Nurses Are the Superheroes of Health Care Guest Post by Suneel Dhand, MD


Being a nurse is one of the most important jobs in any society. It is also one of the most respected. Public opinion polls consistently rank nurses as the most trusted profession — usually ranking well above physicians. And it’s for good reason. Patients in hospital may forget who their doctor is, but they will rarely forget their nurse. The doctor may be in and out of the room in ten minutes or so, but the nurse is the one who will be right there by their patient’s side throughout their recovery.

Nurses work tirelessly for their patients and are their biggest advocates. They run around all day in and out of patient rooms, multitask to an unbelievable agree, constantly talk to patients and relatives, administer all the medications on time, and invariably pick up on any problems that the doctor hasn’t. Every doctor will have a story to tell about how a nurse has saved their patient, even if they don’t acknowledge it as much as they should.

Unfortunately, however, the sad reality is that for such a heroic profession, nursing seems to constantly be facing more than its fair share of administrative battles. It’s a very sad situation if hospital administration is ever perceived to not value their nurses. It’s also unacceptable for doctors to ever disrespect nurses, which frequently happens on a daily basis up and down the country.

Nurses are the foot soldiers of all patient care. Before the foundations of modern nursing were laid by Florence Nightingale in the 19th century, nursing care was often provided by people who practiced organized religious activities, including nurses and monks — which is a profound thing to reflect on (the fact that nursing was equated with religion and good work). That changed after Nightingale’s pioneering work helped established nursing as a more organized profession. The expansion of modern medicine over the last several decades has also allowed nurses to increasingly diversify and specialize. Today there are an estimated 3 million nurses in the United States and 500,000 in the United Kingdom, representing about 1 in every 100 people in each country.

The challenges faced by today’s nurses are surprisingly similar across the Western

world. Here are 3 of the biggest:

1. Workload. It goes without saying that in no other profession does the workload need to be controlled and restricted more than with nurses and their patients (much more so than with doctors). Nurses cannot be expected to be competently taking care of excessive numbers of patients. These safe patient care ratios need to be agreed between nurse unions and administrators, and then strictly implemented.

2. Job duties. Nurses must be supported by the other professions around them and not be expected to do anything beyond the scope of their job. Examples include restraining, transporting, and even walking or feeding patients when there’s lots of other clinical work that needs to be done. Care assistants, transporters, sitters, physical therapists and hospital security—they must be present in adequate numbers to do what they need to do and free up nurses.

3. Pay. How much nurses should be compensated has been an issue for a long time, and is frequently debated in the media when nurse unions may threaten to strike. It’s a terrific shame that nurses should ever feel the need to strike, but at the same time they should be valued appropriately for the difficult job they do. Paying an hourly rate which is lower than other jobs which require only a high school education, or offering pay rises of only a few cents an hour — when nurses have debt to pay off and a family to support — is not an acceptable situation.

With the ever-changing health care landscape, the job of nurses is set to continue to evolve and expand. We need to attract the best and brightest students into the profession while keeping compassion at its core. The above three issues are widespread, and while there is no magic pill, there should be constant recognition of the vital work that nurses do. The medical world needs to support our nurses and treat them as what they are: the absolute heroes of frontline health care.

Suneel Dhand is an internal medicine physician and author of Thomas Jefferson: Lessons from a Secret Buddha and High Percentage Wellness Steps: Natural, Proven, Everyday Steps to Improve Your Health & Well-being.  He blogs at his self-titled site, Suneel Dhand.


The Delicate Balance: Flow with Life


feather and stone balance

Inspired by the ancient book of wisdom; The Tao Te Ching: Verse Two

When the world knows beauty as beauty, ugliness arises.  When it knows good as good, evil arises. Thus being and non-being produce each other. Difficult and easy bring about each other. Long and short reveal each other, high and low support each other. Music and voice harmonize each other, front and back follow each other

Therefore the sages: Manage the work of detached actions. Conduct the teaching of no words they work with myriad things but do not control. They create but do not possess, they act but do not presume. They succeed but do not dwell on success .It is because they do not dwell on success that it never goes away

Lao Tzu


Through the words contained in verse two, Lao Tzu instructs that in our efforts to explain what cannot be explained, the human experience can be a journey along a continuum of emotions. He shares that we feel joy because we have experienced sadness.

