Why can’t we live free from expectations? Post-COVID, will we be crushed by workplace demands, and is spirituality the answer? We’re all familiar with generic, New-Age wellness programs. Vanilla approaches to truth rarely help those struggling with addiction, serious bullying, and other real issues. Nick talks to Hank the Sonic Shaman about all those uncomfortable topics, from Jesus and prayer to shamanism and mental health.
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Is this another blog lauding Simone Biles and Naomi Osaka for prioritizing their mental health over athletic achievement? Nope. What about criticizing the work ethic of millennials whenever anything gets difficult? Also no. The focus and effort to become the best comes with a cost. The more we force-feed life scripts to celebrities we feel can champion our causes and beliefs, the less we can deal with nuance and complex issues that can’t be summarized in a tweet or headline.

Even if all the information is available (it never is), you don’t have to pick sides. Do you know anything about these women–not their accomplishments, but as people? Quickly choosing a side is how content on the Internet works. Algorithms calculate what outrages or motivates you, and feeds you only that, so you will view as many advertisements as possible until you tear yourself away from the screen to live in the real world. Neutral information giving you the space to formulate your own individual conclusions doesn’t have the captivating power of strong emotions. In the early years of the Internet, anonymity allowed people to say despicable things to those they didn’t agree with. Then they would log off the forum board, turn off their computer, and still have polite conversations in real life. It’s much harder to hide behind a screenname now, but instead of encouraging more civil behavior at work, church, and online, we’ve polarized ourselves into tiny tribes seeing every news story or political difference as an opportunity to define Us and Them.

Are Simone and Naomi oppressed women of color taking power back from sport organizations capitalizing on talents until they join the ranks of broken and used up athletes? Are they instead taking advantage of their celebrity when it suits them, but using excuses when it doesn’t? It was a busy July. Most recently, Simone said she was struggling with vertigo (which everyone was ok with), before pulling out of Olympic gymnastic events citing mental health concerns. After failing to appear at mandatory press conferences at the French Open, Naomi cited similar issues in deciding not to compete at all. Struggling with a hyper-extended knee, Giannis Antetokounmpo persevered in the NBA Finals, bringing glory to the Milwaukee Bucks and his home countries of Nigeria and Greece. There are much deeper narratives here, related to the employer/employee issues we’ve dealt with at BEHAVE Wellness for years.

Can we look unflinchingly at all sides of an issue? The above meme doesn’t reflect the reality of organizations and corporations committed to squeezing out every ounce of productivity possible. We try to withstand the pressure, reminding ourselves that we need to perform and earn the degree as an “amateur athlete”, or tenure, or the 401K, or a medal. It’s true that employees are understandably also less loyal in today’s culture. Gender norms still lead to men more often achieving themselves to death–in many anesthesia departments, it’s the male CRNAs offering to stay late and earn more money rather than going home to their families. Although NBA stars often have the power to whine until traded to another team if they wish, if Giannis had skipped the NBA finals because of anxiety or depression, Internet trolls would have a field day.

However, the answers aren’t as important. Simone and Naomi will be heroes or villains for those searching for characters in whatever self-serving story they want to promote. Everything that we stand for at BEHAVE Wellness should take the side of those prioritizing their own wellness above material success, right? But again, we dehumanize complex situations if Simone and Naomi are nothing more than talking points for a cause. The questions are more important–the realization that the issues of exploitation, responsibility, sacrifice and selfishness need addressed by all of us in our personal lives. Our judgment of others is irrelevant, though what offends us reveals us. We are all heroes and villains, because we are all imperfect humans, prone to mistakes and courage and fear and accomplishments woven together in this experience we call life.


Along with other accomplished nurse anesthetists, Nick and Shannon are presenting at a conference live on Instagram. Topics include finances, wellness, bullying, and strategies to accomplish one of our mantras: don’t graduate alone.
Don’t graduate alone has two parts. The first: graduate. All the activism and speaking your truth and resilience won’t matter without actually accomplishing your goal. The second: if you do graduate, but lose all the important relationships in your life in the process, it’s not a win. The whole point of navigating from nurse aide to registered nurse to advanced practice is an increased quality of life. For more on that, here’s a video about mental health strategies and relying on support systems appropriately.


Our topics also apply to entrepreneurship and disciplines where the challenges make traditional views of work-life balance untenable, so you’re more than welcome to join us and get your questions answered. Through the practices Shannon will teach us, students can better become steel snowflakes: intricate, individual, fully present, but with sharp edges that do not melt when faced with adversity. Nick’s steel snowflake theory emphasizes brutal self-reflection coupled with the grace to learn and make mistakes as we live an authentic life of meaning. We’ll also be teaching from the many resources we’ve developed at BEHAVE Wellness as we strike that balance between self-care and serving others. The conference is free, so be sure to invite your friends!
Before we begin, our thoughts and prayers are with the people of Virginia Beach, where an employee of the city’s public works department killed 11 people before police shot him. The same circuitous conversations about mental health, gun control, and maybe toxic work environments may fade before even the first funeral, but the frequency of these incidents doesn’t negate the tragedy for affected communities.
No one is Immune
We get anxious too, leaving work at the office or operating room only to find the stress following us home. Too bad it’s so difficult to learn new skills and change the world without stepping out of your comfort zone. The three of us here at BEHAVE Wellness are part of the team that launched Alleviant Health Centers in Akron about a month ago. It’s a lot easier to talk about creating an oasis of wellness for employees than it is to form a business with a team of experts capable of treating complex patients who’ve been let down by conventional therapies.
Zap it with Medical Technology
Whether situational anxiety or an actual anxiety diagnosis, cultural norms in this country dictate trying to get rid of it, preferably in the most advanced manner possible. It’s the same philosophy that leads to unnecessary heart catheterizations and removal of helpful organs.
There’s nothing inherently wrong with desiring a quick fix rather than trying to earn wellness through the hard work of dietary changes, exercise, and self care. Either approach brings up issues of worthiness and identity. Starting this week at Alleviant, we’re offering Transcranial Magnetic Stimulation (TMS) for anxiety. Typically, insurance only covers a month’s worth of sessions in cases of treatment resistant depression. What we’ve quickly discovered is that the drug-less, pain-less technology is powerful and incredibly effective, but still works best in combination with a patient’s own efforts.
At the risk of resembling a “Top 10 Tips” clickbait article, we’ll list a few ways to reduce anxiety the three of us are using more than ever. Alone, each one may fail to move the needle, but shifting from a compartmentalized to a holistic approach is Step 1 to reduce anxiety. Feel free to leave a comment to learn more about Alleviant Health Centers or BEHAVE’s tools and workshops for corporate wellness!
Natural Anxiety Reducers
1. Probiotics. Seems unrelated, but we’ve seen dramatic differences due to this step in repairing the gut-brain connection. Herbal and mineral supplements decrease anxiety, but working with a qualified practitioner is best to find the right combination.
2. Eat right. In the same article, dietary changes reduced anxiety more than multi-strain, high quality probiotics.
3. Know your body. After all, although everyone knows sugar is bad and at least some exercise is good, we’re usually overwhelmed by the differing opinions about optimal lifestyle changes. Staying in tune with what the body wants answers questions such as, “Do I still feel good on this raw, plant-based diet three months in?”
4. Talk. Some people improve their self-awareness by talking to others. Find friends and family who can serve as a mirror to see what’s going on the inside. Professional counselors can also help sort through causes and solutions for anxiety.
5. Breathe. Several branches of alternative medicine focus on restoring the balance between the “fight or flight” and “rest and relax” portions of our nervous system. Slow, deep breaths allow the parasympathetic nervous system to regain control.
6. Cherish moments. Like dapples of sunshine reaching the forest floor, sometimes joy reappears. Live in these moments, not focusing on how long they will last or if we deserve it or the ten other things we should be doing with our time.
Healthcare is all about “critical thinking,” which occasionally prevents us from getting stuff done and actually healing patients. Click the picture to take our new course about communication and acting on properly processed information. That’s a major challenge at any workplace: removing the distorted lens of perception and seeing things as they are. Is the boss terrible, or does corporate culture just place that mantle of ineptitude on everyone in leadership? Are coworkers clear and brutally honest, or are you being bullied? And finally, do I really use phrases like “mantle of ineptitude” when internally asking myself questions? Yes.
