Career Benefits of Saying "No"

Today I want to share some insights on the power of "NO", or to say it more eloquently, explore the nuanced benefits of selective engagement, and how this can help us guard against burnout, sharpen our focus, elevate the quality of our work, and preserve the sanctity of life outside of our careers.

Possibly the biggest internal resistance we face, whether consciously or unconsciously, when it comes to saying "no" to an opportunity is the concern of missing our on opportunities and/or burning bridges.

Entirely valid concerns, ones that I (and some colleagues who are far more advanced in their careers than I am) still have at times.

Like a muscle, the more your train it, the easier it gets.

If you're after some tips and strategies on how to have these conversations, I'll be sharing these at the end.

Before we get there, I'd like to unpack this topic a little more in-depth, as this will help build your internal confidence and clarity to get clear on your "yes & nos".

Changing Gears in our Careers

In the early stages of our careers, embracing every opportunity is encouraged, as this fuels our growth, expands our networks, and increases our expertise.

However, as we progress through our careers we need to shift gears so we can settle into a sustainable rhythm.

The easiest way to visualise the concept we're discussing today is driving a car and changing gears.

1st gear gets us going and starts to build momentum, it's also much easier to zip, weave and change direction when we're in low gear and travelling at low speed.

As we begin to move up through the gears we've been generating power consistently, creating more momentum, and inertia is well at play here.

Zipping, weaving and changing direction at this stage is usually more difficult and may come with more risk.

Yes, it can be done, but it needs to be more calculated in order to stay on the road and not lose control. In this context, losing control can be seen as being distracted, overwhelmed and burnt-out.

Attempting to travel a great distance at high speed in first gear won't bode well for the longevity of your engine. Much the same as saying yes to everything and anything as you begin to build momentum in your career isn't going to bode well for your time, energy, and mental health.

The Evolution from 'Yes' to 'No'

Navigating a career in healthcare—or any profession, for that matter—often begins with an enthusiastic inclination towards saying 'yes'.

This initial approach to 'yes' will serve us well. It creates opportunities for us to explore, network, learn, and open doors to potential pathways that may not have even been on our radar.

However, as we begin to progress through our career, the shift towards saying 'no' becomes an essential skill to continue to foster our growth, increase our satisfaction, and most importantly, preserve our work-life boundary.

Early Career Emphasis on 'Yes'

This phase is characterised by a willingness to step outside of our comfort zone, take on challenges, and sometimes it may stretch us thin across commitments.

This approach serves multiple purposes:

• Skill-Building: Each new project, task, or role offers us a chance to acquire and hone skills, some of which may become fundamental to our professional identity and expertise.
• Networking: Engaging in a range of opportunities broadens our professional networks, connects us with potential mentors, peers, and future collaborators, all of which may play pivotal roles in our careers as they develop.
• Experience Diversification: Exposure to a variety of roles and settings provides a clearer understanding of the healthcare ecosystem, helping individuals identify where they feel most aligned and where they can make the most significant impact.

The Pivot to Selective Engagement

As we begin progress in through our careers, we have been accumulating a wealth of experience, insights, and developing a clearer understanding of our strengths, passions, and the type of work that aligns with our personal and professional aspirations.

This accumulation of knowledge, skills and self-awareness will, at some point, lead us to a critical pivot point: the transition from an indiscriminate 'yes' to a strategic 'no.'

This shift is driven by several factors:

• Refined Goals: Over time, we begin to grasp what direction our career trajectory is heading in, even if we don't have a clear destination, we have been able to identify what we enjoy, what drives us, inspires us, and what meaning we derive from our work.
• Awareness of Value: Experience also gives us an understanding of our unique value proposition, that is, becoming clear and confident on what we bring to the party. This allows us to focus on opportunities where we can make the most significant contributions and derive the most fulfillment & reward from.
• Capacity and Well-being: Often through trial and error, we've begun to recognise the limits of our energy, (hopefully) leading to the acknowledgment that not every opportunity is worth pursuing, especially if it compromises the things that really matter - our health, well-being, and personal life.

This pivot is NOT about closing doors but rather about opening the right ones.

It involves a strategic assessment of opportunities, considering not only the potential for growth and learning, but also alignment with long-term goals, values, and the potential impact on our overall quality of life.