The completeness that comes with knowing that you belong to someone can only be truly embraced when you have known the void of being alone. Our belief systems define our experiences as good or bad, bitter or sweet, beautiful or ugly and so on. It is in this struggle to get a handle on something; to find an explanation for why things are the way they are that is the basis for dissatisfaction with one’s life.

However, Lao Tzu goes on to write that there is an alternative to the dualistic battle that we create for ourselves. The option lies in the insight that the Universe is ever changing and that our assignment is not to rage against the tide of change but to flow with it. In reality, all is as it should be even if it is not obvious or easily understood. Caregivers can find accepting this a challenge. We set up a dualistic continuum of our very own, fixed versus broken. After all, isn’t it our job to fix things? Fixing things, turning negatives into positives is what we do best, right? Here is where we can get ourselves into trouble if we are not continuously in touch with our true motivation for caring and how being a caregiver can serve us.

It can really feel good to be needed by someone and to be able to meet that someone’s needs. It feeds our compassionate nature. It can give us a sense of purpose and competency. The caring can very subtly start to become about us. When things work out, that is, the desired outcome is the outcome achieved; we can delude ourselves into thinking that we have control or at least a strong influence over those results. It can be a bit addicting so we begin to give more, care more. Before we realize it, caring becomes a socially acceptable substitute for doing one’s own work, walking one’s path and addressing all our personal life lessons along the way.

Some of the dangers signs we tend to ignore include the inability to put our needs such as pursuing our own interests first. We deny the need for help when a lifeline is offered. We can find it challenging, even irritating to seek or accept assistance from any resource for a respite citing any number of plausible reasons. We tend to allow our compassionate nature or work ethic to be used against us. Finding ourselves in the role of the go-to-person on a constant base is not always a complement. The added stress can deplete us of valuable energy and lead to resentment.

The common denominator for all of these behaviors is our tendency to make judgments and the need for control. It seems almost cruel to assign such labels to a person’s commitment to service. However, it is necessary to shed some light on this dark side of a one’s good nature. Caring too much enables us to write and tell our story in the context of another’s rather than let the meaning of our own life, scary as it may be, unfold. When we think we’ve been successful in fixing something, that feeling fills in some of the places in our personality where we are wanting and vulnerable.

Caring too much has a paradoxical effect on our life. You would think it would build relationships but in reality, it ultimately causes us to become increasing isolated from others. Our propensity for judging begins to alienate us from friends and colleagues. The increasing need for control causes individuals to push back and the frustration that this drives can become the foundation of mistrust and anger.

So where does the answer lie? It should be no surprise to discover that in all struggles with duality, the answer lies in the middle. The middle way gives us perspective and feedback. This is a great start to creating balance. The challenge is to blend compassion for others into your life and not allow that wonderful capacity to dominate and impede your ability to live your life fully.

Develop a personal spiritual practice that offers you quiet time. Not just free time to fill up with doing other things; but real quiet time that allows you to strengthen your ability to slowly access your intuitive knowledge and higher-self. The support and guidance you can gain will begin to transmute your need to cling to the duality of your emotions into an ability to peacefully coexist in the world without the need for judgment or conflict.

Your ego will slowly let go of the need for the allusion of having control and relax into the reality that all is well and all are safe. The answer truly is in the silence. Taking the time to put your own oxygen on first lets you come to know and embrace this truth. Moving away from the habit of defining your life in dualistic terms lets you step closer to understanding that developing a trilistic relationship between yourself, your life lessons, and that god-like nature inside each one of us provides us with the inner fortitude and skills to walk our own path, feel compassion for another and flow with life












9 Authentic Leadership Lessons Guest Post by Bill George

Bill George is worth listening to if you have an interest in building a trust culture, and growing your market cap. He should know. During his tenure as Chairman and Chief Executive Officer of medical device firm Medtronic, (NYSE MDT) market cap increased from $1 billion to $60 billion. PBS named Bill George as one of the top 25 CEO’s over the past 25 years.

