Is there a higher criterion for life?

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There is a distinction between lived truth and theoretical knowledge. Gaining knowledge through personal experience differs significantly from reading about experiences or characteristics in journal articles and books. However, philosophical views become meaningful when applied through experience. As other scholars have noted, understanding and interpreting the experiences of elderly citizens in a nursing home are highly context-dependent (Rykkje et al., 2023). That being the case, while caring for those who are ill, do patients and caregivers experience a spiritual awakening? The lived experience of assisting others in their recovery within acute care settings fosters a recognition of the existence of a higher power.

With the understanding that helping others during their time of need, let us consider the great novelists of the 18th century, such as Leo Tolstoy, in his detailed masterpiece, War and Peace, who understood the concept of spiritual awakening. It is therefore believed, at least experientially, through helping others and seeing them cope with illness, that one becomes aware of a supernatural existence.

Although Tolstoy's great novel offers many insights into the meaning of life through its epic narrative and his profound understanding of history, the significant conflicts, especially the campaigns of the French brigand Napoleon Bonaparte and his demise and disillusionment, are particularly notable. For reference, one of the characters in Tolstoy's work, a fictional person, is portrayed as reflecting on his own thoughts about life and grappling with his internal struggles and the meaning of it all, set against the backdrop of the events leading up to the French invasion of Moscow during the War of 1812.

The fictional character Pierre Bezukhov, although imaginatively created by Tolstoy, possesses experiences that readers can readily identify with. As the story goes, during the winter of 1812, Pierre finds himself decisively staying behind in Moscow, not leaving as the French enter and begin to pillage and maraud (Adler, 1952, p. 512 ). The homes and estates are left vacant by their former inhabitants. Pierre believes, although it is not realistic and he demonstrates a hint of lunacy (Adler, 1952, p. 513), that he can, with a pistol in hand, take out Napoleon himself. As such, much of the story unfolds as Pierre is captured by French officers and taken as a Russian prisoner, suspected of being a firestarter or arsonist (Adler, 1952, p. 547). At the same time, Moscow, in the background, burns as Napoleon's army occupies the city.

Pierre, who is thought to be an arsonist, is taken alongside other Russian prisoners and lined up before a firing squad. As a chance happening, Pierre escapes death and avoids being executed by a firing squad and is apparently acquitted of taking part in torching Moscow (Adler, 1952, p. 551). He is let go, only to witness the punishment of those other individuals captured on suspicion of being arsonists by the skin of his teeth. In contrast, watching others get slain is a turning point for Pierre that Tolstoy wants the reader to be mindful of.

During these scenes in the story, Pierre meets another Russian soldier, captured and becomes a source of spiritual help to Pierre, named Platon Karataev. In one moment of the scene, Platon offers Pierre a slice of baked potato, with words of comfort and wisdom seasoned with poverty-stricken salt saved and wrapped in a cloth, which becomes the best thing Pierre has tasted in some time (Adler, 1952, p. 554). Recovering from a near-death experience, Pierre begins to change his outlook on life, and things that he formerly thought important, such as ambitions, the acquisition of wealth, prestige, and status, now hold little importance. His wild idea to slay Napoleon also loses significance. Life is now the most precious jewel he possesses.

One can make the argument that near-death experiences can help reshape one's philosophy on life as Tolstoy intended, or as scholars have noted, approaching the end of one's road in life, as is familiar with nursing home residents, where trying to understand the role of spirituality is challenging (Rykkje et al., 2023).

References:

Adler, M. J. (1952). Tolstoy. In The Great Books of the Western World. (Vol. 51). Encyclopedia Britannica.

