• Megan Filoramo

Using the worst idea

Today I gave my patient a terrible idea. We were talking about ways of increasing her exercise and activity despite her severe chronic low back pain and the limitations inherent to being in a pandemic. As soon as the words came out of my mouth, I knew the idea was terrible and she would never do it. I actually felt stupider for having said it. But there it was, hanging in the appointment room like the dark cloud of political talk at the Thanksgiving table (ok, that’s totally an exaggeration, it wasn’t that bad.)


The truth is, I have no idea what the best idea would be for my patient to actually increase her activity. I can’t possibly tell her what would work for her or what she would find sustainable. And yet, I made this completely ludicrous suggestion, wishing as I soon as the words were out of my mouth that I could retract and rephrase.

Thankfully I have been doing this long enough that I didn’t really sweat it. Instead of asking for a do over, I waited to hear her rebuttal. The rebuttal always comes when you put a terrible idea out there. She told me exactly why my idea sucked and then, like a pawn playing beautifully into my hand, she told me what would work instead. Of course, I didn’t actually plan that. I didn’t walk out of the room with a sinister laugh but it definitely got me thinking.


The beauty of a bad idea is it can birth other ideas, useful ideas, ideas that can promote meaningful change.


It’s like the idea of the “shitty first draft” coined by the novelist, Anne Lamott, in 1995. This idea, promoted to writers, was that the first draft of any literary piece should never be expected to be any good. It should be put on the paper, purely as a launchpad for the true masterpiece. The actual purpose of this first draft is just to take forward motion, to get started. I saw this to be true with my patient. I didn’t even need to take the step of asking for clarification, she launched right into exploring the holes in my suggestion as well as alternative solutions.


So how can we blend this clinical experience and literary advice into a usable strategy for ourselves?


First, we have to come up with the bad idea without holding any true attachment to it. Acknowledge it for what it is, a catalyst for change, nothing more. If I had argued with my patient, defending my idea, neither one of us would have gotten any benefit from the discussion.


Not sure what to do or how to proceed toward a goal that seems to stay just out of your grasp? If you get stuck, ask someone else for their opinion. Nine times out of ten you will think their idea is bad.


But here’s the trick.


When you come up with all the reasons why the idea is bad, or won’t work, or doesn’t apply to you, you need to take those reasons and solve for them. THIS is what will birth the ideas and approaches that are specific to you, your personality, your struggles, and your strengths. Don’t fall into the trap of stalling out at the rebuttal phase. You have to move into the counter-offer.

Let me give you an example. I'm sure that most of you, like me, have had someone suggest to you that if you just got up a little earlier and exercised that your life would be filled with magical unicorns and rainbows and all your problems would be solved. Let me tell you why this approach doesn’t work for me. First, I am already up at 5:15 to get ready for work and leave by 6 am. On top of that, I am not a great sleeper so when I am watching the clock at 3:42 am the idea of getting up earlier is somewhat abhorrent. There are evenings that I am fighting to stay awake when my family is just getting home so I am afraid to get up earlier and go to bed earlier.


To top it all off, unicorns aren't up before 5am either and the sun isn't out for rainbows so what’s the point.


When I look at all these reasons, I have to start solving for them. Exercise does give me energy but when I really need that is after work, not before. Therefore, my personal solution is to exercise right before or right after dinner. Maybe this isn’t in sync with conventional wisdom but I am pretty sure that no exercise guru would say "not exercising at all is preferable to exercising right after dinner."


My point? The reasons the original idea was “bad” were the solutions to finding a system that worked for me.


So quick steps?

  1. Identify the problem

  2. Come up with ANY SOLUTION AT ALL.

  3. If your gut feeling is there is no way it would work, ask yourself clarifying questions. “What about it won’t work?”

  4. Find solutions or work arounds for those reasons and come up with a new plan.

  5. Try it- the beauty of adjusting a bad idea to a good one is the stigma of failure is eliminated. We are just trying something better than the original proposal which 100% was going to fail.

  6. Feel satisfied with yourself.

It’s pretty straight forward. And bad ideas aren’t hard to come by.



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I’d love to hear from you. What do you find yourself struggling with day to day? Have a blog topic request? I’d love to take on the challenge. Message me at Megan@Nursingbeyondthejob.com


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