Mr. George is a bestselling author of two books, ‘Authentic Leadership‘ and ‘True North‘, is a professor of management practice at Harvard Business School, and writes about authentic leadership at hisblog. He developed a leadership template that all leaders can follow, which is simply to be yourself, be authentic, and find your True North, that one thing you have been gifted to do to make a change in the world. In this interview conducted by Wharton management professor Michael Useem, Mr. George outlines timeless and proven practices which helped him to succeed in leadership during his own career.

These tips and truths about being authentic in leadership can serve you well as you develop lasting relationships and build value in your organization. I’ve distilled this interview down to nine key points which provides a holistic template for outstanding authentic leadership.

1. Clean out the unethical behavior This needs to be done swiftly, and so that others will notice. Everyone needs to understand that unethical behavior cannot be tolerated. Period. This of course needs to be modeled by you as a leader, and in turn you need to hold those in your company accountable to this basic standard of leadership.

2. Remove the Perks If you are going to make a difference, you need to be serious and do some things that will not only be different in some places, but also help to define who you are. Begin doing some of these things immediately and you will get some attention and positive responses. Stop the company parking spots reserved for executives. Give the best view office over to the lunch or breakroom. Set up your desk in the factory, or close to it. This is not about you, it is about the organization, and treating all stakeholders with respect.

3. Preach the Mission and Vision. Live the Core Values Travel to all operations and preach the mission and vision. Be collaborative when establishing your core values, but once you have them, don’t ever deviate from them. Stay focused on the mission, and drive hard for the vision. Give awards, celebrate victories.

4. Be Authentic Authenticity is a reflection of how truthful and real we are in our relationships with others, and in understanding ourselves. Being authentic means you will be honest, vulnerable, real, and maybe a little intimate when sharing who you are as a person, or how you would like others to be when in relationship with you. At a deep level, most people want to be in authentic relationships. Without authenticity, relationships will be slow to develop, if at all. And without authentic relationships, trust does not grow. Without trust, leaders will not have influence, and without influence, they will not build value throughout their organizations. A recent postdescribes a leader that did not build trust, did not have much influence, and as a result destroyed a great deal of market cap. If you don’t feel you are being the authentic you, and don’t have a North Star yet. How can you develop that authenticity? Don’t lose sight on what you are called to do. Be yourself, and don’t try to imitate others. Say what is on your mind, with truth and grace operating at the same time. Respect the human element. You need to come in as who you are. Be the real person you were made to be. Follow your true north. Don’t ‘emulate other great leaders. Jack Welch was unique, as is Bill Gates, Warren Buffet, Jeff Immelt, and every other leader out there. Get away from the great man (or great woman) theory of leadership. Just be yourself.

5. Identify and Leverage your Crucibles Crucibles are those events or seasons in one’s life that are challenging. We all have them, or soon will. First you need to accept yourself. Know yourself, have self awareness. Have compassion for your difficult times, but learn from them. Have Crucibles. Have difficult times. This is the marrow of life. It’s what is necessary before you can gain a high level of wisdom and leadership ability. Once you accept who you are, it is very freeing. You can’t be a leader until you deal with all of your issues, confront them, and deal with them. Helping other people walk through that process in a mentoring relationship is exciting.

6. Find your True North What are you here to do? How can each of us make a difference in the world? You will get pulled off this, but your compass will guide you back. Review your own life story, spend time in meditation. What is the greatest crucible in your life, what are your beliefs? Once those are firmly set in your mind, you can contemplate the purpose of your leadership. Ask yourself…What are the things I am most motivated by? Your intrinsic motivations. Not money, fame, power. You can identify and be aware of your weaknesses in this process, but please don’t spend a lifetime working on your weaknesses. Focus on what are your strengths.