Rykkje, L., Morland, M., Ferstad, K., & Kuven, B. M. (2023). A qualitative hermeneutical understanding of spiritual care in old age when living in a nursing home: The residents' voices. Journal of Clinical Nursing, 32(21–22), 7846–7859. https://doi.org/10.1111/jocn.16855

Navigate the Obstacle

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Sociologists have explored and investigated the concept of middle-aged thriving and have asked the question: What does it mean to be well and, more pointedly, be well mentally (Ryff & Keyes, 1995). Criteria and points of reference for defining well-being are, by extension, measures of positive life functioning such as accepting oneself, environment of control, favorable relationships, living a goal-oriented life coupled with self-improvement and self-determination (Ryff & Keyes, 1995). Suppose the criteria mentioned earlier, such as well-being, are operationalized or realized in one's life. Would indicators such as a spirit of good cheer, peace of mind, and depression be mediated?

In their thirty-year-old study, Ryff & Keyes (1995) highlight that their research reveals strong correlations between mediating happy feelings, life satisfaction, and symptoms of depression, particularly in relation to self-acceptance and environmental control. As for the other domains, such as healthy relationships, having a purpose in life, developing oneself over the continuum of life, and being independent, these are poorly correlated with mediating a person's happiness, satisfaction with life, and depressed mood. In other words, from their study, accepting one situation in life and trying to the extent that one can exercise some form of control over the world around them correlates to positive life functioning with behaviors reflecting a joyful spirit, being contented with life, and improved mood, however it is essential to acknowledge what Ryff & Keyes (1995), concluded: that there is more to getting on with life and that being well or psychologically healthy than the pursuit of happiness and being fullfilled. Of note and to the credit of their study, one domain of well-being that was not investigated, at least in this research, was spirituality.

G.K. Chesterton wrote a biography to defend the works of Robert Louis Stevenson, best known for his novel Treasure Island. Chesterton notes that Stevenson exemplified a character who, despite living with debilitating childhood illnesses, grew up with those challenges and faced life's adversity. Consider an excerpt from his work.

Chesterton states in his 1906 publication about R. L. Stevenson's character, "Stevenson's great ethical and philosophical value lies in the fact that he realised this great paradox that life becomes more fascinating the darker it grows, that life is worth living only so far as it is difficult to live" (Chesterton & Nicoll, 1906, p. 15). How did R. L. Stevenson believe that when life becomes complicated and overwhelming, it is precisely then that it becomes truly fascinating? 

This perspective presents a thought-provoking and philosophical approach to living even today, and applies to all of humanity. Not many will argue that parents, teachers, and coaches, who have many irons in the fire, face a myriad of challenges. Still, with an approach of living with acceptance and a whole-hearted intent to practice an environment of control to the best of one's ability, most people could achieve the feeling that life is worth living, as R. L. Stevenson demonstrated.

We can also gain insight by contemplating the ancient writings found in the Old Testament texts, particularly in the book of Ecclesiastes, and investigating the spiritual component of life. The great teacher emphasizes in chapter seven in the fourtenth verse, contemplative ideas about good circumstances and less fortunate ones, discussing the fact that God has set things in motion in a persons life such that one can not determine his future and that when days are joyful be glad, and when days are cumbersome consider that God has brought this for some devine reason (The Holy Bible, New International Version, 1999, Ec. 7: 14).

References:

Chesterton, G. K., & Nicoll, W. R. (1906). The characteristics of Robert Louis Stevenson. James Pott & Co. Internet Archive. https://archive.org/details/robertlouissteve00chesrich/page/4/mode/2up?view=theater

Ryff, C. D., & Keyes, C. L. (1995). The structure of psychological well-being revisited. Journal of Personality and Social Psychology, 69(4), 719–727. https://doi.org/10.1037//0022-3514.69.4.719

The Holy Bible: New International Version. (1999). Cornerstone Bible Publishers. (original work published 1973)

Rolling with the Punches

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Emerson's works remain relevant today, thanks to the authority of the great American author of the mid-19th century, who, as historian Richard Whelan asserts, was the youngest graduate of the Ivy League school at Harvard. To suggest that the influential writer and author has an enduring impact on those who follow his writings is an understatement.

According to Richard Whelan, who summarized Ralph Waldo Emerson's essays in his book titled Self-Reliance, in the opinion of the fervent lecturer of nearly a century and a half ago, when you see a man in isolation, alone and in solitude, being true to himself, you can trust that he is sincere however, hypocrisy often emerges when you add another person to the situation (Whelan, 1991, p. 114).

Emerson's writings suggest that most men only reveal a part of themselves, showing you their side or their back, but if you encounter someone willing to display their true face and heart, consider them a rare gem and friend. Lastly, Emerson emphasizes that hospitality should be about genuine service, rather than a showy approach, as the latter diminishes the host's value (Whelan, 1991, p. 131).

Be Authentic

How does Emerson speak to those in leadership? How do solitude, honesty, and hospitality impact organizational influence? It is about being authentic, and resilience is needed to keep it afloat because adverse situations in leaders' roles and positions impact them for better or worse. Consider how healthcare leaders describe one way to be authentic at work, as defined by Wei et al. (2019). Nurse leaders who engage with staff operate in the middle zone of daily work. These leaders engage with staff, strike a healthy balance between office work and patient care, and operate in the space between employee and leader. When authentic leaders lead by example, they bridge the gap between their leadership role and a role up their sleeves mentality to support their team. That is what operating as a leader looks like in the space between the office desk and the patient's room.

Practice Resilience

Before the pandemic, isolation may have been a direct choice; however, when mandated social and physical distancing was implemented, being alone, separated, and disengaged were new experiences for all, especially in the helping professions. Doctors, nurses, and all allied health professionals were challenged to protect themselves, patients, and loved ones from the effects of the coronavirus. According to Barthelemy et al. (2021), all personnel worked in a once-in-a-lifetime situation during the peak of the patient surge, requiring exceptional physical and psychological endurance from physicians, such as neurosurgeons. This was true for all healthcare professionals regardless of their specialty.

Although today, the gap between peak hospital surges and normal departmental census has decreased because of attenuated positivity rates, there are still pandemic stressors, such as those experienced during the days and months of the surge, such as depressed mood, anxiousness, irritability, and abnormal sleep patterns endured by all members of the healthcare team (Barthelemy et al.,2021). Resilience practice can help.

The recommendations for practicing a resilient psychological threshold during the pandemic are applicable today for those in leadership. As other scholars have pointed out, according to Paltmitter et al., (2020), most people experience some stressor or adversity and that does not mean that one is not particlualry resilient, as the thoughts we think, the attitudes we bring to situations and the reactions we portray in response to demanding and ovewheliming situations are familiar to us all and can be trained, strenghthened and molded that adapt for the better when they occur again.

As stated, the days of Covid-19 patient surges may become a distant memory. Still, the daily stressors of patient care, staff management, organization frugality, and achieving healthcare benchmarks are a daily pressure coupled with the weight of standards and accreditation readiness; leaders are required to maintain an environment of service excellence, affordability, and teamwork. Creating a safe culture and the best place to work, all wrapped up in high-quality care, can be daunting for leaders tasked with stewardship of departments in healthcare.

As a close, the authors, according to Barthelemy et al. (2021), remind those in positions of influence to maintain an optimistic outlook despite overwhelming task competition and attention distractors, reappraise internal dialogue, lean into peer support and mentors, champion self-care activity, and capitalize on personal strengths.

References:

Barthelemy, E. J., Thango, N. S., Hohne, J., Lippa, L., Kolias, A., WFNS Young Neurosurgeons Forum Task Force, & Germano, I. M. (2021). Resilience in the face of the COVID-19 pandemic: How to bend and not break. World Neurosurgery. https://doi.org/10.1016/j.wneu.2020.11.105

Palmitter, D., Alvord, M., Dorlen, R., Comas-Diaz, L., Luthar, S. S., Maddi, S. R., O’Neill, H. K., Saakvitne, K. W., & Tedeschi, R. G. (2020). Building your resilience. American Psychological Association. http://www.apa.org/resilience/building-your-resilience

Wei, H., Roberts, P., Strickler, J., & Corbett, R. W. (2019). Nurse leaders' strategies to Foster Nurse Resilience. Journal of Nursing Management, 27(4), 681–687. https://doi.org/10.1111/jonm.12736

Whelan, R. (1991). Self-reliance: The wisdom of Ralph Waldo Emerson as inspiration for Daily Living. Random House Inc.

