26 November 2014

Showing gratitude. What a gift!

During one of my recent traveling adventures, I was browsing a bookstore in the Minneapolis airport. As I approached the checkout stand to make my purchase, I was pleased to see a generous stack of P.M. Forni’s book Choosing Civility (2002) piled high and prominently displayed right next to the cash register. I was delighted to see that the topic of civility is one that still resonates with readers. It is my hope that the concept will continue to be a focus of attention, not only in nursing and health care, but in American society and beyond.

One of my favorite quotes by Forni is, “When we are on the receiving end of an act of civility, we feel validated, valued, and it gives our life meaning.” If you prefer a more colloquial version of this observation, you may enjoy a quote from Mark Twain who quipped, “I can live for two months on a good compliment.” Whichever quote strikes you most, each author makes a similar and compelling point—that we feel valued when we are recognized and appreciated by others.

Reflect for a moment on a recent or past experience when you felt affirmed and validated. Perhaps the affirmation came from a co-worker, student, family member, supervisor, or friend. As you contemplate the affirmation, consider the thoughts and feelings associated with the experience. My hunch is that they are enjoyable and pleasant. That’s because affirmations and words of encouragement add meaning to our lives and can lift us up during challenging times. They are like a port in the storm or a buoy on the choppy ocean. They situate us in the sweet spot of contentment. Unfortunately, when the opposite happens and we are treated rudely with disdain or disrespect, we feel dismissed, diminished, unimportant, and insignificant.

During one of my recent workshops, a nurse in the audience commented that the effects of incivility last far longer than the two months of gratification cited by Mark Twain. The nurse observed that the impact of incivility can be crippling, while a genuine affirmation penetrates like a warm, welcoming, soothing salve.

A few months ago, just before our youngest daughter left to study at a university in England, we were visiting one evening—simple family talk, really—when she gazed at me for a moment, and declared, “You know what, Mama? You have always been a good mama, but I want you to know that I think you are also a very impressive woman.” Wow! What an unexpected and always-to-be cherished affirmation. Since her departure for Europe, I have reflected on that sweet, yet powerful pronouncement, and it lifts my spirits every time.

Like me, you have received affirmations that you treasure and hold onto tightly. But I wonder how many of us have to ponder a while to recall a time when we felt affirmed and validated. It’s perplexing that, while we know how great a positive comment feels, we are slow to affirm others—even those in our closest circle for whom we care the most. For whatever reason—busyness, stress, lack of face-to-face connection, or believing that a real “thank you” costs money—we often miss opportunities to affirm others. I would like to suggest several ways to acknowledge and express gratitude that cost very little, yet render high-impact results.

Smiling and greeting others by name can go a long way in helping colleagues and students feel welcome and significant. Make a point to say ”Good morning,” or extend a similar greeting as you go about your day. As Lady Mary Wortley Montagu reminds us, “Civility costs nothing, and buys everything.” Say “Thank you” often, and offer praise in front of others. Be specific with your praise. It’s good to praise, even when you express it in general terms, but it’s better to be specific, and it’s best to extend praise beyond the confines of the current setting.

Suppose you are a nurse working on an oncology unit. You have just put in a very long day attending to very ill patients, many of whom suffer from terminal conditions and are receiving palliative and end-of-life care. You are an attentive and compassionate nurse, but clearly exhausted and ready to go home. Just as you are leaving the unit, your charge nurse approaches you and says, “Great job today! I really appreciate you.” Obviously, this comment feels good—in fact, it might feel very good.

Now, what if your charge nurse is a bit more specific with her feedback and addresses you by saying, “Chris, I am so impressed with the care you provided today. I especially appreciate how you collaborated with Dr. Bailey to find the right combination of medications to relieve Mrs. Jones’ pain. Her family is deeply grateful, and because of you, she is going to have a restful night. Thank you for being such a great nurse. You are a valued member of the team.” Wow, what an incredible message! It’s specific, unambiguous, and, clearly, your charge nurse is appreciative and observant. You will likely remember this personal affirmation for a long time.

What if we take this expression of gratitude one step further and elevate the message beyond the work setting? In his book, Creating Magic: 10 Common Sense Leadership Strategies from a Life at Disney, Lee Cockerell (2008), former executive vice president of operations at Walt Disney World Resort, suggests sending a note of recognition to a family member. For example, in the above situation, the charge nurse might take a few minutes to mail a handwritten thank-you note to your family member or significant other that reads something like this: “Dear Terry, I want to take a moment to let you know how much we appreciate Chris. She is a caring, talented, and gifted nurse who takes great pride in the care she provides for every one of her patients. She is a joy to work with, and I can’t begin to fully explain how much she means to our team, and most especially to our patients and their families. Thank you for sharing her with us. She is a very special person.”

Now that is a powerful message! It’s a low-cost reward with high-impact results. And it takes only a few minutes of time and the price of a postage stamp. There are many other creative ways to say thank you. We can treat a colleague to lunch, leave a note of appreciation on their car or in a public place; give them a lottery or movie ticket or a gift card to their favorite coffee shop.

Shortly after delivering a plenary address at a nursing conference where we discussed the power of acknowledging others, I was approached by a nurse who shared a personal experience. She said, “I have worked in the neonatal intensive care unit for 16 years. Every day, I come to work, caring for very sick babies and tending to families terrified of losing their greatest treasure. Many of our babies don’t make it, and the toll it takes on the people in their lives is nearly unbearable. 

So, a few years ago, I started a support group. It is a safe space for loved ones to share thoughts and feelings and, in many cases, to express the pain of their devastating loss. I facilitate the group on my own time, but it is worth every minute. While my teammates appreciate what the group means to families, for years it went largely unnoticed by my manager and others throughout the hospital. But, of course, I wasn’t doing it for the recognition.

“And then one day, a colleague showed me a brief write-up in the hospital newsletter. On the front page of the newsletter was a short paragraph describing the support group and the positive impact it was making on the families of our babies. One of the families had sent a letter to the CEO expressing their gratitude for the support group. I had no idea, but there it was in black and white on the front page of the newsletter! My name was even mentioned! I decided right then and there, I can do this another 16 years!”

Let this holiday season begin a long tradition of inspiring others by affirming their value and giving them the glorious gift of gratitude.

Cockerell, L. (2008). Creating Magic: 10 Common Sense Leadership Strategies from a Life at Disney, New York, NY: Double Day Publishing Group.

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