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  • Writer's pictureMegan Filoramo

When change makes you want to vomit

How do you feel about change? Most people get a little put off by it.

We are going through a lot of change in our practice right now, so it's on my mind a lot.

The problem with change is we often have no actual control over it. Combine this lack of control with uncertainty of the outcome and it can trigger a significant stress response.

It makes sense. On the most primitive level, our brains interpret uncertainty and change as probable danger. Why? Because if you don’t know what’s going to happen, it seems safest to assume it’s going to be horrible and prepare for the worst.

Without anything actually happening, we engage our fight/flight response. We become hypervigilant (read “fixated”) on the problem

…the potential problem.

Hello and welcome to cortisol.

No wonder why we feel anxious, our bodies are trying to protect us.

Here’s the thing, from an evolutionary perspective, this no longer serves us. Releasing all that cortisol and having elevated heart rate and blood pressure doesn’t protect us from anything in the present moment.

To top it all off, when we fixate on the possibility of a problem, we are distracted from the reason that we are actually at work, the reason that can make us feel better: patient care.

When we are scanning our world at work for danger, we prevent ourselves from being open and present with our patients.

And then, to top it all off, when we become aware not being patient focused we add on a healthy dose of guilt.

No wonder why we feel terrible.

So how do we deal with change or uncertainty at work? It’s pretty simple (simple, not easy). When we feel the increase in heart rate, the flushing of the face, the hypervigilance, we take a minute to acknowledge it. Nothing has gone wrong here; it’s just misplaced primitive programming. We can't just ignore it (it’s like a toddler, if you ignore it, it gets louder and louder and more disruptive).

Take a breath. Acknowledge why you are feeling this way; your body is trying to keep you safe. Acknowledge you are safe because the whole reason you are at work is to care for patients and you can still do that.

Even with change. Even with uncertainty.

The patients can ground us. They can keep us present and focused with just a simple decision from us to be present and focused.

Take a breath, tell yourself you are safe and then drag your attention away from the uncertainty and back to the importance and satisfaction of caring for other people.

It’s all ok. We are nurses.

We figure things out.


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