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Tuesday, September 29, 2015

Becoming a Deviant

I recently learned about an interesting concept: “positive deviant”.  I first read about it in Atul Gawande’s book:  better: A Surgeon’s Notes on Performance,  How can someone be a deviant and positive?  I realized that that is my bias, in my mind deviants are bad, criminals, rule breakers. What I learned is that positive deviants are those who are doing something well, or “make a worthy difference”.   
Isn’t that a beautiful notion? How different that is from my definition. It reminds me of how I enjoy it when my library books are overdue and the librarian tells me I am “delinquent”.  All my life I have been the good girl, the rule ranger, Miss Goodie Two Shoes.  Being a deviant or delinquent feels risky and exciting.   I don’t mind being a deviant or delinquent if it means I am becoming a better person or nurse.  
Atul Gawande gives 5 suggestions for how one might make a worthy difference. I love them all. I am familiar with them and have been working on them individually, but I never put them all together as he did.
1. Ask an unscripted question.  This is the best part of my job, getting to see patients in their homes and learning about them as individuals.  Just as he describes, I am often pressed for time: the cell phone rings or the pager goes off in the middle of taking care of a patient, I am already 30 min to an hour behind, I have calls to make and other patients to see.  But, I make time to talk about something completely unrelated to my purpose, it is the best part of my day. It does “make the machine feel less like a machine.”
2.Don’t complain. Gawande is completely correct here, no one wants to listen to the complaining. Not your spouse, or your boss, nor your colleagues, and it does “get you down”.   This one I am still working on. Having seen it written in the book as eloquently as he wrote, makes me realize I need to work harder on this one.
3. Count something.  I realized that a long time ago, just keeping track of something was a way to get me thinking of how to work on the problem.  I like to do math in my head, it is a satisfying exercise. I think it also makes your brain mull the problem over and search for solutions.
4.Write something.  My husband remarked the other day how I rarely ask for him to proof my papers I write for school.  When I was completing my BSN 20 years ago, I would suffer trying to put my ideas on paper and he was an enormous help at the time.  Now, I volunteer to write, I feel very comfortable with writing.  My first experience with journalling was in one of my grad school classes.  I enjoyed it and I meant to continue, but… life, school, work got in the way.  After losing someone close to me, I took up journalling to process the conflicted and painful feelings I have. This is another example like don’t complain, people around you, no matter how much they care, get sick and tired of hearing about your grief.  Except for those who share in the grief.  However, we try to lift each other up more than use one another as a sounding board. 
5. Finally, Gawande suggest we Change.  I do so want to be an early adopter, I want to make positive change, count my successes (and failures), write about it and not be afraid to ask people what they think.  I do so love school, it gives me an opportunity to explore ideas I would not normally explore and challenges me in ways I would never challenge myself. I am sharing my reflections as Gawande suggests.  “The published word is a declaration of membership in that community…”.

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