7. Use your boards Draw out those who are quiet. Those are board members that don’t say much but know a lot. Engage them. How does a CEO relate to the board? How does the Non-executive Chairman get the most out of their members. What is the strategic guidance? You just need to have the dialogue and get it right. Use the quiet ones on the board, get everyone engaged. You can’t do this with the whole management team in the room.

8. Learn to follow your passion What would you tell young people? What are your passions, what excites you? How do you want to make a difference in the world? What will you or have you done to make a difference? You need to be true to what you believe. Follow your own passions. Did you use your greatest gifts that your creator gave you to solve problems, and make a difference in the world?

9. Have a mentor who can teach you, and have a student who can learn from you Mr. George believes in seeking mentors who can help you think through the difficult choices you make as a leader. One of his own mentors was Warren Bennis, who shaped his thinking and behavior as a leader. He also believes your wisdom should be shared with others. He now teaches at Harvard Business School, sharing wisdom gained from his years as a successful leader.


How to Live with Integrity with 4 Simple Habit Guest Post by Carthage

Successful people live with integrity. They say what they do and they do what they say. They are trusted by those whom they interact with and they build healthy relationships with consummate ease. These relationships then help them to achieve bigger and better things.

When you live with integrity, you influence, inspire and motivate others; not just with your words but with your actions too. Others see the positive example that you are and attempt to emulate you. When you choose to live with integrity you will experience a number of benefits, including:

  • You become more valuable both as a person and as an achiever. People see your importance and the value you add.
  • You get better opportunities. You become seen as somebody who gets things done. People are more willing to trust you and want to include you in the bigger projects.
  • As the respect and value you command increases, you are better able to pick and choose the projects you wish to work on.
  • The positive relationships which you build, lead to more people being willing to work with you. This allows you to get more done.
  • You get bigger and better rewards both in terms of personal fulfilment and pay and remuneration.

How to live with integrity

The following are 4 of the most critical steps to help you live with integrity. If you turn these 4 steps into daily habits you soon begin to see some of the benefits which I have listed above.

1. Make better choices

You make thousands of decisions every day, some big but many small ones. The bigger decisions often get your full attention, allowing you to make a higher quality of decision. Do the small decisions get your full attention too? Usually not, but when you regularly make the wrong decision, it starts to add up to some big problems.

To ensure that you make better decisions on a daily basis, you need to have aclear vision for your life; a clear sense of purpose, and effective goals which will help you to realise your vision and fulfil your purpose. Life is not a set and forget process; you need to consistently remind yourself of your values, purpose and goals. When you do this, they are at the forefront of your mind, allowing you to make smarter decisions which are consistent with the person that you are and the life which you are trying to create.

 2. Develop positive habits

Many of the bad decisions you make on a daily basis will be down to force of habit. Over the years, you will have done things in a certain way until they have become second nature to you. When the situation arises, you don’t think about it, you just resort to habit. Maybe you are always late for appointments, or you consistently work late. In some cases your bad habits might not appear to be a problem for you, but they are usually a problem for others. If you want to live with integrity, you need to replace the bad habits with positive habits.

To develop positive habits, you first need to identify your bad habits. Take a few moments to list all of the bad habits of which you are aware. I would also suggest asking some trusted friends, or family, to help you identify any bad habits whcih you may have missed. Once you feel you have a completed list, go through each habit and write down the long term effects of sticking with this habit. Then, identify a positive habit which you are going to implement in its place and make a plan for how you are going to implement that new habit.

 3. Keep your agreements

Every day you make agreements, both with yourself and with others. At the time of making agreements, you will generally intend on keeping that agreement but in a busy life that often proves to be easier said than done. It may not seem like a big thing when you fail to keep an agreement but every time you break an agreement, you erode a little of the trust between you and the other person. To live with integrity, requires that you keep your word so that you can build trusting and healthy relationships.

