The Tao Te Ching: Verse Seventy-Five

Is due to the glut in their ruler’s pursuit of life The people’s hunger
Is due to the excess of their ruler’s taxation
So they starve
The people’s difficulty in being governed
Is due to the meddling of their ruler
So they are difficult to govern
The people’s disregard for death

So they disregard death
Therefore those who do not strive for living
Are better than those who value living

                                                                              Lao Tzu

Trust is a very broad moral value that we customarily learn from our parents. It is delicately built on a foundation of honesty, faith, reliability, integrity, respect and bankable confidence in another. The dictionary defines Trust as having a confident dependence on the character, ability, strength, or truth of someone or something. Trust is the cornerstone of establishing credibility; and while the strength of Trust is great, it is not resilient.

The message contained within these words of the Tao speaks to the consequences of the decay of Trust. It is virtually impossible to reach adulthood without having your Trust shaken on some level but we continue to hope that our Trust will be well placed. Many times our Trust is bruised by thoughtless acts of inconsideration. We may find it easier to buy-back into that relationship if we are able to believe that intent and malice played no part in that indiscretion. It is the intent to hurt and the need for malice that devastates and destroys any hope of restoring a betrayed Trust.

We are all citizens in the Great Oneness that is the Universe (the Tao). A huge part of our obligation to one another, within that citizenship, is steeped in mutual Trust. It is vital that we take the time to reflect on how each of us may have inadvertently or willfully damaged the Trust of being caregivers to each other.

Anyone who has had their Trust violated can relate to how visceral a blow it is. It feels violent. Like any other traumatic event; it leaves a residual, lingering effect. This is what we (professional caregivers) subject each other to when we pledge to create and maintain a healthy work environment free of lateral/horizontal violence yet break that pledge by allowing it to continue either overtly or in the shadows. Choosing a career in healthcare has often been likened to taking on a sacred Trust; first do no harm. We usually interpret this directive as referring to the recipients of our care but it also refers to doing no harm to each other.

So much has been written and discussed on this issue. Everyone agrees that it must stop. Yet, everyone knows that it continues. Research shows that the on-the-surface ripple effect of lateral and horizontal bullying in healthcare affects efficiency, patient safety, quality outcomes, and retention. Stephen M.R. Covey, the author of The Speed of Trust, writes, “When trust goes down, speed goes down and cost goes up.”

But no one can measure the long term effect it has on those who have been the object of hostility. How do they cope and heal with the unacknowledged anger they must live with? In her landmark work, Ending Nurse-to-Nurse Hostility, Kathleen Bartholomew, RN, MN shares that the effects are holistic taking a toll on self-esteem, motivation, contributing to substance abuse/overeating, decreasing immune responses and increasing the likelihood of cardiac disease.

So how do we go about repairing this Sacred Trust? Definitive action is needed. I suggest we consider the tactics of law enforcement first responders to a mass shooting; go into Active Shooter Protocol. The Active Shooter Protocol is direct and results oriented. Simply, the agents enter and conduct a search for the shooter. They initially step over the injured in relentless pursuit of the perpetrator with the single minded goal of stopping them before there is one more victim. Imagine.

In this analogy, we are the first responders. No more being a bystander and turning a blind eye to what is going on. No more believing that some individuals are sacred cows and insulated from corrective action, no more being intimidated, manipulated or acting like the walking wounded. Professional caregivers promote lifelong learning, specialty certifications and strive for professional empowerment but what does that all mean if we cannot stand up tall for what is an inalienable Right for ourselves and each other?

I refuse to believe that members of the same staff cannot agree to poll their courage and act. Be professional. Set limits and keep them. Find your courage and your voice. Be thoughtful; speak from a place of truth free from emotion. Use the Team STEPPS approaches taught to you and SBAR if necessary to organize your thoughts. Be respectful of your chain of command and Human Resource department. Hopefully, your Trust will be well placed in their leadership. Seek the counsel of an attorney if the situation warrants. Be part of the answer to restoring Trust. If not now, when?

“Self-confidence is knowing that we have the capacity to do something good
and firmly decide not to give up.”
His Holiness the Dalai Lama

2 thoughts on “The Tao Te Ching: Verse Seventy-Five

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