Magnetic Influence

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What do the following characteristic traits of leaders who practice the following strategies look like who promote social work connections in there organizations, who possess a positive mindset, find the strengths in others, and capitalize on them, who empower and develop others, encourage self-care activities and work-life balance, perform mindfulness techniques and try to be present in the moment with staff, while seting an altruistic example to others? According to scholars with a focus on leadership, Wei et al. (2019) suggest that it is related to leader resilience. Two areas for immediate review are breaking down departmental barriers and maintaining a magnetic presence.

Break Out of the Silo

Apple TV currently has Season 2 series on its entertainment streaming service, Silo. The show that is in the not-so-near future is set in a post-nuclear time frame where, after a significant atomic fallout, the Earth has been devastated by nuclear war, and nothing is left on the surface. Set in what appears to be the United States, it is a scene of destruction; however, as the series begins, life as one would know it, unfolds in a habitat in the shape of what looks like an old nuclear missile silo, dug deep into the Earth's core with approximately more than two hundred stories of floors. The remaining survivors from the fallout are in various groups and classes of citizens. Those who perform the governement, civil services such as guardians and police, agriculture and farmers, mechanics, doctors and the like and as one would suspect multiple social classes to keep the "silo" up and running and to keep chaos at bay the poeple follow a code, if this is ever broken, people are sent out of the Silo to clean a window that peers into the devastated and barron landscape and enter the radioactive environment outside the Silo never to return and parish.

As the second season unfolds, the viewer is learning that other Silo's exist, and roughly ten thousand citizens are living in each one. However, the adventure gets even more exciting as survivors begin to understand that there are other silos with residents living unbeknownst to them, due to a major cover-up and secrecy from those appointed as legislators.

The key point for leaders is that when silos exist between departments, for example, in patient units and procedure areas, or between surgical service lines and critical care units, healthcare organizations experience a negative impact on the workplace environment, which in turn affects patient outcomes and workplace culture (Wei et al., 2018). Leaders must break down interdepartmental walls and build collaborative work relationships for staff and the patients they care for. Communication and bridge building are key through intentional interdepartmental rounding.

Positive Mindset

A saying in the US Marine Corps is, "If you don't mind, it doesn't matter." At the root of this mindset lies an optimistic outlook on any situation. Maintaining a positive attitude, despite the challenging conditions a Marine will encounter during training or on the battlefield, is a key element of military training for units. This is also true in the delivery of healthcare services, as mentioned in other essays; the environment is often volatile, uncertain, complex, and ambiguous. For more on the VUCA discussed in other posts, see here. Maintaining a positive mindset is challenging, but first, what does that mean to stay positive for a leader? We will consult William James for this insight.

In terms of mindset or mental life, as elements of psychology, the brain, as we know, is cerebral, and we know that when a thought occurs, typically there is an action to follow; whether or not it happens is arbitrary at this point. However, we will reframe the positive mindset in terms better suited to beliefs, attitudes, passions, attractions, judgment, behaviors, and conduct (Adler, 1952, p. 1). William James succinctly describes this idea by interpreting the attraction states of iron filings to a magnet and the physical properties of air bubbles rising to the top of a water jar, which realign with the atmosphere, all of which illustrate attraction and an element of positivity. The antithesis of positive is negative, and the elements therein apply. Maintaining a magnetic perspective or practicing an altruistic gravitas even in the face of overwhelming situations is paramount. The leader in the healthcare environment will always need to be the magnetism in their area of service, or they will suffer the consequences for their staff and patients, despite the various challenges that arise on a day-to-day basis in healthcare operations.

References:

Adler, Mortimer J. (1952). William James. In The Great Books of the Western World. (Vol. 53). Encyclopedia Britannica.

Wei, H., Roberts, P., Strickler, J., & Corbett, R. W. (2019). Nurse leaders' strategies to Foster Nurse Resilience. Journal of Nursing Management, 27(4), 681–687. https://doi.org/10.1111/jonm.12736