Keeping your agreements requires an effective personal productivity system whereby you capture all of your commitments so that you can then process them and act on them. One of the biggest mistakes that you can make when it comes to commitments is relying on your memory to keep track of your agreements. Instead of memory, you need a reliable system to record your commitments and the actions you need to take. That way, you don’t need to remember every single commitment; you just need to remember to check your system on a regular basis.

 4. Raise others up

If you want to build a healthy relationship with another person, the best place to start is by finding some way in which you can help them. It could be something as simple as taking a few minutes to listen to their needs. It seems counterintuitive as you probably focus on what you need to get done. But, when you have helped somebody, they see that you have value to offer and you can be trusted. With one quick action you will have taken giant strides towards creating a healthy, new relationship.

To live with integrity is to live as your best self. Each relationship must be seen as bidirectional. By helping others, you help them to feel good about themselves, and you are also helping yourself by creating a healthy new relationship.

When you live with integrity, you live your best life. You respect yourself by living in a manner which is consistent with your values, purpose and goals. These factors guide each decision that you make, thus allowing you to achieve more. You know that you can never truly succeed on your own so you offer the same level of respect to others. You focus on building healthy, supportive relationships which are based on mutual trust and respect. There will be moments when it seems like living with integrity is the most difficult thing but in reality, when you practice the 4 steps, above, the easiest thing you can do is to live with integrity. You will have a great deal of clarity in your life, allowing you make clear, effective decisions and ensuring the important stuff gets done. When you live with integrity, the benefits and the possibilities are endless.


The Delicate Balance: Appreciating Each Moment

feather and stone balance

Inspired by the ancient book of wisdom; The Tao Te Ching: Verse Nine

Holding a cup and overfilling it
Cannot be as good as stopping short
Pounding a blade and sharpening it cannot be kept for long Gold and jade fill up the room, no one is able to protect them
Wealth and position bring arrogance and leave disasters upon oneself When achievement is completed, fame is attained
Withdraw oneself, this is the Tao of Heaven

Lao Tzu

This ninth verse of the Tao challenges us to explore why we tend to pursue excess. We chase contentment like a phantom in a dream. We never quite wrap our arms around it. We torture ourselves with relentless thoughts such as you can never be too rich or too thin. Where is the finish line? Why is it so hard to appreciate the here and now?

More is just that, more. More does not equate to happiness. In fact, Lao Tzu suggests that excess is often burdensome. He counsels that a cup is easier to hold if it not filled to the brim. He cautions that over attachment to possessions can doom you to a life lived in fear of losing them. He echoes the teaching of the bible that great pride comes before the fall. The enlightened soul understands that the greatest experience is in the moment we are living right now. Everything else is an illusion created by our egos.

This is not to suggest that we should never set goals or strive to be our best. It is a gentle reminder to appreciate each and every moment of your life as you journey. Being mindful changes your perspective from happiness as being contingent upon attaining possessions and status to happiness as always being in your life with the occasional bonus of very satisfying moments showing up along the way.

Caregivers tend to wait to be happy until something is fixed. If we were to slow down and settle upon the fact that things are always changing and nothing stays the same (fixed) for long; we might enjoy a good laugh at ourselves for our very human, compassion driven silliness. Find your contentment in the now. Even if the only sense of joy you can touch is your own ability to be open and available to another human being when they are most in need.

10 Ways to Embrace Changes In Your Personal and Professional Life Guest Post by Andrew Walton


For many individuals, accepting change in their personal and professional lives is oftentimes a difficult proposition. Yet change is inevitable; it is the only thing that is constant in our world. Whether it is in your personal life or your professional life, you can anticipate changes that you will have to adjust to.

However, accepting change is not a popular idea and we typically oppose or resist it. People are reluctant to step out of their comfort zones because they get attached to old habits and their lifestyles. This makes it difficult to achieve our goals.

