@mars – Thanks. Fortunately my life generates lots of material. Unfortunately I still have to deal with all that material, even after writing about it extensively 😉

Today’s stats – 1159 words.

Nothing really deep today.  Some thoughts about yesterday’s writing, thoughts about my next writing topics (transcribing the next excerpt from “Successfully Changing Behaviors” presentation is still a priority), and logistics for the day and week ahead.  I was thinking I could take each of the “story” examples from my above writing and flesh it out into a story.  So share a story about the patient telling me what’s actually going on and how that changed things for the better.

I’m going to want to start a blog page at my new site.  Not this morning, though.  This morning I want to take a shower before I wake boys, pack snacks, move the laundry, unload the dishwasher, and get the boys fed before we have to walk out the door 90 minutes from now.  May the force be with me!

@saramccann – I’m so glad you saw the connection between the “stories” concept and the writing about my pill problem.  That’s exactly the conversation I want to start.  The idea is that for us to promote and encourage change in others, we have to live through the experience ourselves.  So many of us practice from a space of having the right answers, and not really thinking about the fact that those right answers don’t work for all of our patients and often they don’t work for us either.  It’s not about having the right answers.  It’s about having a conversation, considering our experience, exploring our options, and then experimenting to see how that changes the equation.  This is where I try to practice from – sitting in the truth of being an imperfect human and reaching out to the patient to discover if we can help one another to higher ground.

@bradleytmorris – I appreciate your input.  I’m not completely sold on the tagline and yet I think you underestimate many healthcare providers.  I’ve gotten such a warm and positive response from so many people who have participated in my talks, who have appreciated the human element I’ve brought to the conversation.  Do you know how many talks I’ve attended in the last few months with facts and graphs and studies and admonitions that our patients are failing and we are failing our patients?  Talks that don’t even acknowledge the challenges of persuading people to change their behaviors, the barriers that I face in my clinic every day?  It frustrates me to no end!  There’s something valuable about learning it’s okay to relate to our patients on an imperfect human level, and it’s okay to ask for small changes and not expect the world to change overnight – or even ever – and to praise patients even when all they’ve done is notice that they didn’t do what they said they were going to do.

I’m not out to transform everyone.  I’m out to find others who, like me, want to provide a more wholehearted and caring experience for patients because it just feels like the right way to do things.  There will be people who don’t like what I have to say, who will think it’s too soft and personal, but those people are not my target audience – at least not until I can capture someone they know and transform that person’s heart and practice and demonstrate the value in approaching healthcare from a softer side.

Talk to a group of nurses (one of my target audiences) and ask them why they decided to become nurses.  Many of them will tell you that they wanted to take care of others and make a difference in their lives.  Many of them (possibly all) will tell you a story about someone close to them who was diagnosed with some type of illness and inspired them to pursue a career in healthcare.  Same thing with teachers and parents (some of my future target audiences).  There are people in helping professions for other reasons, but many of the ones that I’ve met have arrived there by following their hearts and listening to stories about how helping professionals can make a real difference in the world, one patient at a time.

I’m still feeling strongly about the HEART and STORIES part.  Not sure if transform is the right word or not, and I think that first word can really electrify the phrase and drive the concept home.  Here are some other ideas.

Transforming the Hearts and Stories of Healthcare Professionals

Elevating the Hearts and Stories of Healthcare Professionals

Energizing the Hearts and Stories of Healthcare Professionals

Validating the Hearts and Stories of Healthcare Professionals

Enhancing the Hearts and Stories of Healthcare Professionals

Expanding the Hearts and Stories of Healthcare Professionals

Affirming the Hearts and Stories of Healthcare Professionals

Honoring the Hearts and Stories of Healthcare Professionals

Nurturing the Hearts and Stories of Healthcare Professionals

I’ll have another go-think and a few drinks and see where things end up 😉

@judyb – I appreciate your interjection, especially given that time is short (in the same boat, for entirely different reasons).

Hearts and stories = not actually congruent ideas

transform and story = overused

so, piggybacking off Dina Rose, one of the authors I admire, a sociologist who advocates for improving childhood eating habits (what is a sociologist doing writing about childhood eating?  Helping!!!)  Her tagline is “Changing the Conversation from Nutrition to Habits” –

Operation Healthcaring: Changing the Conversations of Healthcare Professionals  

Bam!  Concrete. Measurable. I think that will do it  I feel really good about that one on many levels!!!

now off to finish preparing dinner, starting bedtime, and doing all the chores that keep this house above water…

@davidj – Thanks for your feedback.  You inspired my entry today.

Here’s the stats page.  And, for anyone who’s interested (or powerless against the written word, out of curiosity or just plain habit) here’s the actual writing.  I definitely need to start a blog page at my site before the end of the month so I can capture some of this writing before it falls into that deep void of written words never to be seen again…

I checked my email before taking Bella on her walk this morning (I don’t usually do that – clutters the head with all kinds of extraneous matter before I’ve had a chance to clear the existing cobwebs here each morning) and DavidJ said that I was “prodigious” – which was definitely a compliment. I’ve been doing well for this challenge, but then I think there are a few reasons for that, with maybe a couple of those being unfair advantages for me.

1) I can type 80+words per minute. That means typing 750 words takes me about 10 to 15 minutes. My best time so far is 8 minutes, which means I typed close to 100 words per minute that day as I captured my immediate train of thought. So that gives me a definite advantage over someone who types at only half the speed. On the days when I struggle to start, I tell myself that I can dedicate 10 minutes to the cause. If I typed 30 words per minute and I had to dedicate 30 minutes (on a good day) then it would be a much harder investment.

2) I’ve been working at this habit for more than a year. If you look at the top of my sharing page and the badges there, you’ll see that I started in June of 2016. You’ll also see that my longest writing streak is 33 days – an accomplishment, yes, but not what I would expect from someone who has been working at this for more than 300 days. If I showed you my stats, you would see that there were months – many of them – when I wrote only a few days. This past summer I struggled to finish a week each month. As I share in my practice, my speaking, my writing, it takes time to build a habit and it can be surprising how long it takes. For most people, it doesn’t take 21 days to build a new habit. It takes an average of 66 days to build a new habit, and often it can take even longer – as much as a year. So compared to someone who is starting where I was last June, I’ve had more opportunities to work at this and fire and wire new pathways in my brain. I’ve had more time to prioritize this habit, and I’ve had more time to highlight the advantages and rewards to myself – clearer head, improved mental health, an outlet for questions and frustrations. I’ve also attached it to another habit I’ve been working on for just about as long, which is taking a walk each morning after I wake up. I’ve actually had a much better success rate with that one – mostly because our family got a dog almost a year ago and the dog looks forward to her walk each morning so it’s hard to get out of it, even now that the backyard is fully fenced. Even so, I’m just now starting to feel that my morning ritual has become nearly automatic: getting out of bed to turn off the alarm clock, walk into the bathroom, and then walk straight out the bedroom door, down the stairs, and into the kitchen where I take out my walking shoes and the dog leash. So I’ve been working at the writing habit for more than a year, I’ve been working at other habits for more than a year, and I’ve been reading extensively on the topic for more than a year so I have a really good understanding about how habits work. All that being said, it’s still been a struggle for me to stick with just these two behaviors: my writing pages and my daily walk. I just have to prioritize it, make the time, and make myself do it.

3) The last advantage that I’m going to list here is the fact that due to my extensive reading on the topic of building habits and changing behaviors, I’ve learned more about myself and how I work best. A couple of months ago I read a book by Gretchen Rubin called “The Four Tendencies” and in that book she shares a framework for thinking about people’s personalities based on our willingness to meet inner and outer expectations. I learned that I am an Obliger – someone who is really good at meeting outer expectations, often at the expense of my own inner expectations for myself. So it’s more likely that I’ll meet the needs of my family and patients first and put my own needs on the back burner because that is the way that I’m wired. That being said, now that I’ve read the book and had that realization, I’m learning to structure tasks so that I’m better motivated to follow through on them. That’s why I’ve been so consistent with my daily walking habit – I now have a dog who relies on me taking her for a walk, and if I’m not prepared to follow through she’ll whimper and whine and not leave me alone until I provide her with what she wants. Likewise, the GEA challenges have been incredibly reinforcing for me because they provide me with outer accountability – I make a declaration in the monthly campfire, and then I know that I’ve made a “public” commitment and people will be expecting me to follow through with the commitment and even supporting me in doing so. There is no way I would have made as much progress with my website and content and all this other stuff were it not for those monthly challenge campfires. I need accountability. I crave it. In order to be sure that I’ll follow through on something, I need to connect that behavior to something that needs to be done for someone else. That’s just the way it works.

See? It’s 6:29am and already I’ve reached 1000 words in just over 20 minutes. I found a spot in my day to plant the writing so it becomes a habit (in the morning immediately after I walk the dog), I focus on the benefits and ease of engaging in the behavior (I feel more mentally prepared after clearing my head and I feel happier with my self for following through on my commitment to myself), and I’ve shared my commitment with others so there’s another incentive to follow through on the commitment (I want to look good and I want to set a good example).

I think it also helps when I can link my passion project to my daily life. That means I can write all about my writing habit and my walking habit and the challenges and joys of working on those habits, and in some way that writing will actually apply to my website and I can count it as “content.” When the information all relates, I can say that I’ve just written content for my site – even though I might have written this otherwise and for a completely different purpose than generating more material. As I’ve been able to demonstrate in my introduction to the “Successfully Changing Behaviors” talk and The Pill Problem writing that I shared with the group, one of my primary ambiitions in creating this site is to share more personal stories and relationships and talk about how the topics we discuss with patients each day actually relate to the behaviros that we perform each day even outside the dialysis clinic.

That’s why I’m changing the tagline from “Transforming the Hearts and Stories of Healthcare Professionals” to “Changing the Conversations of Healthcare Professionals.” I need to focus on an outcome that’s concrete and measurable. I’m not sure how to measure whether I’ve transformed someone’s heart, but I can hear when I’ve changed the conversations of healthcare professionals. When I’ve done my work, I’ll be able to change the conversations that healthcare professionals have in their own heads, the ones they have out loud with themselves, the ones they have with patients, and the ones they have with other healthcare professionals. I’ll hear people giving less information and sharing more stories. I’ll hear people blaming and shaming less and sharing and confiding their own struggles more. I’ll hear healthcare professionals talking less and listening to and reflecting on their patient’s experiences more. I’ll hear people talking less about outcomes and more about behaviors. I’ll hear people giving fewer comprehensive handouts and more narrow and specific behaviors. I’ll hear people having more conversations with patients about their interests and their families. I’ll hear people have more conversations about effective strategies to use with even the most challenging patients. I’ll hear people believe in their ability to make a difference, even when there may not be any evidence to hope that things may actually change. Patients are going to be able to hear that stuff, too, and that is going to encourage the right thinking and the right behaviors and the right habits as well as a spirit of compassion and forgiveness and nonjudgement. There will be a spirit of presence, mindfulness, paying attention, noticing, exploring, experiencing, and then experimenting with different behaviors and strategies and talking about how things worked and what the next plan of action will be – to continue whatever they started, whether to tweak it a little or a lot, or whether to throw that idea in the bag and start anew with something completely different. Those are the convversations I want to encourage healthcare professionals to have with themselves, with their patients, with their colleagues, with their families, with their communities. It’s a spirit of caring and being and wondering about the world. Curiosity. Creativity. Connection.

So I think that’s nearly enough for today, except that I’m so close to 1650 words and I know I’ll get an alert when I’ve hit the daily NaNoWriMo goal for writing. I’m there! I did it! Where’s my alert so I can log out and post my writing for today?

WOOHOO!!! 40 minutes, 1684 words.

Crazy.  This whole “greasing the wheels” morning pages thing has got my brain on overdrive today!  After leading that webinar this morning, my head has been popcorning ideas all over the place.  I have these ideas about how to enhance the area dietitian meetings – I actually made a suggestion last week that our lead dietitian loved so we are going to be sharing our best productivity practices at the next meeting (I even get to compile the powerpoint slides submitted by other RDs).  I’m enjoying all of these experiments at my company because I get to learn so much from them (presentations, feedback, struggles, etc.) without the pressure of having to perform at a high level because I’m getting paid.  I can use these opportunities to build my confidence and experience so when I finally take the leap into full-time (or maybe even part-time) entrepreneurship, I will be all set to go with many trials and experiments already under my belt.

I’m having this thought that my speeches and webinars can be like confession halls or AA meetings.  You know, when people stand up and share the secret that they’ve been trying to stifle for so long.  For any of you who have seen the movie “BAD MOMS” (that was a much-needed catharsis for me this past crazy weekend), I’m envisioning the end scene in the gymnasium when each of the moms stands up and confesses to some type of “evil” sin (i.e. “I don’t even have children and I come to PTA meetings because I’m lonely at home.”)

Am I allowed to tell you that I used to dress my young children in their next-day clothing instead of pajamas at bedtime, so they were all set to go when they woke up the following morning?  I shared that with my sister and since then she has proudly told me that she does the same thing with her daughter.  Liberating, right?

Anyway, back to Laura’s healthcare professional confessions:

“Hi.  My name is Laura Koller, and I can’t stand writing monthly notes every month.  Last month I didn’t finish half of them until the last possible day, when we were drawing labs for the following month.”

“Hi.  My name is Laura Koller.  I feel like I’m supposed to have all the right answers and I’m supposed to know what I’m doing, but the truth is that I have no idea what I’m supposed to say to patients or what strategies I can share with them that can actually have an impact on their results.”

“Hi.  My name is Laura Koller.  Every month there’s a new project or initiative, and the truth is that I can’t even manage to stay on top of the workload that’s required already.  So many times I merely give lip service to those extra projects so I can put my energy where I really feel that it counts.  I don’t feel like the company supports me in fulfilling the core purpose of my practice.”

After I give a presentation or have a talk with someone I work with, I feel like that person has experienced some sense of relief – like they’ve been doubting themselves or holding something inside and then, when I’ve shared my own observations and experiences, it validates these feelings that they felt were abnormal.  So with patients and healthcare professionals alike, it seems like the most important thing that I can do is NORMALIZE their experience and let them know that they’re not alone.

Do you know the most important predictor of living a long and happy life?  It’s not riches, or luck, or even great health, although those can certainly be byproducts of this primary predictor.  The most important preditor of living a long and happy and fulfilling life is SOCIAL CONNECTIONS.  The more people that you know and maintain close connections and friendships with, the longer your likelihood of living.  There’s multiple research studies that support this claim with cold, hard evidence – or shall I say with a warm and caring embrace?

Combine that reality with our world of smartphones, computers, and video games, and there seems to be a disjoint, a lack of connection.  Compare the idea of social connections to what people typically qualify as social connections these days – Facebook friends, social networks, earning the most “likes” – and there’s a total lack of connection between the two.

And then look at the way we typically provide healthcare.  Doctors have patients scheduled in 15-minute increments for several hours straight (I’m not a doctor, but I happened to see my doctor’s daily schedule the last time I was in her office and my jaw literally hit the floor in surprise and outrage).  We puncture arms, perform scans, review lab results, and diagnose problems.  Where are the PEOPLE in healthcare?  Where is the CARING in healthcare?

So that’s one of the primary goals of Operation Healthcaring: to change the conversations of healthcare professionals.  When you sit down in your provider’s office, I want the first glance to be at your face and not your chart.  When the provider asks her first question, I want it to be about your family and not your illness.  As Teddy Roosevelt once said, “People don’t care how much you know until they know how much you care.”  People will tune out what you say until they’ve been reassured that they matter.  Similarly, Maya Angelou (oh how I love the work of Maya Angelou) once stated so wisely, “People will forget what you said, people will forget what you did, but people will never forget how you made them feel.”  If we want people to care for their health in the most positive way possible, then shouldn’t we encourage people to feel good while they’re sitting in exam rooms and interacting with their healthcare providers?

So that’s what I believe we need more of in healthcare – healthcare professionals who can start talking about feelings and emotions and social connections and frustrations and struggles and build a network of support and assistance and caring.  We need to think about people first and problems second.  We need to think about humanity first and the scientific advances second.  We need to think about quality of life first and results second.  I’m not saying those other things aren’t important because they are.  But those other items are important because of how they fit into the context of people’s lives and not in and of themselves.  At the end of the day, building social connections is something that will improve the quality of our interactions, the level of commitment that our patients are willing to dedicate to caring for their health, and ultimately the outcomes that can be realized when we use healthcare as an opportunity to for people to build meaningful relationships with others.