How I see it …. things that come back to bite you

As a predominantly positivist quantitative researcher, my goal is usually to explain why something is the way it is and provide a logical conclusion. Coupled with this, I am a nurse who has an inherent desire to problem solve an fix things seeing solutions long before the plan to get to these is fully formulated. What happens when these two skills do not allow you to overcome a problem adequately?

Today I discuss grief, which is not a new experience to me yet is still providing me with learning opportunities.

Grief is an interesting concept which doesn’t neatly fit into a box or category that be fixed, and therefore I find living in this space challenging; there are many theories to explain it, yet the experience is very individual and doesn’t fit into my schedule or lifestyle.

Some might quote “the stages of grief” first introduced by Elisabeth K├╝bler-Ross that became a popular way to categorise grief.

  • 1. Denial and isolation
  • 2. Anger
  • 3. Bargaining
  • 4. Depression
  • 5. Acceptance

Today I have been considering the application of these stages of grief to some situations I find myself in and want to discuss the challenges of navigating these.

Interestingly, I have experienced all of these stages of grief for differing reasons in the last week and as a consequence learned about the compounding nature of this experience.

For example, one experience (this week), triggered a previous knowledge of grief (20 years ago), which in turn triggered the third experience of grief (16 years ago). All with different context but interlinked and at varying stages and severity.

One of the things I learned from this is that multiple forms of grief can be concurrent; however, deciphering the nature and origin of each thought or feeling can be challenging. Using Kubler-Ross stages of grief as an example, I found myself, angry, frustrated, bargaining and depression concurrently but for different reasons. The challenge I have noticed is that processing all of these can become erratic, for example, bargaining in relation to one experience can trigger and then enhance anger in another, depression can trigger isolation and blaming oneself.

I will end with a positive experience of acceptance. I was teaching a class of around 100 students this afternoon, multiple perceptions of the same situation along with this the discussion also included those beginning nurses may operate without seeing the bigger picture until they have the knowledge and experience to allow a broader view. We also discussed the need to be aware that this could occur.

To illustrate this (along with the clinical examples), I used several personal stories. In particular, this was to use my experience of glaucoma, retina damage and lack of peripheral vision to illustrate that there are ways to compensate for “tunnel vision”. It was a first for me to be completely honest with my class about my reduced vision. In the past I may have alluded to it but not overtly told the class as a part of a lecture. The interesting part for me was that this showed acceptance of reduced vision and it was natural to discuss. However, until this time it had been uncomfortable for me to discuss this in a public environment (other than by blog).To illustrate this (along with the clinical examples), I used several personal stories. In particular, this was to use my experience of glaucoma, retina damage and lack of peripheral vision to illustrate that there are ways to compensate for “tunnel vision”. It was a first for me to be completely honest with my class about my reduced vision. In the past, I may have alluded to it but not overtly told the class as a part of a lecture. The interesting part for me was that this showed acceptance of reduced vision, and it was natural to discuss. However, until this time, it had been uncomfortable for me to discuss this in a public environment (other than my blog).

How I see it – vulnerability the good the bad and the ugly

A person that I have a lot of respect for thanked me for being vulnerable and honest today. These words were what I needed; however, in hindsight, an exploration of their context revealed more.

Showing vulnerability is a part of building relationships, but just how much of yourself is the right amount to share? As a teacher, showing vulnerability is considered a good trait. For example, to let students know when you don’t know the answer to their question is deemed to be good practice and being honest. However, as humans, we walk a delicate line, and because of this, the line between sharing information and over-sharing seems to blur. Similarly, the line between sharing and truth can also be less clear.

For example, in society, sharing surface information is considered appropriate, but often anything more profound is not suitable or wanted. What springs to mind here is the typical situation of passing a colleague in the corridor, and they ask “how are you”? Often my immediate response is “fine thank you” or “I’m good” whether I am or not. As much as I might want to share my true thoughts, I do not as the other person often doesn’t want or need the truth; it might hurt them, or be difficult for them. On the other hand, when I walk past and ask someone “how are you?” at times, I am just being polite and don’t want the truth only the superficial answer.

In both of these situations, the sender and receiver of information make assumptions about the needs of the other. More often than not, I tend to consider the needs of the other person to be more worthy than mine. Some may argue this is a form of protection. However, it makes me question myself, asking why I so often consider others needs, thoughts and feelings to be more important than my own? (although this tangent is for another day).

In considering this reflective question, the saying “a problem shared is a problem halved” kept springing into my mind. However, in a situation that prompted this blog entry, I was distressed and needed to separate current from historical context to make a life altering decision. I chose to confide in someone without full consideration of the position that this knowledge puts them in, and the part of this which bothers me is that action goes against my usual nature and values. While sharing information made my position clearer and easier, it likely had the opposite effect for the person I chose to confide in making their position more tenuous.

Bringing this back to thinking about vulnerability. Sharing too much could be harmful to others. Perhaps confronting to the person receiving information and as in this case complicating their context. On the other hand, not sharing or showing vulnerability can make building relationships with those around you challenging.

Situations like this are tricky, however, posing myself some questions in future situations like this may assist in navigating the complexity.

For example:
1) Why did I share or show vulnerability?
2) What emotions was I feeling?
3) What was my intention in sharing these?
4) Does the purpose of sharing match my values?

How I see it – self doubt could be a good thing

Some days I feel like the strongest person in the world, confident and self-assured, yet other days, I feel the exact opposite. People (and literature) will say that this is normal, human nature and a part of life. Lately, I have been wondering why many of us are conditioned to doubt ourselves rather than questioning this, considering context or seeing all we are achieving.