Why are People so afraid of Change?

Even though you may want to control your own destiny, making changes in your life may be so intimidating that you will end up settling for less or doing nothing at all. There are 6 reasons why so many people are afraid of change including:

Agonizing over certain decisions because you feel isolated:
-Clinging to those perks, possessions, and statuses that you have acquired along the way
-Doubting yourself and feeling that you are not up to the challenge of making changes
-Fear of the unknown and being reluctant to take any chances
-Focusing too much on the external world around you instead of yourself
-Overlooking the fact that there are always options available

It’s important to remember that you never have to settle for what transpires when making changes in your personal and professional life. When you have enough confidence to act in the face of your fears about change, it gives you a sense of control. Ultimately, it will provide you with a purpose in life.

10 Benefits of Change

Conversely, the person who is willing to gamble and embrace change has a greater chance of achieving success in their personal and professional lives. Whether it is in your personal life or in your professional life, there are 10 benefits of change to be aware of:

1) Flexibility – frequent change enables us to adapt to new environments, new people, and new situations.

2) Improvements – without change, nothing improves by itself. Therefore, there would be no improvements in our finances, homes, and incomes without change.

3) Life values – when you are open to change, you see things in your life differently and have an easier time of re-evaluating your life. Sometimes, this enables you to reinforce your life values.

4) New beginnings – change is about closing one chapter in your life and opening another. New beginnings arise and life becomes more exciting.

5) Opportunities – when you adapt to change in the workplace or make changes in your personal life, you will find that different opportunities present themselves. In many cases, change provides you with choices that bring about fulfillment and happiness.

6) Personal growth – every time change occurs, you have an opportunity to grow and learn. You discover insights into your life and certain aspects of it.

7) Progress – certain aspects of our personal and professional lives develop and improve as change has a way of triggering progress.

8) Routine – without change, your life would be routine. It would be dull, predictable, and very uninteresting without it.

9) Snowball effect – when we attempt to make big, immediate changes we oftentimes give up because we feel like we just can’t do this. It is during times like this that making smaller changes can become very important. Making these smaller changes can result in the bigger, desired change or goal.

10) Strength – unfortunately, change sometimes leads us to unpleasant times in our lives. When you overcome these difficult periods, you grow stronger as a result.

Additional Benefits

In addition to the above, change accommodates personal and professional growth and helps us to address specific problems at home and at work while staying up to date on market trends and technological advancements. Although change may seem inconvenient at the time, it has a way of bringing about benefits in a company setting such as bringing attention to it. Some changes enable companies to attract higher caliber job candidates such as changing their pay and benefit structure.

10 Tips for dealing with Change

1) Be flexible – you improve your chances of succeeding by being flexible and adapting to change. Take a look at what is required of you in these new circumstances after changes have been implemented in your professional life.

2) Communication is imperative – this is especially true when you are facing change. Effective communication has a positive impact while the lack of it has negative consequences.

3) Continue with your work as usual – corporate reorganizations are never any fun. It’s easy to have a bad attitude when changes are implemented in the workplace since you don’t know if the work you are doing will continue being important.

4) Envision the big picture – realize that the goals of making change are usually beneficial. The sooner you see the big picture, the better off you will be.

5) Maintain your network of contacts – whether external or internal, your network of contacts can be invaluable. They can be a sounding board and share their experiences regarding change.

6) Perform self-assessments – when planning for the future, many companies will analyze the opportunities, strengths, threats, and weaknesses in order to determine what they need to improve on. Self-assessments also help individuals determine their strengths and weaknesses while showing you where you need to improve.

7) Realize that change is inevitable and is the only aspect of our lives that is constant – as we grow older, we experience change in our personal lives. Why should it be any different in our careers and professional lives?

8) Recognize the stages of change – these include shock, denial, guilt, anger, and moving on. In some way, the stages of change resemble the stages of grief over the death of a loved one.

