The information found on this site is the personal opinion of the authors, and is intended to educate and interest, rather than to direct clinical management for specific patients. Copyright is shared between the author/s and this site. You may reproduce this content as long as the original source is credited. No information on this site may be reproduced for profit.

Joy in Work

Seb Gray

We live in a world and we work in a system where joy has become lost – re-finding it, celebrating it and spreading it has the potential to revolutionise our working lives.

But what is joy?

The Oxford Dictionary defines joy as “a feeling of great happiness”. Short but sweet. Quite literally.

We can’t talk about joy without addressing the elephant in the room and that is burnout. A study of over 15,000 physicians in USA found that almost half had symptoms of burnout. Historically, paediatrics was always thought of as one of the happiest specialties, but we now sit somewhere in the middle. Only 26% report that they are happy. ¾ of doctors personally know someone who has left due to burnout and 1 in 4 nurses are actively seeking other employment.

Burnout causes a significant burden on the individual but also on those they work with and the patients they care for. Effects include:

  • Lower levels of staff engagement
  • Lower patient satisfaction
  • Lower productivity
  • Increased risk of workplace accidents
  • Lower quality care
  • Limited empathy

But why are we burning out? What has changed?

Resilience often gets cited as the problem – older generations branding the newer generations as snowflakes is unhelpful and belittling.

One of my local ED colleagues, Annabelle Harris, describes a wonderful analogy which I’ve tweaked slightly…

If you have a canary in a cage, in a room, it would be fine. It might even find moments of joy. If you start pumping that room full of noxious, toxic gases it will no longer be fine. It is not the canary’s fault. It is not because the canary is not resilient enough. You could try making a tiny, miniature gas mask for the canary to help with its resilience, but this is a short-term measure that does not address the problem. It certainly will not attract more canary’s and if the canary gets the chance, it will fly as far away as possible and not come back.

Resilience is important but it is not the route of all burnout and focusing on the ‘R’ word alone would be a waste of time, energy and resources.

We all know that health is more than the absence of disease but similarly, joy is more than the absence of burnout. We shouldn’t be aiming for things to be ok. We should be aiming to have the absolute best working life possible.

We start our lives so full of joy, so full of wonder and enthusiasm. Everyone with small children will be familiar with the Christmas process of spending a small fortune on an expensive gift, putting it in a box, wrapping the box. Maybe even putting a bow on top and then placing it under the tree. When Christmas comes, they excitedly rip off the paper, take the toy out of the cardboard box and then spend the rest of the day joyfully playing with that box.

But what happened? How did we go from finding joy from cardboard boxes to where we are now? Nobody wakes up in the morning and says, “Today I want to be miserable.” Healthcare is one of the few professions that regularly provides the opportunity to profoundly improve lives. Caring and healing should be joyful activities.

We put so much pressure on ourselves and we keep moving the goalposts.

We think that if we work hard and achieve our goal, we will have been successful and then we will be happy. But how many of us stop and then take stock? We naturally set new goals – bigger, better, harder to achieve. We have to work harder, but we tell ourselves that it’s worth it because when we get there, we will have achieved success and then we will be happy.

There is a powerful study about 2 groups of people. One group has won the lottery and the other has become paraplegic. If I gave you the choice, I know which one you would choose but fast forward one year – both groups are equally happy. You cannot buy happiness. It is a state of mind and sometimes by losing something, you realise what you have left and value it more. Look at the sums below…

1 x 2 2
2 x 2 4
3 x 2 6
4 x 2 8
5 x 2 10
6 x 2 12
7 x 2 14
8 x 2 16
9 x 2 18
10 x 2 25

What did you notice?

Like every healthcare professional, you focussed on 10 x 2 not being 25. The one wrong answer out of 10. 9 out of the 10 sums were correct but you didn’t think to focus on that or congratulate me. 90% is considered a pretty good mark in most industries but it’s become ingrained that we focus on the negatives in healthcare – we do it without noticing and it takes conscious effort to reverse that attitude.

Healthcare is so focused on the sharp end of medicine

When things go wrong, things can be catastrophic for the patient but it’s well documented that the effects on the person who made the mistake are significant and potentially long-lasting. This second victim phenomenon can ruin careers and lives. Whilst safety will always be important the emphasis needs to be re-balanced.

Bob Wears said,

“Trying to understand safety by looking at adverse incidents is like trying to understand sharks by looking at shark attacks”.

The odds of being killed by a shark are nearly 1 in 4 million. To put that in perspective, you’re 50 times more likely to die from being struck by lightning than by being eaten by a shark. Sharks don’t spend their days swimming around eating people and yet there is a narrative influenced by media that has given sharks a bad rap. In healthcare we spend the vast majority of the time doing things well, even exceptionally. That is what we should be focusing on.