The "Energy Matrix"

The energy matrix easily conceptualises a framework of how we can understand how to manage our energy and commitments throughout the different stages of our career.

This matrix can help us gauge where our energy is being invested across various activities and roles, enabling us to make more strategic decisions about where to focus our efforts.

The Energy Matrix categorises activities and commitments into four quadrants based on two criteria: the level of energy they require (high or low) and the degree of fulfillment or satisfaction they provide (high or low).

These quadrants are:

High Energy, High Satisfaction (Performance Zone)

Activities that are both energising and deeply satisfying to us. They often align with our values, strengths, and professional aspirations. Engaging in these activities often further fuel our motivation and drive career progression.

High Energy, Low Satisfaction (Survival Zone)

Tasks that consume a lot of energy but offer little in terms of personal fulfillment. There will be times in which we need to output from this zone, yet constantly operating in this zone can lead us down the path of burnout and dissatisfaction.

Low Energy, High Satisfaction (Recovery or Comfort Zone)

Activities that may be enjoyable and fulfilling but don't necessarily challenge us or contribute significantly to professional growth.

While these can provide a necessary respite, continuing to operate out of this zone may lead to stagnation.

It is worth noting that operating out of this zone isn't necessarily a negative, it all depends on our overall values (personal & professional), our reward system with work, what we want to achieve in a career-sense etc...

Low Energy, Low Satisfaction (Burnout Zone)

There are two common reasons we can end up here.

Firstly, is spending too much time in the survival zone, and our energy has begun to wane. We then gravitate (if possible) to routine tasks that need to be done but neither require much energy nor provide fulfillment.

Alternately, we may end up performing these repetitive, routine, and/or unfulfilling tasks simply because they are part of our job description. Despite often being necessary, spending too much time here can detract from more impactful pursuits.

For example; You have a desire to work in musculoskeletal rehabilitation, yet you are working in a routine nail care clinic. Despite the work being entirely necessary, it is personally unfulfilling to you.

In contrast, you may be someone who truly enjoys the client interactions and day-to-day running of a general nail care clinic, and the thought of back-to-back musculoskeletal injury assessment appointments is your nightmare fuel.

Neither is right or wrong, it simply highlights we are all different in terms of what we enjoy, what we derive meaning from, and where our skill-set lies.

How to Know Where I am Operating From?

High Positive Energy (The Performance Zone)

• Do I feel motivated and engaged in my work?
• Am I experiencing a sense of fulfillment and satisfaction from my interactions with patients and colleagues?
• Do I have the energy and enthusiasm to tackle challenges and new opportunities?

High Negative Energy (The Survival Zone)

• Am I feeling overwhelmed or anxious about my work or patient outcomes?
• Do I find myself reacting impulsively or defensively in stressful situations or in response to feedback?
• Am I experiencing signs of burnout, such as fatigue, irritability, or detachment from my work?

Low Positive Energy (The Recovery/Comfort Zone)

• Do I feel calm and content with my work, but perhaps lacking the energy or motivation to push beyond my comfort zone?
• Am I taking adequate time to rest and recover from the stresses of my work?
• Do I feel like I'm in a routine that's comfortable but not necessarily challenging or growth-oriented?

Low Negative Energy (The Burnout Zone)

• Do I feel a sense of detachment or indifference towards my work?
• Am I struggling to find any joy or satisfaction in my interactions with patients or colleagues?
• Do I feel like I'm just going through the motions without any real engagement or energy?

Becoming Discerning with your 'Yes'

Regardless of the stage of your career, a great place to start developing our yes-no thought process is with the Eisenhower Matrix (TEM), also referred to as the'Urgent-Important Matrix'.

The Eisenhower Matrix

“I have two kinds of problems: the urgent and the important. The urgent are not important, and the important are never urgent.” Dwight D. Eisenhower

The tool divides tasks into four quadrants based on their urgency and importance, helping us to prioritise tasks and manage our time effectively.

Quadrant 1: Urgent and Important (Do First)

Tasks that require immediate attention and are critical for your career or business. These are the crises, deadlines, and problems that need to be solved right away.

Quadrant 2: Important but Not Urgent (Schedule)

Activities that contribute to long-term goals, personal growth, and overall career success. These tasks are important for your development and success but do not require immediate action.

