• Megan Filoramo

When "evidence based" is totally the WRONG approach.

I’m a big fan of science,but recently I realized that the focus on an evidence base for our nursing practice is not necessarily translatable into my “real life”. GASP! But before you burn me at the stake for heresy, hear me out. You may actually be super happy to convert to this way of thinking.


Our day to day activities at work are dictated by current scientific evidence. We use it as a compass to guide our decision making and develop our plan of care. Much of our day is spent looking for evidence of health or pathology (AKA doing physical exams, taking health histories, picking up nuances in the changes of patient status). And even for those who may not be doing this on a regular basis in their current jobs, it is so ingrained in us that it shapes the way we think. Our reliance on scientific or objective evidence is forefront not only in our job descriptions but in our habits and perspective.


So what’s the problem?


The problem is when we erroneously apply this approach to changing the status quo in our personal lives, when we rely on past evidence to try and create new results for our future.

If we only look to evidence of things already achieved, we rob ourselves of the belief that we can do new, amazing things; that we can blow our own minds.


The belief has to come first, not the other way around. It all goes back to the following model.

Thoughts (AKA beliefs) create your feelings.

Feelings create your actions.

Actions obviously create your results.


If you don’t believe something is possible this generally leads to a feeling of discouragement, futility or apathy. How many productive actions do you take from those feelings?


This all sounds fine and dandy, just BELIEVE your way to a new result.


Sorry, no Christmas miracle here, action is still required. But in order to take effective action and get the results you want, you do need to believe. So how do we do that? How do we all of a sudden believe that we can finally make progress toward our dreams?


Good news, as always I have some steps.

Step 1: Be very clear on what you believe currently. These beliefs can be sneaky, dancing around in your head, pretending that they are facts.


Not sure what I mean? Answer this question for me. Why can’t you <insert goal here>( get in shape/ eat healthy/ love your job/ deal with your mother-in-law/ go on a vacation/ pay off your credit cards)? The answer to that question is what you believe.


Some of the most popular beliefs:

I don’t have time.

I don’t have the money.

I don’t have the right genetics.

I don’t have the willpower.

It’s just not who I am.

She is unreasonable.

It just isn’t possible.

It’s too much work.

Everyone’s expectations are too high.

Or, my personal favorite, it never works.


Ok, now that we are good and agitated, let’s move on to step 2. It’s the tricky one.


Step 2: Acknowledge that these beliefs are not facts but just thoughts, thoughts that may have been programmed into you since a young age but thoughts nonetheless.


I know the temptation is to start defending why they are true. Feel free to defend these if you want to stay stuck. If you are tired of feeling stuck then humor me and entertain the idea that in a court of law, these may not hold up as “facts”. I’m not asking you to reverse these thoughts, just see them for what they are, just unchallenged beliefs. Beliefs that have produced the actions that have gotten you to where you are now, but if you want to go further or in a different direction, they aren’t going to get you there.


Step 3: Decide what you want to do with the thought. Maybe you want to keep it, maybe you don’t. Some thoughts have produced good things in our lives but their season is over. For example, I was always 100% sure that I was going to go to college. This belief helped me take all the necessary steps to get into and through nursing school. It did its job, but now its job is done. It can retire and I can start working on a new belief.


IF you want to achieve something new, better, exciting, you need to try a new thought.


How about this one. “I am already her.”


I am already the person who will achieve these things. I don’t have to be someone better, or different. I just have to keep taking action from a place of belief. This belief that I am already who I need to be results in confidence, and confidence GETS SHIT DONE!


Even when it doesn’t work the first time, or the second time, or the 10th time.


If I am already her I can save myself from going down the self deprecation spiral and stay focused and productive, gathering info along the way for what works and what doesn’t. If I am already her, I am so dedicated to the result that I will figure out the how as I go along.


Stop using irrelevant evidence from the past for why it won’t work- I was never a nurse practitioner, until I was. I was never a mom, until I was. Using past experiences or even past failures as evidence against ourselves is just mean, and useless, and simply not relevant. We get the evidence AFTER the experiment, AFTER we keep taking action, AFTER we achieve the goal, not before.

I didn't have any evidence that I would go to college, just the belief that it was definitely happening. The evidence came after I got in, stayed in, and graduated.


If it’s too much of a leap to go to “I am already the girl who …. loves her job,” then maybe start with the baby step of “it is possible that I could…. love my job, lose the weight, write a book… you name it.” It’s amazing how using the prefix of “it’s possible that” can change the whole feeling (and therefore your actions and results). Start with a more gentle hypothesis and work on proving that true.


Building a belief is the first part of any meaningful change in our lives… before planning any actions (we love trying to figure out the actions first and then use willpower to try and stick to them).


Believe in the result more than the how, after all,

you are already her.

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