THE POWER OF PAUSING

What do ants, naps, a moment of silence, quiet hours in ICU, and vacations have in common? These seemingly disparate things all demonstrate the power of pausing.

So far, my blog has been about veterinary ownership and quality issues.  However, in order to successfully own or work long term in a high quality veterinary practice, the work must be sustainable.  The power of different ways of pausing is that they build sustainability through rest, reflection, efficiency, and the discovery of meaning.

Ants?  Pausing?

A really interesting study just published in Science was discussed in the New York Times.  The study looked at how ants dig tunnels efficiently.  We normally think of ants as busy and working all the time. However, when researchers painted ants different colors and watched them dig, they discovered that the greatest efficiency was when only some ants were working hard. The others rested and stayed out of the way.  When the hard workers were removed, others stepped in.  The study showed that the most efficient tunnels were built when not all ants were working at once.

This pausing conserved energy, removed traffic jams and also allowed for more sustained digging.  Because most hospitals aren’t tunnels, it doesn’t mean that more of us should be lazy. However, it does remind us that letting others help with the work while we pause and assess may sometimes be more efficient than just blindly being busy.

Naps

Naps also demonstrate the power of pausing.  We often think of naps as just for kids and 90% of the adults in North America reach for caffeine instead when they are tired.  However, a 2008 study in Behavioral Brain Research demonstrated that a short nap was better than caffeine in improving both verbal memory and procedural motor skills. Another study showed that naps can reduce frustration and decrease impulsive behavior. .   Several companies, including Google, Zappos, and Ben & Jerry’s, have listened to the science and provided space for naps.  Many veterinary emergency hospitals used to have nap rooms, but this trend has moved in the opposite direction. But what if as a veterinary owner, you allowed yourself a nap during your admin day?

The Power of Pausing in Healthcare

I first heard about the power of the pause in healthcare at a Society for Critical Care Medicine (SCCM) Meeting.  Dorrie Fontaine, RN PhD FAAN, the Dean of the University of Virginia School of Nursing, spoke about the Compassionate Care Initiative she founded in 2009.  The purpose of the initiative is to cultivate compassionate and resilient healthcare workers through innovative education and programs.     As the initiative started, the healthcare instructors realized that when they were really present in the moment, they provided more compassionate care for patients AND found more meaning for themselves.  They discovered that detachment, rather than being protective, is often unhealthy.

While the initiative was being developed at the school, there was an incredibly difficult CPR in the University hospital.  Because the patient was cold and previously healthy, the staff worked for more than an hour to try to bring him back.   At the end, everyone was emotionally and physically drained.

Jonathan Bartels, RN, an instructor at the college, was involved in the CPR.  He suggested to the healthcare team that they take a 60 second pause to honor both the patient and their own heroic efforts to help.  The moment was so powerful for all involved that the process has now been formalized and shared with hospitals across the country.  This pause, even in an incredibly busy ICU, acknowledges the emotion that accompanies death and the importance of our teammates working together.  It helps us be resilience because it reminds us of the why behind our jobs.

Quiet Hours

The power of pausing in healthcare can be seen in other ways as well.  Recently, a group of veterinary emergency and critical care specialists discussed the idea of quiet hours in the ICU.  This is a practice where rather than scheduling treatments every hour or two, a set period in the middle of the night is designated where treatments should be avoided whenever possible.  Lights are turned off, patients are undisturbed for several hours, AND nurses and doctors can regroup.   While we are taught that patients in an ICU should be intensively managed, the vast majority may actually heal faster if they are allowed more uninterrupted sleep.

In a study of the implementation quiet time hours at Columbia University Teaching Hospital in New York, the authors state:

“Nurses reported increased job satisfaction and decreased levels of stress during Quiet Time periods. Just as patients are given uninterrupted rest periods, nurses have the added benefit of potential time to catch up on charting and other tasks. Patients report increased rest and relaxation during Quiet Time periods and overwhelmingly agree that it contributes to healing”

It may be that more quiet hours in all of our hospitals would help our patients heal.  Could it also help alleviate some of the burnout in our hard-working ER staff?

Vacations

I think we all know in theory that vacations are important. However, it is easy to plan a vacation and then work through it, answering emails, and phoning into meetings.  If we really pause our work and truly go on vacation, we allow ourselves to see the world differently, read a novel, sleep enough, and have new conversations.  This power of this type of pause is not just that we come back rested. Vacations give us the space to put different ideas together and maybe be more innovative.

A recent conversation among my veterinary classmates made me realize that  the lack of paid vacation on a production-based salary can contribute to burnout.  When we make debt laden new graduates choose between a break to recharge or avoiding negative accrual, are we serving our profession well?

Pausing for sustainability

These studies from different journals and different industries point out that we need a breath of input and ideas in order to create a sustainable veterinary career and business.  The best innovations may come from allowing ourselves and our staff to pause and investigate new things.