The Tao Te Ching: Verse Eighteen

The great Tao fades away
There is benevolence and justice
Intelligence comes forth
There is great deception

The six relations are not harmonious
There is filial piety and kind affection
The country is in confused chaos
There are loyal ministers

                                                                                                    Lao Tzu

Image a world where nurses and other members of the Interdisciplinary healthcare team actually supported each other and collaborated well. I can hear the groans and cynical replies such as: are you crazy, not in my lifetime as I type these words.  Countless articles and books have been written on this subject. New terms have entered our professional vernacular such a nurse-to-nurse hostility and horizontal violence. We can protest the insinuation but the reality still lingers; many professional caregivers have a tendency to eat their young and often anyone else who comes close.

There is no clear cut answer as to why this is. It has gone on for a long time; therefore it is fair to say that the root cause is anchored deep under many layers accumulated over many years. The price that is paid by the object of the aggression and by the aggressor is immeasurable.  Just reflect a moment on our overall state of physical health. Obesity, joint pain, heart disease, endocrine issues, back and neck pain, depression, migraine; we are slowly killing each other. Blame it on the stress of the “job” if you want but I want to propose an alternative reason. Is it possible that we are all suffering from Post-Traumatic Stress Disorder?

The years of disconnect from the reason why we went into human services, how were learned to practice in school and the inevitable reality shock of what it takes to render care in any healthcare venue have taken its toll. I am beginning to believe that the years of staffing issues, overtime, downsizing, rightsizing, DOH surveys, the Joint Commission accreditation processes, Magnet designation status, get a degree, get another degree, where’s you clinical certification and the subtle but sustained message that no matter what you do; it just isn’t good enough have left us all shell shocked.

Google anything on post-traumatic stress disorder and see if the symptoms don’t sound alarmingly familiar. Interventions to workplace aggression, no matter how well intended, are often too little and too late. So what is the answer? The answer lies in awareness and recognition. Post-traumatic stress disorder is not a diagnosis reserved for the veterans of war; it also applies to warriors who battle within the healthcare industry trying to make a difference one patient/resident/client at a time.

The common denominator for individuals with PTSD is a sense of helplessness. When a professional feels helpless to influence their circumstances, anger soon follows. How we express this anger and who is the object of our anger is what I am beginning to believe is at the heart of our aggression toward each other. I encourage each of us to consider this possibility.

If these thoughts resonate with you then you must take action to help yourself. Work with a mentor, coach or if necessary, seek appropriate therapy. I implore you to resist seeing the issue in everyone else and find the courage to deal with yourself. We are all guilty. Even if your response to co-worker aggression is to turn a blind eye, you are involved. You may not be able to change the mindset of a profession but you can certainly change yourself. With faith, courage and loving kindness directed inward; you can heal yourself.

As you take solid steps toward wellness keep in mind the time honored message that Lao Tzu is sharing in this verse of the Tao; treats the other as you wish to be treated. If the other treats you unjustly, responding with aggression only feeds the darkness so respond with (Light) compassion.

The most important ethical principle in Taoism is the concept of Wu-Wei, which is defined as either acting naturally or as non-action (Renard, 2002, p. 377). Wu Wei is not laziness or indifference; it is being in the flow with the Great Oneness. The ethical belief underlying Wu Wei, is the principle that people are to act for the greater good at all times.

Act without struggling or trying to force events to occur. By conducting yourself in this way, you are not reacting to a negative workplace culture or unofficial rules established by bullies and cliques. You are maintaining your standards of ethics and inner moral code without allowing outside influences to affect them. Then, you need to try to forgive; remembering that forgiveness does not require that you to forget an event. It does require that you let go of the pain that is associated with that event. Forgiveness does not absolve the other person. It frees you.


2 thoughts on “The Tao Te Ching: Verse Eighteen

  1. I would wonder if fatigue and patient nurse ratio’s are a factor as well. I have also observed other disciplines under go stress and rapid change. I wonder if they have similiar issues of PTSD.
    thank you for the opportunity to read your blog.

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