Nick Jacob’s blog post, So You Want to Be A CEO Part Eleven, resonated with me today as I covered general surgery in a rural Vermont hospital.

It was a typical Sunday morning, as I set out to make rounds on the medical-surgical floor, learning that a medical patient in the ICU with a previously tiny pneumothorax now had a much larger air leak that required a chest tube to decompress it.  At the same time, I received a page from the Emergency Department that another patient had a bowel obstruction, fever, and elevated white blood cell count.  As I hung up the phone, I tried to remind myself, with only partial success, that the three areas where I was called to serve did not know what others had asked me to do.

Not until another 3 hours had elapsed, and I had dealt with all three issues, did I remember what Nick had written February 9, 2008:

“One of my teachers once told me that the Great Barrier Reef, the largest collection of living organisms in the world, is a unique phenomena.  On the bay side where things are calm, everything is dead, but on the ocean side where the waves smash against it, life prevails; positive stress seems to be the answer to survival. “

I am not sure what “positive stress” means, but I think it refers to our ability to put events in perspective and move from “Why is this all happening to me?” to “Let’s figure out what we need to do to care for patients.”  Our ability to cope, in my experience, requires a certain resilience, which those of us who have survived residency describe as, “This will make a great story if I survive this weekend on call.”  It is a little like surfing the edge of chaos, where one has the excitement of doing things that make a difference in patients’ lives superimposed on the fears of failure, chaos, and harming people.

 Price Pritchett and Ron Pound refer to the “dungeon of stress” in their pamphlet A Survival Guide to the Stress of Organizational Change, www.pritchettnet.com.  Here are their 15 Steps to Lower Stress:

• Invest 30 minutes a day, 3-5 times per week in vigorous physical exercise (assuming your doctor doesn’t have a problem with that)
• Learn relaxation techniques
• Cut down on caffeine
• Eat right
• Meditate. Get still. “Center”
• Develop better time management habits
• Play. Have fun. Recharge
• Get plenty of sleep
• Smile more. Laugh. Use humor to lighten your emotional load
• Count your blessings daily.  Make thankfulness a habit
• Say nice things when you talk to yourself
• Simplify
• Set personal goals. Give yourself a sense of purpose
• Forgive. Grudges are too heavy to carry around
• Practice optimism and positive expectancy. Hope is a muscle- develop it

I can think of at least five areas where I could benefit from daily practice and better results.  In what areas do you think that, as healthcare professionals, we could benefit the most from improvement for our patients and ourselves?

As always, I welcome your input.