My initial response to this question was that it is easier to change yourself than those around you. But on reflection, I now feel that this answer only scratches the surface or in more colloquial terms is a cop-out answer. Looking from the outside, I am a strong, independent, and accomplished person yet so often still doubt my abilities.

In my profession, an important part of being an effective nurse is to question, be curious, challenge your thinking and that of others while advocating for those who can not. These actions or traits are the part of my job I value very highly. Furthermore, it is where I feel that I can make a difference, where it is rewarding and where I usually operate. These are not traits I associated with someone who often doubts their ability.

Many times after doing this I am left thinking, I did my best and made what seemed to be the right choice at the time, however, in hindsight, I doubt myself, my actions and my decisions. The interesting part is, in all of the situations (as far as I know), none of my actions or decisions was necessarily questioned or interpreted as doubt or failure by others in the way I sometimes did myself. There seems to be quite a mismatch here, and as we do, I thought of a label for myself – a high functioning self doubter (in jest).

Reflecting on this led me to question my leadership style, I tend to lead by example, get stuck in, be kind and compassionate, help others to be the best that they can be, give the task at hand all of my energy and effort. On the other hand, I can be firm and stand my ground when need be. The people I respect as leaders or am inspired by also share some of the traits I see in myself but don’t appear to have any self-doubt. The wise might say, that I don’t see their self-doubt which led me to consider if all people doubt their actions or decisions at some point in time and try to imagine what life might be like for someone who didn’t ever doubt themselves or their actions.

Much of the doubt or non-doubt could be conditioning, or in a way institutionalization or learned behaviour and in that respect my mind suggests that if this is, in fact, conditioning then self-doubt “should” be able to be undone or removed. My immediate thought was – let’s ignore that self-doubt. On considering this, I imagined what life would be like without questioning myself (which is a form of self-doubt), and I thought that without the ability to question your actions how could you learn or move forward.

After a lot of thought, my conclusion at this time is that we need self-doubt as a regulating mechanism. If I didn’t question myself, how would I learn and improve? One could argue that doubting yourself is questioning yourself and therefore, in my case, something that I value.

With this in mind, my mantra relating to self-doubt has changed. Including reframing self-doubt, moving away from the all-consuming doubt in my abilities and convert this thinking to valuing self-doubt as a tool and part of moving forward.

Watch this space … now I know what I would like to change, I need to figure out how to do it!

How I see it … Post PhD Exhaustion

I handed my PhD in on Tuesday this week and I must admit it is a relief it is gone in. However, what I didn’t anticipate was the sheer exhaustion after having finishing it.

As expected, the PhD has been replaced by an increased workload. But, what I didn’t anticipate was the sheer exhaustion after finishing and the impact this would have on my own functioning. I had been doing 60+ hour weeks to complete and found that while I was doing this, I didn’t notice the physical and emotional signs of fatigue as readily. However, since handing in, I have realised just how fatigued I actually am.

Fatigue is not new to me. As someone with a vision impairment, I generally read very slowly and favour discussion or audiobooks. To compensate for reading taking me longer than those around me, when I need to read and am under time pressure, I often subconsciously read by the shape of the word rather than larger text, but this can cause errors. The more visually fatigued I get, the more I revert to reading by the shape of the word. It is a chicken and egg situation as I make more errors when reading by shape, or large print reduces errors but is much slower, and I work longer. Either way, it takes more time and visual energy.

Just over a year ago (2 years into my PhD), I realised that “visual fatigue” was an actual issue. I found myself subconsciously needing to take a break at 0930, 1300 and 1530 ish every day whereas before I could just keep working through these. When I analysed the situation, what I was doing was subconsciously reducing visual activities, such as getting away from the light, screen, office and moving objects. I was finding that when I was beginning to get tired ordinary tasks became a problem, such as the room lights would be too bright, I would walk into things and people (with an already reduced visual field) and anything that took visual processing became a considerable effort.

My strategy until this time had been pushing through these things and keep on going, but now the problem was that the effectiveness of this solution was inadequate. I also found that my peers didn’t understand the extra need for time or the extra fatigue with visual processing for someone who has low vision. I didn’t really know any different so would explain I was tired, often the response I got was “well we are all tired” or “PhD is a right of passage, it is hard”. So to be less of a burden on those around, I gave up trying to explain, worked harder, longer and just kept on going.

The interesting part of this story is the impact of the PhD related fatigue. Usually fatigue is manageable, but post handing in my PhD, I am actually noticing all of the things which relate to visual fatigue more, whether they are actually more of a problem or whether I am noticing them more is a different issue. But, proofreading is harder, lights brighter, walking home in the dark is more of a challenge and even distressing, even using my computer (which I usually enjoy) is causing more than usual problems. What this has reminded me is that I need to remember to know myself, to notice when things become difficult and actively work to reduce the issues. Literature suggests people with low do take longer to process and fatigue more quickly because of needing to process what they see differently. Yet, for me, who relies on evidence based solutions, this is hard as it means asking for more time for things.

The dilemma here is I see those around me working hard, I don’t want to be seen as different, but, If I just keep going, I will start to make mistakes and become more fatigued. Yet, I want to support those around me and don’t want to be seen as a person who doesn’t do her share. My natural instinct in this situation is just to keep on going, but, in some respects this is not the right solution, nor is it sustainable.

Today, I couldn’t keep on going and had to stop visual processing and go and rest. Noticing this is a positive step for me, yet in the background, I feel guilt as I know there is more work waiting and others relying on me to get things done.

Back to the good part my PhD is submitted!