9) Stay alert for subtle clues in your surroundings – try to listen in on the rumor mill at work. Are there meetings occurring that you are not invited to? Is your boss acting distant towards you? Realize that change is desirable but also recognize when it is happening in your surroundings.

10) Stay positive – keeping a positive attitude during change will enable you to handle the uncertainties that come with it.


A Caregiver’s Bill of Rights By Wendy Lustbade

I have the right:

  • To take care of myself. This is not an act of selfishness. It will give me the capability of taking better care of my relative.
  • To seek help from others even though my relative may object. I recognize the limits of my own endurance and strength.
  • To maintain facets of my own life that do not include the person I care for, just as I would if he or she were healthy. I know that I do everything I reasonably can for this person and I have the right to do some things just for myself.
  • To get angry, be depressed and express other difficult feelings occasionally.
  • To reject any attempt by my relative (either conscious or unconscious) to manipulate me through guilt, anger or depression.
  • To receive consideration, affection, forgiveness and acceptance for what I do from my beloved one for as long as I offer these qualities in return.
  • To take pride in what I am accomplishing and to applaud the courage it has sometimes taken to meet the needs of my relative.
  • To protect my individuality and my right to make a life for myself that will sustain me in the time when my relative no longer needs my full-time help.
  • To expect and demand that as new strides are made in finding resources to aid physically and mentally impaired older persons in our country, similar strides will be made toward aiding and supporting caregivers.


The Delicate Balance: The Freedom of Forgiveness

Inspired by the ancient book of wisdom; 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

Imagine 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. Countless articles and books have been written on this subject. New terms have entered our professional vernacular such as lateral and horizontal violence. We can protest the insinuation but the reality still lingers. 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 that followed have taken its toll. I am beginning to believe that the years of staffing issues, overtime, downsizing, rightsizing, regulatory oversight, juggling academic preparation with family responsibilities and the subtle perception 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 or 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 the darker side of the profession. 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. Treat 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. This is defined by Renard (2002) as either acting naturally or as non-action. 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 overt or passive aggressive 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. Remember forgiveness does not require that you to forget an event. It does require that you let go of the pain that is associated with recalling or reliving that event. Forgiveness does not absolve the other person. It frees you.

Phyllis Quinlan, PhD, RN-BC

5 Critical Reasons Why You Fail to Reach Your Goals Guest Post by Carthage

If you are one of those people who consistently fails to reach your goals, it may be that you see goal setting as the whole process, rather than just part of the process. Setting effective goals is essential but unless you take action to achieve the goal, it will never truly be a goal, merely a dream. Napoleon Hill said, ‘A goal is a dream with a deadline.’Setting a deadline, for the achievement of your goal is another critical step in the process but unless you strive to meet that deadline, you are still just dreaming. Are you great at dreaming but struggle to reach your goals? If so, you must identify what it is that is holding you back. Once you do, you can take corrective action to get back on track and reach your goals.

Why you fail to reach your goals

Here are some of the most common reasons why you may fail to reach your goals:

1. Lack of purpose

Your purpose is the overall meaning and reasoning behind the way you live your life. Those who live with purpose understand that their time on Earth may be short but the positive difference that they make can last much longer. To live your best life, you must have a clear sense of purpose. Your goals should, at least in some small way, help you to live your purpose. They certainly should not contradict your purpose.

When you set goals, you are encouraged to write down any potential goal that pops into your head. It is important that you suspend evaluation and judgement during this process as it interrupts your flow of thinking and can cause you to miss out on identifying a valuable goal. Once the process is complete, you can then begin to evaluate each goal to determine how important it really is i.e. does it serve your purpose? Those goals that are deemed unimportant at present, should not be deleted; they should be added to a list where they can be considered again in the future.

Too many people skip this evaluation step and end up pursuing the goal that looks coolest, rather than the goal which is most important. This may work for a short while but eventually you lose motivation for anything which is not really important and so the goal remains unachieved.

Discover your purpose.