Quadrant 3: Urgent but Not Important (Delegate)

These tasks are urgent but not necessarily important to you. They might be important to someone else's goals or agendas. If possible, these tasks should be delegated.

Quadrant 4: Neither Urgent nor Important (Eliminate/Delete)

Activities that offer little to no value and can be considered as distractions or time-wasters. These should be minimized or eliminated.

What can I automate, delegate or eliminate?

“Never automate something that can be eliminated, and never delegate something that can be automated or streamlined.” Tim Ferris

How to Know What Task Goes Where?

Quadrant 1: Urgent and Important (Do First)

• Does this task have a deadline approaching soon that will significantly impact patient care or my professional responsibilities?
• Is this a crisis or emergency situation that requires immediate attention?
• Will failing to complete this task promptly have serious consequences for my practice, patients, or career?

Quadrant 2: Important but Not Urgent (Schedule)

• Does this task align with my long-term career goals or contribute to my professional growth?
• Is this activity essential for maintaining or improving the quality of care I provide, even if it's not urgent?
• How does this task contribute to my personal or professional development in the long run?

Quadrant 3: Urgent but Not Important (Delegate)

• Is this task urgent but not directly related to my core responsibilities or goals?
• Can someone else or does software exist that can handle this task without compromising the quality of work or patient care?
• Am I the best person to do this task, or could it be an opportunity for a colleague or team member to learn and grow?

Quadrant 4: Neither Urgent nor Important (Eliminate)

• Does this task offer any real value to my practice, patient care, or professional development?
• Am I doing this task out of habit or because it's "always been done this way" rather than it being genuinely necessary?
• Could my time be better spent on tasks that are more directly aligned with my priorities and goals?

The Art of Saying 'No' Effectively

Saying "No" often has us sitting in a state of varying levels of discomfort, this is often due to a variety of psychological, social, and professional factors, such as;

Fear of Missing Out (FOMO)

Many of us worry that by saying no, we might miss out on opportunities that could advance our careers. This fear can lead to over-commitment and the stress that comes with it.

Concern About Relationships

There's often a concern that saying no might damage relationships with colleagues, superiors, or patients. Typically, we value our professional relationships and may fear that refusing requests could be perceived as uncooperative or selfish, potentially harming our reputation or workplace harmony.

Guilt and Self-Expectation

By our nature, we are typically dedicated and drawn to to helping others and may feel guilty for not being available or saying no to requests for help. This guilt can be compounded by high self-expectations and the desire to be seen as competent and reliable, leading to difficulty in setting boundaries.

Professional Culture

The culture in many healthcare settings often celebrates self-sacrifice and long hours, with an implicit expectation that saying yes is part of one’s professional duty. This can make it challenging to say no without feeling like one is going against the grain of professional norms and expectations.

One of the biggest issues myself and countless colleagues have faced, is working for small clinics in which the clinic owners expect a business owners level of commitment and sacrifice from their employees. This is unreasonable, unhealthy, and just plain toxic!

Lack of Role Models

In environments where there are few role models who balance assertiveness with compassion, or who demonstrate effective boundary-setting, clinicians may lack examples of how to say no in a professional and empathetic manner.

Fear of Repercussion

Clinicians may fear professional repercussions, such as a pay increase, the possibility of receiving fewer opportunities, or being viewed as less dedicated if they decline additional responsibilities or tasks.

Difficulty in Prioritisation

Understanding what to say no to requires clear personal and professional priorities. Many of us, especially early in our careers, often face difficulty in prioritising tasks due to the unpredictable and multi-faceted nature of healthcare, making it hard to decide which tasks, requests or opportunities align with their goals and values.

Strategies for Selective Engagement

Here's some tips and strategies that may help you have these conversations.

Given I'm providing written examples, they may come off as stiff or scripted if you copy these verbatim. As always, if you're using any of these examples, tweak to reflect you, your personality and the topic you're discussing.

Assertive Communication

Being assertive means expressing your thoughts and feelings in an open, honest, and direct way.

When saying no, it's important to be clear and to the point, while also being respectful of the person making the request.

Use "I" statements to communicate your decision, such as "I am unable to take on any new projects this month due to my current workload."

