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Attrition in a Bed of Roses


In our field, we are blessed to see life begin and end, whether in normalcy or chaos. Time is short. You do not know what tomorrow will bring. What is your life? It's even a vapor that appears for a little time and then vanishes away. So why, as clinicians, who should be most connected to this, act like we are so far from it in understanding? Why do we not take advantage of this principle? It is time to find our way out of auto-pilot. What I am going to write about is not a new concept, it seems it is just forgotten and we all need reminded, especially in this time. 

The results of your organization are a direct reflection of the behavior of the people who operate in it. This includes you. How much time, money and energy do we put into everything around us? How much of that do we invest in personal transformation? We are the most complex, confusing, interesting variable. So everything we do must touch on behavior, even down to the hiring process. We will change what we believe just to belong, right? Going against the grain, the self-motivation, it makes you stick out like a sore thumb. This especially occurs in organizations where certain behaviors are tolerated and not remediated or educated to improve. "To educate a man in mind and not in morals is to educate a menace to society."

Don't be average in what you do. Too many good people are average leaders. There is less competition at the top with elite clinicians. If you are in the pile of average, you are in the most competitive arena and there is no chance anyone is going to find you, as an organization or individual. Average feels so safe. Because if I try to become elite I could fail, right? Okay and what, become average again? You go back to the same place you were already in. You are just afraid of being where you are already at. The second you look around and you notice most people look like you and do it like you, that is the first sign you are in the wrong place. If you want your organization to change it starts with the individuals changing, including you. Everybody says, "they need to change." Some people say, "we need to change." Only the elite say, "I need to change." The culture you get is not what you declare for yourself or where you work. It is not a framed quote on the wall. It is discipline and behaviors of each individual. What do we do to change?

It is written of "The Four Loves." All these words in Greek translate to love but all a different meaning. First is Storge. This is a need or gift-type love. Second is Philia. This is a friend or "we" oriented love based on common interests. Third is Eros, a romantic but selfish love based on feeling. Lastly, Agape love. This is others oriented. This is a selfless, sacrificial love. Uncommon commitment. This love drives the individual. To be elite, you need this agape love. This is unconditional love. If you can acquire this, you will do the unthinkable and change the organization you work in. This love is not always fun, it is serious conversation and discipline. It is love that bounds anything from the Navy Seals to a elite college football team. If you don't love where you are at in a job or position, that doesnt make you a bad person. Lift up the hood of the car and see what's the problem. You need to examine where you are at and if after attempting to escape auto-pilot with no changes, don't continue to bring hate, a negative attitude and average to your co-workers and the organization. These negative attributes are like birds, you can't keep them from flying over time to time but you don't have to let them nest in your hair. In this line of work, that is something that others around you and patients do not deserve. 

As a clinician, there will be pain but you will come out better because of it. When adversity and challenges hit, I rejoice because I know the good that will come from it. Stop asking yourself, "why me." Start asking yourself, "what is this teaching me?" "How can I help others from this?" A bed of roses is a beautiful place, but nothing ever develops there. You can be comfortable all you want but you can equate being comfortable to being lifeless. If you ever want to grow, there will be heavy discomfort and sacrifice. We are all, including myself, going to hit that wall of opposition and adversity. I am sure you, like me, have been there many times already as well. Though it is never about what happens to us, it's about how we respond to it. We can control that. If you are resilient you will get what you're looking for and if you are consistent you will keep it. 

In life, we do not burn out because of what we do. We burn out because life makes us forget why we do it. Every single day in whatever you do as a Paramedic, Nurse, Emergency Physician or whatever it may be, ask yourself a question. Dig deep down to your core with conviction and ask yourself why do I really do this? Most importantly, who am I really doing it for? Ego? Pride? Extrinsic reasons? My three whys are on a post-it note on my dash so I am reminded of why I do what I do every day. It reminds me why I sacrifice time to educate myself on subjects that do not involve my schooling. Why I train on topics that are out of my scope of practice. Why I read literature that I may never apply in the field. Why I lose sleep and add stress like most here. Why I sit with books instead of a gaming console. My three whys is what makes me aware that every single day until I take my last breath, I am going to spend training mentally and physically, study and educate to impact others lives in what I do in and out of the job and give them the best possible chance. Even if that just means holding their hand. What is your why?  

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