Respect for Yourself in Your Professional Capacity

There were a few things that helped to restore my sense of equilibrium. The first was to make a conscious effort to spend time with my wife. . . . A second source of balance came from getting together with other people who were facing similar pressures at work. . . . Another thing that helped was to take 10 or 15 minutes during my morning commute to sit quietly, reflect about my life, and say a few prayers. This helped center me for the day. It gave me a sense of perspective . . . Together these small things helped bring my life and my work back into balance.

J. Allegretti 1

Chapter Objectives

The reader will be able to:

• Discuss some benefits of putting family and friends high on one’s priorities.

• Name two types of bonds that can develop among work colleagues to help create a network of support and mutual respect.

• Describe guidelines to make an assessment of how supportive an employer and future colleagues are likely to be.

• List some questions that highlight whether future or current colleagues will contribute to enjoying one another in the workplace.

• Distinguish between the characteristics of being an intimate and a personal caregiver in the health professions.

• Compare important aspects of social and therapeutic relationships, describing why maintaining this distinction in everyday practice affects self-respect and respect for others in a professional environment.

• Identify and discuss two respect-enhancing goals that the interprofessional health care team approach is designed to meet.

• Compare key values realized through team decisions that are hierarchy derived and those that are community derived.

• List four criteria for referral of patients.

• Discuss how a health professions career allows one to participate in increasing goodness in the world.

This chapter continues on the course of moving from your role as a student to thriving in your lifelong career in the health professions. We introduce you to several specific capacities that, if nurtured, will serve you well in this setting. First and foremost is to build on the confidence you gained through attitudes and activities that honor care of yourself. As you recall, we urged that only through self-respect are you in a position to show care well for others. Additional emphases in this chapter prepare you to engage in skilled activities that distinguish your everyday relationships from your professional ones and pointers on the strengths of working as a member of an interprofessional health care team whatever your level of professional preparation.

Together these capacities will help ensure that you will experience deep satisfaction and self-respect throughout your work life.

Showing Respect for Yourself while Enjoying Support

In Chapter 4 you were introduced to some ways to engender and preserve self-respect that are particularly relevant to the unique situation of being a student. We also emphasized that many of the general themes in that chapter continue to be relevant throughout your professional career. We turn now to several considerations that you can add to what you learned, among the most important the necessity of being willing to graciously accept support when you need it and set priorities that keep the most important people in your close circle of your caring. Family and friends are at the top of the list. Professional colleagues are close behind.

Putting Family and Friends First

Because professional life can be so involving, family and friends outside of your work environment are at risk of being left out of your life in important ways unless you make conscious efforts to include them (Figure 5-1). Often they are taken for granted and may get the leftover part of your days, the majority of the best hours having been spent in workplace activities. This excerpt from a day in the life of a health professional reflects a routine that many in health care positions can identify with regarding the amount and quality of time spent with their families:

It is now 7 o’clock. I drive home. The day of work is finished. I know that I shall not have any more calls as I sign my phone out to the telephone answering service. I sit down to dinner with my wife and three school-age children. I listen to the children recount the activities of the day. It is March, and my wife and I begin to talk about possible vacation sites for this summer. After dinner I go to my study and take a journal from a pile of unread periodicals. I thumb through it, unable to concentrate enough to get interested in any one article. I turn on the television and begin to watch an NBA game. Later, my wife wakens me.²

REFLECTIONS

• What do you find encouraging about this scene as you think about your own work life? What is troubling about this scenario?

• What habits do you have that will serve you well in terms of nurturing your most important relationships over the long haul? (You may want to go back to Chapter 4 to the exercise regarding your priorities and how to honor them.)

FIGURE 5-1 Health professionals should remember to make time for family and friends. (© Getty Images/100069.)

Your challenge is to establish habits early that will reflect the rhythms needed for your family members and friends to be able to support you when you need it. A young lawyer quoted at the outset of the chapter has this further comment as he recounts the choices he began to exercise when he felt himself being consumed by his work:

There were a few things that helped to restore my sense of equilibrium. The first was to make a conscious effort to spend time with my wife. In the beginning, I resisted when my wife would plead, cajole, and sometimes push me out the door of our apartment so that we could spend a few hours watching a movie or going to dinner. Eventually, I realized how important this time was. It strengthened our relationship by keeping the lines of communication open between us. Not only that, it also made me a better worker by giving my anxious mind a much-needed rest.

A second source of balance came from getting together with other people who were facing similar pressures at work. Two or three times a month I would meet with a few friends from law school who were working in other firms around town. Our get-togethers were combination lunches and b.s. sessions. These meetings did wonders for my perspective. I found myself becoming less anxious and self-absorbed as I discovered that my friends were dealing with the same worries and concerns I was facing. We helped ourselves by helping each other.

Another thing that helped was to take 10 or 15 minutes during my morning commute to sit quietly, reflect about my life, and say a few prayers. This helped center me for the day. It gave me a sense of perspective. It allowed me to see the ways in which my work was an integral part of my spiritual life. . . .

Together, these small things helped bring my life and my work back into balance. They let me see my work more realistically. They stopped me from investing too much of myself in my work. And they reminded me that I was more than a worker and that my work was only work.1

In short, this young professional used the resources of family, colleagues, and his own form of spiritual reflection to create the balance he felt slipping from him. In the process he created a support network that not only benefited his work but helped him maintain a balance that showed respect for himself and those closest to him. He just mentions in passing that he realized his immediate professional colleagues also were a resource. It is so important that we examine this in more detail.

Honor Bonds with Colleagues

One source of support is that persons working in a health care situation have several common bonds, all of which help to establish rapport and support among them.

Bond of Shared Concerns

Care can be enhanced through having a place to air common concerns about a patient’s problems, prognosis, or progress; about the department; about what is happening in their field; and about health services in general. You voluntarily place yourself in the mainstream of human suffering, thereby showing that you care. No one commits you to this role. You choose to be there because you care enough about human well-being to want to effect certain changes by the use of your professional skills.

But this life you chose makes intense demands on you, and an essential resource is to know there is a trusted group with whom to share your common worries, uncertainties, and questions.

Bond of Shared Care and Gratitude

In the crush of everyday work, colleagues take less time telling one another directly that they appreciate and care about them than they do sharing their concerns. Creating a generous atmosphere of such expression helps transform a workplace from a work site only to a true community. Gratitude, too, is expressed too seldom by persons working together. A simple word of thanks can create more good will than months of competent work together, during which neither person makes an effort to express appreciation to the other. There are many ways to say “thank you” or “you are appreciated.”

REFLECTIONS

• What are some ways in previous jobs you have held that you and your colleagues have shown appreciation for each other’s contributions?

• What ideas do you have for helping to create a happy and supportive workplace for yourself and your colleagues?

Remembering another person’s birthday or the anniversary of a special event and performing other “random acts of kindness” creates a general environment of congeniality in which the language of mutual respect for the efforts and gifts of one another’s skills and presence can flourish.

Seek Supportive Institutional Environments

The bonds of shared concern and shared caring and gratitude work together to encourage the realization of mutually shared goals and values. However, as you learned in Chapter 2, it is not enough for individuals alone to desire to create a respectful environment—respect must also be reflected in the structure and values of those who have policy authority. As one group of health care administrators working to contribute to organizational structures that meet the requirement noted: “Optimally there is full alignment among (1) the moral identity of individuals, which informs and shapes their behavior as they work in an organization; (2) the implicit values of the organization as embodied in the organizational culture and stated and unstated practices; and (3) the organization’s explicit social purpose and stated mission.³

It is a good idea, then, when you look for a position in a new setting, to seek at least one person who appears to be a potential source of support. If no one promises to be such a resource, it is better to look elsewhere. In addition, you should be bold in asking questions that will allow you to gain some understanding of how support is expressed within the department and larger institution. To make an assessment, the following guidelines may be useful:

Inquire of your future employer whether there are meetings or other sessions where problems associated with the everyday workplace stresses of health care delivery are discussed.

Ask potential colleagues what they believe to be the sources of the most intense stress in that environment and how the group handles them.

Make a mental note of those who appear to be potential sources of support, or if no one appears to be. If everyone denies that problems exist or becomes defensive about such questions when they are tactfully posed, this probably signals a setting in which stresses are dealt with alone, without the support of one’s colleagues, or the institution.4

Fortunately, only in rare situations are no support mechanisms available. In fact, being a support to others is often the key to finding support from them when it is needed. The adage “To have a friend is to be one” holds true in the workplace.

Play: Enjoy One Another’s Company

No one could—or should—keep their self-respect if they unnecessarily put up with or contribute to an atmosphere of doom and gloom. Persons in health professions fields are fortunate to be in a line of work in which they know they are usually making a positive difference in patients’ lives. That in itself is reason to enjoy their work.

But there’s more. Shortchanging the joy that can come from remembering to put some levity and fun into the environment is doing yourself a disfavor. It does not take much—a cartoon, a good joke, a lighthearted story that a colleague or patient is trying to tell, or some other type of pleasure can do the job. One author, himself a health professional, observes:

Joy is only possible for persons who are attentive to the present. One cannot be happy if one is continually ruminating about what might have been or fretting over whether wishes will come to pass. Americans have a tough time with real joy. Americans are oriented toward outcomes, expectations, and the future; toward ever more competition in proving that they deliver the best results, and anxiously pondering how things might have turned out if only they had chosen differently. This makes it hard to be happy. In health care, these tendencies are exaggerated. Worries about what will happen next to the patient and worries about their own future careers blot out the possibility of joy for many health care professionals. Joy is a present tense phenomenon. It is possible only if one attends to the moment.5

Sometimes activities outside of work hours enhance the ability to enjoy one another in a more relaxed environment. There are the usual afternoon coffees or parties or sports teams, but the activities need not stop there. For instance, two of the authors were part of a writing group some time ago. We met regularly with several other health professions colleagues after work. We wrote about our work experiences in the form of short stories, poetry, and essays. At first all of us were scared to share anything, believing it would not be good enough. However, as we became more comfortable with one another, we started looking forward to hearing one another’s stories. In addition to writing about some serious problems, we found our gathering to be a great vehicle for laughing at ourselves and good-naturedly at one another, as well as an “excuse” to get to know one another better. One delightful outcome was that we were able to publish some of our work for others to share, too.

In your own search for finding a congenial group, or whether you should stay in your current position or move on, you can use some of the same approaches that we suggested earlier to assess the type of situation you are getting into. Ask yourself: