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Thank you for joining us for this part two discussion with Dr. Cynda Rushton talking about wellness and well-being in nurses and nurse educators. Thank you for joining us again. So this area this topic of a psychologically safe environment I know I'll speak for you Rachel that because I know you so well that it resonates deeply with us and we've always talked about how it's not a one and done kind of situation. It has to be kind of almost have to create it for
yourself internally first right. What do I believe, what what is my philosophy of teaching, of professional practice. Cynda you did a beautiful job in the R3 program of talking about identifying our core values. What are the one or two or three things that really create your structure in which you operate morally, ethically, emotionally
and you can lead with that. So this idea of exploring our ourselves as teachers or mentors are psychologically safe kind of landscape and then creating it and then checking in and maintaining it and evaluating it. Is this still feeling like a container that we're learning and risk can happen and vulnerability and then re-establishing it.
Sometimes it starts falling, the wheels start falling off and you're like, uh oh, you know particularly after an exam, perhaps the wheels start falling off and our learners get upset, they activate emotionally because of all kinds of really important emotions -disappointment, fear, anxiety, do I belong here, so all of this comes up in the classroom and if we don't know what to do with that or how to respond or and then we don't know sometimes unconsciously
again we're absorbing all of this and we may not know how to respond in that moment and we may shut down and a lack of just not knowing what to do so I think about that I mean I think that experience happened in the classroom that I just described but it happened in the the nursing unit, the nurses unit and the hospital. It happens in
community practice. It happens everywhere and I feel like I just commend you for creating these modules and awareness and skills and knowledge and content where people can just learn how to do this and have more awareness about it. You know, it's not like we got a playbook you know, and you know I think back on my own career.
Part of the reason I got involved in these ethical issues is as a pediatric ICU nurse I was involved in hard decisions at a time when technology was advancing, hopefully to benefit children and youth, but there was also a downside of that and we didn't know what those limits were but the distress that I experienced I didn't have a name for.
I didn't know what to even call it. So I think we're in a similar situation now where everybody's sort of attached themselves to the burnout narrative but I don't think it's actually precise enough for us to locate what the source of this distress actually is because if we can't make an accurate diagnosis we cannot decide
what the solution is. We can't figure that out so I think it's creating spaces where we can unpack what's really at stake here, what's going on and we have a pretty impoverished vocabulary about how we're feeling. We say, you know, Michelle I'm
fine. Well I'm not fine. Actually I'm feeling sad or I'm feeling afraid or I'm feeling, I am feeling anxious so some of it is also expanding the vocabulary so that when we are asked how are you instead of creating a mask that is really not an honest response, I'm not actually okay and being able to have a norm and a culture where we can be honest with each other. You know what, I'm kind of struggling today. I'm having
a hard time focusing. I'm distracted because of something that happened at home before I came here that would be a different kind of environment than everybody just soldiering on. I'm hoping that maybe this pandemic will open up that possibility for us that we can turn toward our limitations with a little more compassion in the way that we are compassionate to the people we're trying to
serve. We also need that toward ourselves and I think this idea of changing the how are you from a rhetorical question to a genuine curious question and holding space for that response is so important. When I think about that it takes me back to this quote that at first may not seem applicable here but I read it on social
media the other day. It talks about as a parent the more I become skilled at being a parent I realize it's not about managing my child's emotions and behaviors it's about managing my parent emotions and parent behaviors and I think there's a nod from that that can apply here in that if we're going to hold this space if we're going to model this for our students it really becomes first and foremost a priority of learning the language and
the noticing skills and the management skills for ourselves before we can start really genuinely holding space for others. We often say, "you can't give what you don't have yourself," and what I see happening a lot with I mean all of us nurses but also faculty members is we're so quick to focus on our students to focus on
nurses have the same duties to self as to others including preserving their well-being and integrity. We have a tendency to count ourselves out of the equation and our code is clear that we have to count ourselves in. We have to invest in ourselves to be good stewards of our
ourselves, our energy, our time, our knowledge, our skills, and that's not something somebody else can do for you. That is an internal personal journey of trying to figure out what that looks like. Part of it is I think reframing asking for help as an act of weakness and seeing it actually is an act of integrity, of being able to know myself well enough that I know what I need and I know where to find the resources that
will support me. That is a shift I think that could help us engage in integrity preserving choices rather than reinforcing a victim narrative and one of being disempowered that I have no choice. I think we always have choices. I also think I love what you're saying. There's this side of asking for help, identifying that hope is needed and then having the courage to ask for help and then the other side that would be really wonderful is if that ask for help could
be met with what happened to you. I read that book by Oprah Winfrey and Dr. Bruce Perry that is trying to change the narrative from what is wrong with you to what happened to you so if somebody has the courage to ask for help that they could be met with - share with me what's happening for you or what happened to you and then it could be this opportunity for the person that could be a signal to check in well what did
happen? Why am I feeling this way? What is bubbling under the surface that I can't quite identify and to make a little connection to nerdy brain science with situational awareness. We as humans are really bad at keeping ourselves situationally aware. We need another person to tap us on the shoulder and say, do you see what's going on? We can't do
that ourselves. Sometimes we need help. So even when we're asking for help the other person might need you know that dialogue and that connection can really advance the the whole situation. The whole thing we need, we need investments on both sides of the equation. As faculty members we can be part of that in creating the environment but we've got to do our own human homework before we
engage in that. It's not like a transactional... let me read the script that's only going to get you started, that's not going to actually solve the problem. And at the same time then how do we create learning opportunities with students when things happen? Another module we created was around when hard things happen. Your first code, your first patient death, your first mistake the first time somebody, some person is yelling at you whether it's a
patient or somebody else. How do you process that personally and in collective relationship with your colleagues? It's gonna happen so how do we anticipate that? Instead of being surprised by oh this is a reality and giving people a chance to to explore that in a lower risk kind of circumstance. Simulation is a great place where that can happen. You know, it's not only doing the code it's having a part of your simulation which is about
okay how do we honor the life that just ended? How do we incorporate a ritual at the end of that process that acknowledges our humanity and our own experience and then how do we move from that into a debriefing of how we process the emotional dimension of that? Those are are not soft skills. Those are actually fundamental skills that are necessary to sustain us in our profession, especially if you're working in an environment where those things come up frequently.
