners on her own healing journey, from decay to vitality, provides her with a unique understanding that it’s more than the “treatment,” it’s the total experience that matters. The research report is available at www.experienceinmotion.net, and Deb can be reached at deb@experienceinmotion.net

Our thanks to the research study respondents cited in this article: