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Current Thoughts

Trouble Yes, and...ing: Part 2

Hey oh, back at it. Another busy day, tipping over into too busy but still enjoyable. I completed the Faculty Development workshops for the year today. That is very exciting, and I have mentioned it several times, so I won’t belabor what it means for me, mostly related to challenges of the pandemic and how thankful I am. See links for pictures below!

OK, to continue my stories from yesterday. I discussed having trouble practicing Yes, and… in the hospital when the reality you are trying to build together is challenging and immovable. I am still struggling with the solution to that. I have a few ideas but mostly I would welcome insight from anyone about that challenge. Today’s time when it is difficult to practice Yes, and… in the hospital is in the delirious patient or a patient with dementia. Another patient on my list of patients fits this bill and has had to be sedated and/or restrained due to violence towards the staff. I saw a note in the chart that stated he enjoyed talking about his past profession and if he could be redirected towards that, he would not need restraints. It reminded me of this podcast. Specifically Act 2: Rainy Days and Mondys. Two married improvisors live with one of their mothers who is suffering from dementia. The improvisor says Yes, and… to the reality that the mother suggests and adds to it rather than arguing with her about what her reality is. It was a heart-warming story for anyone, even if they have no improv experience. I don’t know that my patient and I will develop such a heart-warming experience. However, when I tried to just say Yes to his reality, it did calm him down. I am not sure that this is the standard of care for dementia patients, so consult with your loved one’s care provider before implementing improv principles in your interactions. I am giving an n of 1 experience that was challenging to use Yes, and… because saying Yes to the patient’s reality required starting anew at every visit. It is probably the most like practicing improv of any patient care experience now that I am thinking about it. This example is a challenging but potentially rewarding opportunity to use Yes, and… in the hospital. Check out their website from the people in the website

The third example from yesterday came from talking with a colleague (we will call this colleague Michaela) who was noticing burnout in another colleague (we will refer to this colleague as Michelle). Michelle stated that her burnout was beyond being tired or worn out and something much closer to ambivalence. Michelle felt worn out several months ago and it had moved past that. Michaela stated that there was no outward sign that the Michelle was experiencing burn out. There were only subtle signs that could easily be missed if it had not indirectly affected Michaela. So there really was not a direct opportunity for the two of them to practice Yes, and… due to an altered reality from experiencing burn out. In discussing with Michaela, we both fear that this will be seen much more frequently or at least we as a healthcare industry are just starting to see this. The ways to break this really have not returned to usual business or there are barriers to prevent them from returning in someone who is suffering this level of burn out. I have deep concerns that there is a level of loneliness that nobody will notice in many people that I encounter at my work (it is probably not isolated to healthcare either). Only sort of acknowledging other people’s reality isn’t going to cut it. The idea from improv that comes to mind is “if this is true, then what else is true”. That is a great way to make a scene interesting. I also think I am going to be practicing that with my colleagues to make sure they know I am trying to understand their reality and build a new reality together with them.

These were three situations that happened yesterday that made it hard to practice Yes, and… or rather it required me to stop and think before automatically using that idea to guide my response