So Cynda, someone comes up to you and says, everything you're saying is resonating with me. I want to think more about this, think deeper about this. Where would you direct them to go? Where should they start if they really just want to dive into thinking in the space and building some of the skills necessary to tackle these difficult questions? Well, I think there are just many doorways.
There's not just one and I think people have to start where you are and one place you can start is just taking stock yourself of how am I doing right now. What's working, what's not working, and really exploring what's missing. What's missing from my life and my work? Where am I getting energy and where is it being depleted and how can I get more of those energy producing
things in my life? So there's, I think, a discernment part, you know, to start with and it's also exploring our assumptions about ourselves. We've had this talk about words, self-care you know became this thing. Oh, that's self-indulgent. That's selfish. That's for somebody else. I don't have time for
that. In our work we shifted to self-stewardship because self-stewardship is about knowing yourself well enough to know what nourishes you and what depletes you and to know that you are deserving of that investment because you are a human being.
Also involves turning toward our challenges and our edges with compassion rather than judgment and then being willing to take the steps to choose how you're going to allocate your scarce resources of your life your energy, your knowledge, skills in a way that really reflects who you are and why you're here and so that is a lifelong process. I think it's not a one and done. It's not like you can go and get the checklist.
It really doesn't invite us to to create space for that kind of exploration to be curious to remember, you know, I'm a knitter. I started knitting in the second grade.
I stopped knitting for a period of time and one of the things that I realized as I was doing my own self-assessment when I pushed and pushed and pushed to the point where I was kind of burned out and I started thinking about what were the things I really loved to do so I went to the yarn store and I touched all the yarn and I found some really beautiful yarn and a pattern and I decided I was going to knit again I haven't stopped since but it's that kind of remembering
what is it that brings me joy. What is it that nourishes me in my ability to show up every day? What can I start doing to end the day to lighten my load to let go of what's not mine to carry and how I can let go of those self-limiting beliefs so that I can arrive at home with my family without all the stuff in my backpack that's dragging me down. So those are some of the things. It's like start where you are and be curious. Take some risks. If it doesn't work, do something else.
Well I realize, I hope our listeners realize that you all have human homework to do. I love that saying. I'm going to use that if you don't mind, Cynda, with your permission. We all have human homework to do so starting with ourselves and kind of taking inventory can be a wonderful place to start. Thank you and kind of finding what what energizes you, what builds your cup and that then that
gets shared. That resonates and that kind of positive energy is shared with others, so thank you Cynda. I'd like to, if it's okay with you, Rachel, I'm gonna see if we can ask Cynda some questions, rapid fire questions. Sounds good. All right just to get to know you a little bit more Cynda. If you were to write a memoir what would you title the book? The Long and Winding Road. I was thinking human
homework again. I was like maybe everyone needs to have their human homework and you can have a book called, oh gosh. Yeah it's been quite a long and winding road actually life is full of surprises. I guess that's what I'd say. Wonderful. What is on the top of your reading list right now for fun? The fun reading list is very limited right now because I am working on a second edition of our book so I'm not reading a lot of fun things at the moment.
but...the things that I'm really drawn to is one book is by Christiana Figueres who was one of the Paris Climate Accord architects about how to be a persistent optimist in the midst of all of this climate catastrophe and how do we meet that moment which is not so different from what we're trying to do in health care. And what is your favorite quote? I have so many. His Holiness the Dalai Lama says when you meet real tragedy in life you can beat
it in one of two ways. Either losing hope and falling into self-destructive habits or using the experience to find your inner strength. That is beautiful. That is beautiful. And lastly, if you could have dinner with one person dead or alive who would it be? Oh gosh. There's a lot of people. Nelson Mandela. I would love to chat with him. Absolutely - an inspiration indeed. Cynda, thank you so much for giving of yourself and your insight and your
wisdom and talking with us. I've learned a lot. I certainly needed to hear a lot of it so I'm sure others did as well. So thank you so much for joining us. My pleasure. Thank you for inviting me and thank you for creating the space for this conversation. Thank you for joining us on this episode of NLN Nursing EDge Unscripted Surface.
We hope you join us next time. Until then, remember, whether your water is calm or choppy, stay connected, get vulnerable and dare to go beneath the surface. [Music]