A friend of mine who tends to operate a ‘To Do’ list the size of Kenya now also runs a smaller, less pressing alternative list that she calls the ‘Ta-dah’ list. It’s an inventory of successes or achieved tasks that remind her that she has been constructive - she says it stops her feeling that no matter how hard she works she is getting nowhere.
I asked if she wrote ‘write a Ta-dah list’ on her To Do list and, if so, wasn’t it a bit depressing having an even longer list than before? She pointed to number 15 on the list: ‘Ignore Mark when he says something sarcastic about your list.’
I don’t think nurses tend to have Ta-dah lists. They may go home sometimes with a feeling of a job well done, a sense of having done good rather than harm, but that isn’t the same as articulating successes. Indeed, when I asked a group of nurses recently what they felt they had achieved that month, the most common response was ‘survived’. But it later emerged that two of them had saved a life in the previous three weeks.
And if we ever wonder why nurses are so reluctant to pause and reflect on their successes, we only need to look at the things nursing has had to prepare for recently.
First up was bird flu, though luckily one of the reasons that last year’s threatened epidemic didn’t materialise was because the human nose had planned ahead and couldn’t host the virus. Let’s hear it for noses. Then there was swine flu. And that doesn’t appear as dangerous as first feared. Meanwhile, treatments for cancer, stroke and heart disease are improving all the time.
‘First it was bird flu. Then it was swine flu. Now you have to deal with melting ice caps and a massive increase in tropical disease and famine’
But just as you think it’s OK to sit down for five minutes with a cup of tea and a biscuit, you are greeted by the headline ‘Climate change could kill six billion’. You’ve contributed to disease management, health education and protection against emerging strains of virus. You’ve done the drug round, dropped the kids off at your mother’s and done the ironing. You’ve even written some care plans and built an extension over the garage, but now you have to deal with melting ice caps and a massive increase in tropical disease and famine. And they wonder why there’s a recruitment crisis looming?
You find yourself overcoming service transformation, clinical revolution and a whole new bunch of illnesses, only to be confronted by global warming and the end of humanity as we know it. Can’t wait for the Department of Health leaflets to come round about that.
And so I suggest that along with your usual supports - supervision, friendship, sarcasm and bloody mindedness - you consider using a Ta-dah list. Have a moment or two when you reflect on the things you have achieved, the small but all-important successes in your working day.
Because without a sense of the difference you have made, the ever-expanding requirements of the job might just become overwhelming. And then, when the tidal waves come and the concrete melts beneath our feet, where will we be?