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  • Writer's pictureMegan Filoramo

To say yes or no, that is the question.

There’s a lot of advice out there to learn how to say no, lists of ways to say no politely, strategies on setting boundaries, deep dives into self-reflection to excavate reasons for our people pleasing behaviors.

And the truth is, we can learn something from each of these approaches.

The real quandary comes when we don’t really want to say no…but we don’t want to say yes either. It’s a lose-lose situation,

This is particularly tricky for many nurses. We WANT to be helpful, we went into this field to be helpful, and yet sometimes being helpful can feel not so helpful for our own mental health.

So despite all the popular opinions on how to say no, I think a more useful skill to develop would be to feel good about whatever decision you make, yes or no.

Let me explain.

We struggle with saying no because of how we feel when we say no. We may justify saying yes by saying it’s the right thing to do, or it’s expected, or the person really needs it… but that’s not always the real reason.

We say yes because we are afraid of how WE will feel if we say no.

The shame of not being the person who does the “right thing”

The fear of rejection if we don’t do what’s expected

The selfishness of not helping someone else.

No one wants to feel shame, fear, or selfish.

I am not saying this is how we SHOULD feel: it’s just the default background music, constantly playing in our heads and making us feel terrible.

So we don’t say no.

But here’s the rub, saying yes doesn’t make us feel good either. If it is really something that we don’t want to do, for whatever reason, and we say yes anyway, we feel resentment, and resentment feels terrible.

No makes us feel terrible.


Yes makes us feel terrible.


This is why the real skill is learning to feel good no matter what decision you make. The skill isn’t hard to learn, it just takes some intention and some practice.

First step: Acknowledge that most decisions aren’t cut and dry, many house opposing emotions.

And it’s okay. Actually, it’s more than okay, it’s perfect.

When we can acknowledge BOTH sides of the decision (both of our own sides that is)

we can start to feel better.

You may find it helpful to use a 0/10 scale.

On a scale of 0-10, how much do you want to do or not do (fill in the blank) ?

Here’s where the magic comes in.

Why did you pick that number and not a higher (or lower) number?

List out the reasons. This will show you why you do want to do something and why you don’t.

It will help you make a decision that you can feel good about.

For example, on a scale of 0-10, how much do you want to agree to be on a committee.

If I answered 6/10 I would then look for the reasons why it is a 6 and not lower.

I like the people I would be working with.

I believe in the purpose of the committee.

I think I could have a positive impact.

And then, why did I not pick a number higher than 6?

It will take some time away from my family.

I am already involved in other committees.

It meets at a time that would require juggling other commitments.

It’s not just a pros and cons list. It assigns value at the start, YOUR gut reaction to the decision.

The key is to understand why we are making that decision


being ready to defend ourselves, to ourselves, when we start to question that decision.

Success depends on speaking to yourself with clarity and honesty. Don’t keep telling yourself you don’t want to do it. If it’s 60/40 then you want to do it a little more than you don’t want to do it.

Choosing with clarity can help you be happy with what you decide.

And as a HUGE bonus, this skill is SO helpful when helping our patients make decisions (and stick with them) or helping them cope with a decision that they have regret over. Acknowledge that both yes and no can have associated negative emotions, acknowledge WHY you made the decision at the time.

It’s like putting off a shoulder replacement due to fear of pain and immobility. This, on the surface, seems reasonable… until you do this exercise and realize that putting off a shoulder replacement also guarantees continued pain and immobility. Both options have negative components, which moves you in the direction you ultimately want? What are the other components that balance the equation?

Choose with clarity and then commit to having your own back with that decision.

Commit to not entertaining negative self talk if new information comes up that you couldn’t have anticipated.

Commit to remembering why you made the decision.

Commit to yourself.

If you can eliminate the fear of beating yourself up later if the decision didn’t turn out the way you hoped, you can have peace.

Make the best decision you can, with the information you have at the time. Make a decision filled with compassion and understanding.

Compassion and understanding feel so much better than judgement- even when it’s you applying it to yourself: especially when it’s you applying it to yourself.

And then, we can help our patients do the same.


It’s time to stop beating yourself up all the time, it seeps into all parts of your life and makes it harder to deal with the day to day stressors. Sign up here if you need some help.

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