Example Statement: "I appreciate you considering me for this project, but my current schedule/commitments won't allow me to dedicate the necessary time/focus to this."

Offering Explanations

While you don't owe anyone a detailed justification for your decisions, providing a brief explanation can help the requester understand your position.

Keep your explanation concise and focus on factual reasons, such as prior commitments or limited resources.

Don't over-explain! Over-explaining can weaken your stance and invite further negotiation.

Often when you're over-explaining, you're trying to justify it to yourself more than the other person. This habit is often the most difficult habit for people pleasers to break.

Example Statement: "Due to my existing commitments, I'm unable to take on any additional tasks this month. I'm aware that if I take on more at this time it may impact the quality of my current projects/work."

Suggesting Alternatives

When you say no, offering an alternative solution can show that you're still supportive and helpful.

For example, if you're unable to take on a task, you may be aware of a colleague who may have the expertise & capacity to handle the task.

Or you might be able to suggest a different time-frame when you may be available.

Both of these approaches can help maintain your positive relationships and demonstrates your commitment to finding solutions.

BUT, don't offer an alternative that also stretches your capacity - ie: don't offer an alternative simply out of guilt.

Example Statement: "I'm not available to lead this initiative at the moment. However, I believe ___________________ may be in a position/may be interested/has the capacity/ to take this on. Would you like me to make an introduction?"

Note: If you're offering a colleague as an alternative, only do this if you genuinely believe they may be in a position/may be interested/has the capacity/ to take it on. DON'T just offer up someone else to avoid a conversation you perceive as difficult.

Practicing Refusal

Saying no can be uncomfortable at first, especially if you're used to saying yes. Practice saying no in low-stakes situations to build your confidence.

For instance, decline a request for a non-urgent meeting when you're already overbooked.

The more you practice, the more comfortable you'll become with asserting your needs and boundaries.

Low-stakes Example: "Thank you for inviting me to ___________________, but I'll have to pass this time to focus on a pressing deadline. Please keep me updated on ___________________."

Prioritising Tasks

To effectively manage your commitments, you need to evaluate and prioritise your tasks.

Use tools like the previously mentioned Eisenhower Matrix to categorise tasks based on urgency and importance.

This can help us make informed decisions about what we can realistically take on and what we should decline.

Example Statement: "While this opportunity sounds interesting, I need to prioritise ___________________ at this point in time. Though in the future, I hope we can explore more opportunities when my schedule is less constrained."

Setting Clear Boundaries

Communicate your boundaries clearly to colleagues and supervisors. This is often difficult for those in the early stage of their careers, are new to an organisation, or are habitual people pleasers.

Let the person asking know/be aware of your availability, understand your work hours and your capacity for taking on new tasks.

Setting clear boundaries can help reduce overload and ensures you can dedicate your energy to your most important commitments.

Work-Life Balance is bullsh*t! We need Work-Life BOUNDARIES

Example Statement: "To maintain a healthy work-life balance, I'm limiting my after-hours commitments. I'm happy to assist during regular office hours."

Note: If you have a conversation stating your unavailability to take on new tasks etc and your circumstances change, let the people you have previously communicated this with know of the change. If you don't they may run on an ongoing assumption that you're still unavailable.

Re-framing Perspective

Viewing "no" as an opportunity rather than a limitation can shift your perspective on decision-making.

Saying 'no' to one thing gives you the opportunity to say 'yes' to something else that may be more aligned with your goals, values, or well-being.

Re-framing 'no' as a strategic choice can empower you to make decisions that best support your professional and personal growth.

Example Self-Statement: "By declining this opportunity, I'm ensuring that I am; able to dedicate my energy to my current work/giving myself capacity to say yes to more opportunities that resonate with ___________________ (goal/value/passion).

Acceptance of Refusal:

Understand that saying no is a necessary part of professional development and self-care.

Not every opportunity will be right for you, and it's important to recognise when a commitment could detract from your goals or well-being.

Accepting that you have the right to refuse requests is crucial for maintaining your health, relationships, and professional satisfaction.

Example Statement: "I understand if this decision might be disappointing, but it's important for me to commit to projects where I can add the most value while also managing my workload effectively."

As always, I hope this article has been helpful in getting clear on when saying "NO" may be the best move for your career.

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