20 Years Ago - The Mastery of Awareness in Healthcare

A excerpt from"The New Agreements in Healthcare" written 20 years ago. The story of twenty years of "improvement" in healthcare that has the current healthcare system slowly collapsing before our eyes. What are leaders in healthcare doing to save patients, staff and the system itself? The same thing they were doing 20 years ago except more-better-different. They are doing more of what hasn't worked in 20 years of trying--doing what hasn't worked better in 20 years of trying--or doing what hasn't worked in 20 years of trying differently, all while expecting a different result.

Compare this with a change model (3D Healthcare/Loving Workflows) based in systemic love that has been successfully implemented in healthcare for 20 years, not only fixing stressed/dysfunctional care delivery systems, but healing staff of burnout in the process.

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"The New Agreements in Healthcare” - Chapter Three - THE FOUR AGREEMENTS

The Masteries

THREE AREAS OF LIFE MUST BE MASTERED TO TAKE CHARGE OF OUR LIVES: Awareness, Transformation, and Intent. When we become masters of Awareness, Transformation, and Intent, we become masters of life who can create the life we desire, at work and home.

The Mastery of Awareness

THE FIRST MASTERY REQUIRES WAKING UP TO THE FACT THAT THE REAL you is not your mind. It means knowing at the deepest level of your cells that you are much more than thoughts, logic, beliefs, and memories. It is essential to develop the Mastery of Awareness, for when you have aware- ness, everything is possible. Without it, your mind just runs on automatic pilot and you receive what unconscious thinking dishes out for you.

Your mind is made up of thoughts, beliefs and memories that manifest as that critical voice in your head that constantly comments on everything you think or do. When the voice is negative, you’re listening to your judgmental mind. It’s that little voice in your head that may be saying, “What little voice?” or “Oh yeah, I know that little voice.”

Developing awareness of what your mind thinks, believes, remembers, and perceives gives you the ability to change your reality. A well-known universal principle is that as it is on the inside, so it is on the outside. In other words, everything happens from the inside out. Change starts with awareness and awareness begins from within. To change your world, first change your mind because your mind creates your reality and ultimately your world.

Once you’ve developed a heightened sense of awareness, your mind becomes your friend and collaborator. Since the mind creates each individual's reality, it becomes the most powerful tool for enhancing your life and the lives of others.

In order to change healthcare, we must change the fear-based, win/lose mind-sets and cultures that currently infect our healthcare organizations. Two types of awareness are crucial for transformation to occur in healthcare organizations. The first is an awareness of your current mind-set (or culture). The second is an awareness of the systems that are creating dysfunction within the organization, especially in care delivery. Systems literacy (described later in this book) is critical to achieve a mastery of awareness in your life and in the workplace.

Mastery of Awareness is the cornerstone for all other Masteries. Nothing meaningful can be accomplished with personal transformation or transformation of healthcare without developing some degree of awareness. With awareness, the Four Agreements become a practical guide to creating a more supportive workplace. Without awareness, these great teachings are nothing more than nice concepts.

Achieving the Mastery of Awareness requires the following three simple steps: (1) catch yourself in the moment; (2) observe what’s going on—inside and out; and (3) make a choice.

Step One: Catch Yourself in the Moment

LET ME EXPLAIN THESE THREE STEPS OF ACHIEVING MASTERY OF AWARENESS by giving an example. Let’s say you typically behave impatiently, or with frustration, when you can’t find a wheelchair for a patient. You don’t like how you feel about this and you want to change your usual reaction. First, try catching yourself at the very moment you start feeling frustrated or behaving impatiently. Most people are great at catching themselves after the fact, but looking back is an almost meaningless activity.

Instead, catch yourself in the moment. You see, the key to changing is not in trying to change; it’s in becoming aware of what’s happening in the moment.

As typical human beings with little awareness, almost everything we do is automatic. For instance, you probably don’t think to yourself, I think I’ll be really frustrated because I can’t find a wheelchair. You just automatically feel frustrated when circumstances prompt that type of reaction in you. The mind is running the show and you are dragged along for the emotional ride. This is the action-reaction cycle that most of us experience as normal.

If you remain oblivious to your thoughts (and the emotions which are evoked as part of those thoughts), you have little or no chance of creating proactive change. On the other hand, if you become consciously aware of your thoughts and feelings in the moment when you are experiencing them, you become the observer. By so doing, you gain a powerful advantage and an opportunity to take charge and change.

Step Two: Observe What’s Going On—Inside and Out

AFTER HEIGHTENING YOUR AWARENESS OF HOW YOU ARE FEELING AND acting, you can move to the next step of proactive change: observing your thoughts and feelings. With this new awareness, you might think to yourself, Oh, there are those feelings of frustration again . . . the ones I get when I can’t find a wheelchair. This is a great opportunity to watch the situation and my reaction to it.

If you catch yourself being impatient, feeling frustrated, or experiencing any number of different emotions that you’d like to change, just stop for a moment and observe what you’re thinking, doing, saying, and believing in that moment.

In the physical universe, the very act of observing something changes it. The science of quantum physics discovered that two researchers cannot view the same event and see the same thing. That which is being observed is altered by the consciousness of those who perceive it. The act of observing the mind begins to change the mind. This phenomenon presents a useful prospect for creating proactive change in your life and in healthcare.

Step Three: Make a Choice

AS YOU DEVELOP MORE AND MORE AWARENESS OF YOUR THOUGHTS AND beliefs that activate the behavior or experience you want to change—and can consciously observe them—you reach a most powerful place: the place of choice. Here you can choose to be frustrated or not.

If you choose to be frustrated, great! Go all out! Roll your eyes, stomp your foot, throw your hands in the air in exasperation. Whatever you do when you get frustrated, do it now and do more of it. Get really worked up! You might be pleasantly surprised to discover what happens by exaggerating the thing you’re trying to change. Many times you’ll begin to see your frustrated routine for what it is and that will take the emotional charge out of it. You might even laugh spontaneously as you see the humor in it.

You could also choose to be less frustrated. We’ll talk about how to do that in a moment when we discuss the Mastery of Transformation. Either way, you win.

The simple act and process of becoming aware, observing your thoughts and beliefs, and your accompanying feelings creates the option of choosing your actions. The more times you observe the thoughts and emotions that normally cause the unwanted reactions, the more times you can choose your actions. And the more times you choose your actions, the faster you will change.

Emotions—particularly fear-based ones—are signals that it is time to bring yourself to a heightened state of awareness. Whenever you become aware of a strong, negative emotion, catch yourself in real time, observe your emotional behavior, and choose how you want to respond.

Whenever the mind runs on automatic pilot, there’s no movement toward transforming your life. You—not your mind—must make conscious choices. Yet there is no right or wrong choice.

The important thing is to decide how you want to be and what you’re going to do. If you’re angry, you can choose to identify with that emotion (I’m angry) or stop it. Always remember that choosing to change or choosing not to change is still a step in the right direction. At least you’re making a conscious choice. As you will see, the choice itself is not as important as the process you took to make that choice.