One of the most watched TED talks of all time is by Shawn Achor and he shows a graph similar to the one below with made-up data and one anomaly. As scientists, we see this anomaly as the problem disrupting our beautiful linear distribution. But what If we turned things around and focussed on that one red dot that is different from the rest and try to learn what made that dot so special?

Adrian Plunkett has taken this idea and blown it up on a national scale. The learning from excellence movement has been stolen shamelessly and shared seamlessly across the UK as all wonderful things should be. Taking something positive and learning from it to ensure that it happens again is a wonderful notion. Every aspect of the process spreads joy – whether you’re the one completing the report, receiving the report or analysing the report. It makes you feel really good and how you make people feel is the most important thing as Maya Angelou eloquently states:

Joy and happiness are contagious

In 2009 Colin Wynter was at the Sasquatch festival and he was having the time of his life dancing on his own. This was captured on video and watched over and over on YouTube. People start joining Colin dancing and soon enough that joy has spread so that as far as you can see everyone is joyfully dancing.

We need more Colin’s in our workforce, but we also need people to join the Colin’s of the world. It’s easy to join in when there’s already a crowd. It feels like a bold step to be the first to join Colin but ask yourself, what have you got to lose? Or even better, what have you got to gain?

How many yellow cars did you see yesterday?

Not sure, right?

If I ask you to look for yellow cars tomorrow, you will see more yellow cars. If you see more yellow cars, you will think about yellow cars and you will look for and notice all the yellow cars.

The same is true for joy. If you look for the good things, you will see the good things and you will start looking for them more. Journaling; documenting 3 good things each day for 30 days has been shown to improve happiness and give a more positive outlook on life. However, we need to take the time to do that.

Our lives have become so busy, so saturated, that we rarely take the time to stop and take stock. Mindfulness is a turn-off to many but doesn’t need to be as meditative as the popular apps suggest. Building in time into your life to just do nothing is just as important as everything else. Time to reflect. Time to just be.

There is an old story about a man who would buy his newspaper from the same street vendor every day. The man would bring the exact change, they would chat briefly exchanging pleasantries and go on with the rest of their days feeling good. One day the man realised he did not have the correct change and only had a large bank note which he knew the vendor would not be able to change. The vendor told the man not to worry and that he could pay tomorrow, but the man insisted on going to a large shop down the road. He bought something he did not want and did not need just to get the change and went back and paid the vendor. When that happened, something changed. The vendor felt rejected. Devalued.

We all know about Karma – what goes around comes around. We commonly associate this with bad actions, but grace can be even more powerful. By allowing someone to do something kind for you, you facilitate that cycle.

If you give 2 people £100 and tell one of them to spend it on themselves and the other to spend it on others, studies have shown the giver is happier. If feels good to give. By letting someone do something for you, you are planting the seed of joy in them which will grow. Let them.

The #mugged movement is a wonderful thing. Sourcing a mug, ideally of the novelty variety with a positive message and filling it with things you think that person might like. Attach a message of gratitude or positivity and anonymously give it to them. Having been #mugged, the intense feeling of joy was profound and impacted positively on every human interaction I had for the rest of the day. Random acts of kindness are exactly that and they start the ripple of effect that can swell into waves of joy.

We all know that there are plenty of ways to skin a cat but my 4 take-home messages to try and improve joy in your workplace are:

  1. Follow (or be) the dancing Colin – joy is contagious
  2. Look for the yellow cars – you will see more goodness when you look for it
  3. Pay the newspaper vendor tomorrow – graciousness brings others joy
  4. Consider mugging someone – random acts of kindness start the ripple effect

Disclaimer: I’ve loved learning about Joy in Work. I’ve seen lots of inspiring talks and read some amazing books. This post contains some of my favourite ideas and messages and have helped bring me more joy in work. I hope they work for you too.

If you want to read or watch more…

TED Talk: Shawn Achor – The Happy Secret To Better Work
Website: Learning from Excellence
IHI White Paper – Framework for Improving Joy in Work

Written by Dr Seb Gray, Consultant Paediatrician working in Salisbury, UK
Twitter: @SebJGray

One thought on “Joy in Work

  • December 3, 2019 at 4:34 pm
    Permalink

    I loved the practical way you boil down themes and behaviours into things we can actually do.

    Reply

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

The information found on this site is the personal opinion of the authors, and is intended to educate and interest, rather than to direct clinical management for specific patients. Copyright is shared between the author/s and this site. You may reproduce this content as long as the original source is credited. No information on this site may be reproduced for profit. 2018, paediatricfoam.com