2. You cannot remember why

Many of your most important goals will be medium/long-term goals. You can become so caught up in the day to day grind required to achieve the goal that you forget the reason that you set the goal in the first place.

On the first coaching course that I ever attended, it was hammered into us that we should never ask someone why they wanted to achieve a goal. Over time, I came to realise that this approach was a load of nonsense. Knowing why you want to achieve something is the most fundamental form of motivation. On those mornings that you are struggling to get out of bed and get started; you can visualise yourself upon completion of the goal. This is usually enough to kick start your engine and get you going.

Once you have set a goal, write down every possible benefit that you will experience upon completion of the goal. Ask yourself why you want to make this change and answer it as honestly as possible. This list should always be kept close to hand. At least once per week, you can read the list and remind yourself of the reasons that you are pursuing this goal. Keeping a written statement of why you want to achieve your goal keeps that initial excitement with you to push you forward.

3. You take on too much

There is a great old saying which we regularly use in Ireland – ‘A Jack of all trades is a master of none’. You may wonder how this applies to goal planning but there are 2 ways in which doing too much can impact on your ability to reach your goals.

It is easy to get excited with goals and try to take on too much but if you do, you’ll be spending your energy all over the place. Rather than get a lot done on a small number of goals, you will be getting a small amount done on a lot of goals. You won’t have the focus that you need to reach your goals as your focus and energy are too divided. The end result will be burnout, stress and a no results worth talking about. It is best to focus on a small number of goals and, as you reach one goal, add another in its place.

The second problem with taking too much on is that you get bogged down working on tasks that you are not particularly good at. Most goals will require the completion of many tasks. It is unlikely that you will be talented at each task. Rather than waste time trying to do the things that you are not good at, find somebody who is better suited to the task. Delegation and outsourcing are your friends and, if you want to succeed, you need to make use of them.

4. Focusing on what you do not want

The average person can tell you what they do not want but successful people will always tell you what they do want. Knowing what you do not want can be useful but to make it work for you, you must be able to use that information to define what you really want e.g. it is good to know that you do not want to remain in the job you currently have but that does not tell you what job you do want. You will struggle to reach your goals if you do not know what the end result looks like.

As well as giving you a sense of direction, knowing what you want and, focusing on it, will help you remain positive until you reach your goal. Knowing that you do not like your job may give you the impetus you need to start looking for alternative work but if you keep dwelling on the job that you dislike, you will be focusing on negativity which in turn will lead to loss of confidence. Instead, focus on the wonderful new job you’re going to get.

5. Overwhelm

Many people fail to take the necessary action to achieve their goals because of a sense of overwhelm. The goal appears to be too large and too difficult to achieve. They may be lacking in some of the skills required to achieve the goal.

When you’re overwhelmed, it is easy to doubt your abilities. However, you are making a major and, common, mistake here. You are evaluating a future date with your present circumstances. When you do this, you are completely ignoring the fact that with time, you can grow, learn new skills and improve your current knowledge and skill levels.

With proper planning, this isn’t an issue at all. You can break your goals down into sub-goals and daily actions that will get you closer to the end result. In the process, you can identify the knowledge and skills which you need to gain and set sub-goals to achieve them. Once you have done this, you can then focus on the sub-goals rather than constantly looking at the bigger goal. This will reduce the sense of overwhelm and increase your confidence.

To learn to set effective goals which motivate and inspire you; check out theUltimate Guide to Goal Setting.

The main reason that we fail at goals is not the failure to set goals. Most people do set some form of goal, either formally or informally. While most of these people could set their goals in a more effective manner, the bigger problem is the lack of action that they take to reach their goals. There could be many reasons why people fear to take the necessary action but the most common have been listed here. When you recognize that you are experiencing these problems and, you take the necessary action to overcome them, you will become more decisive and proactive; leading to greater success where you reach your goals with relative ease. Goal setting and achievement is a life-long process and we are forever learning but if you overcome the problems above, you will have taken giant strides to reach your goals.