Stop making excuses

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Elizabeth Newman, McKnight's Senior Editor
Elizabeth Newman, McKnight's Senior Editor

How much of your life, either in long-term care or personally, is spent making or hearing excuses?

In healthcare, there's a knee-jerk fear that admitting a mistake or error in judgment will lead to a lawsuit, and so an excuse is made. While it's important to hear someone out as to their reasoning for, say, a resident care plan, there is a difference between explanation and excuse.

While I don't hear the excuses related to clinical care, I regularly hear complaints about bundled payments and reducing hospital readmissions, implementing new technology, or following Affordable Care Act guidelines. I understand: new regulations can be unfair. A case in point is a story this week about whether anti-kickback rules are going to hit innocent providers who get caught up in a web of partner or vendor malfeasance.  

I empathize. Everyone complains. Everyone finds excuses: ask any writer or journalist how well they do managing procrastination. That's why the best advice I've received recently comes from not a healthcare expert, but an occasionally raunchy advice columnist.

Tiny Beautiful Things is a collection of Dear Sugar columns. Dear Sugar (published on The Rumpus) is Cheryl Strayed, whose memoir Wild is also wonderful. But it's TBT where you find advice that is applicable to your life. (It's one of the best books I've read recently. I may buy it in bulk so I can hand it to any friend undergoing a divorce, death or health crisis.)

In response to a person wallowing about her student loan debt, Sugar writes, “I'm going to address you bluntly, but it's a directness that rises from my compassion for you, not my judgment of you. Nobody's going to do your life for you. You have to do it yourself, whether you're rich or poor, out of money or raking it in, the beneficiary of ridiculous fortune or terrible injustice. And you have to do it no matter what is true. No matter what is hard. No matter what unjust, sad, sucky things have befallen you. Self-pity is a dead-end road.”

Sugar writes to those facing heartbreak, terrible life events and major challenges. But if there is an overarching theme, it is that the person seeking advice has to take control over their life.

That also applies to your jobs. This is not to say that we shouldn't gather with colleagues and blow off steam, or that we shouldn't push back against unfair policies. But we must, as an industry, realize that no one is going to do the hard work for you. While you can't control the fate of long-term care, the lives of residents, your colleagues and possibly your facility rests on your shoulders.

This news, rather than making you scared, should straighten your spine. And it reminds me of Sugar's advice to a struggling woman writer who was stuck. In writing about other women writers, Sugar wrote that what they all have in common is not “collapsing in a heap.” While she's talking about writing, Sugar could just as well be talking about caring for the elderly.

“The unifying theme is resilience and faith,” she writes. “It is not fragility. It's strength. It's nerve. And ‘if your Nerve deny you—' Emily Dickinson wrote, 'go above your Nerve.' Writing is hard for every last one of us —straight white men included. Coal mining is harder. Do you think miners stand around all day talking about how hard it is to mine for coal?

They do not. They simply dig.” 

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.

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