Our last post discussed the importance of outside perspectives, but let me illustrate with a story how to achieve a more holistic viewpoint. I (Nick) rent out my house as part of the snowbird process. The final step will be driving 20 miles under the speed limit wherever I go. It’s surprisingly difficult to clean your house for others, because I’m used to my own mess. I mopped the floors and polished the furniture, but almost missed coffee stains on the kitchen cabinets. They’ve probably been there a while, but long ago my brain told my eyes, “There’s nothing to see here. Let’s concentrate on other things.” Take a step back and will your mind to see things for the first time. It may be an emotional undercurrent at the office, or an automatic response to a seemingly neutral stimulus, or even the way coworkers treat certain employees without apparent cause. Notice normal reactions and those that seem out of place. Culture is extremely powerful, especially during times of conflict, stress, and grief. I read a story today of a funeral home simultaneously hosting calling hours for an American–stoic, somber, whispers of dull platitudes such as “God needed an angel” and a Filipino–kids climbing around the casket, people talking loudly, etc. We revert to traditional ways of doing things, and it’s helpful to ask the simple question, “Why?” Why is the best for the patient, client or customer, and why do we think this way is the best way? None of us could work effectively turning over every stone inquisitively, but pick your battles and see what you uncover.
Latest and Greatest
Our new course isn’t the only project we’ve been working on. “Critical Doing” is certainly entertaining, especially the interactive videos filmed underwater in Greece and Florida (very relevant to the nursing process), during hurricanes, and while wandering around forests and crowded malls. We are starting a pain and mental health clinic in Akron, Ohio. We have about a dozen employees, and it’s past time to stop talking about corporate wellness and see if we can actual materialize our idealistic views. By putting employees first, we hope their joy will be contagious and lead to much better patient outcomes than the current cookie-cutter methods of care. We’ll continue to update you all on our progress, triumphs, and failures as we do our part to change the broken healthcare system and practice critical doing.
Since all three of us are nurse anesthetists, we expected clients from healthcare once we launched our business, especially since we’ve written research articles, textbook chapters, and now books about various aspects of healthcare and wellness. We thought questions would come from our guest posts about bullying among nurses, or the nuances of work culture as we’ve discussed on FreshNP. To our surprise, the same two themes orbit work issues in the hospital OR, at McDonald’s, and in the cubicles with a pointy-haired boss: relationships and finances.
As much as we stress leaving work at work and home at home, the two overlap substantially. If they desperately need the money, employees will accept far more abuse at work than someone already ambivalent about their job. Perceived lack of support from a spouse or loved one amplifies unintentional slights at work to full-blown rejection. Self-care and wellness techniques help realign our perceptions closer to reality, limiting miscommunication and awkward misunderstandings. Work is inherently awkward, like any other activity where at least one party is only present because they are being paid to do so (think Uber, Airbnb, or that boy you bought pizza at lunch every Friday for a month so he’d go to the Sadie Hawkins dance with you).
For a good time every time, observe other people’s awkwardness for a minute. That’s what much of How to Succeed in Anesthesia School is about–prospective students and seasoned clinicians quickly mastering social dynamics so they can concentrate on the next step on their career path. The quirky humor and irreverent satire may seem at odds with what BEHAVE Wellness stands for, but learning should be hilarious whenever possible. We’ve learned that a stiff, walk-on-eggshells work environment always has more problems than a cheerful place with blundering, authentic goofballs. Besides:
We should really eat before writing these posts. Subscribe on the right with your email address, and you’ll get these witty compliments every time we write a new post. So, besides new information on debt and investing wisely (but not necessarily conservatively–see our Bitcoin post) and balancing a successful career as a caregiver with satisfying, deep relationships, what else does the book teach? Topics include selecting a healthcare specialty, interviewing well, and the best ways to transform theoretical knowledge into something practical for patients. Lest it get too annoying and upbeat, one of the chapters is titled “Picking up the Charred Remains after you Crash and Burn”, not too dissimilar from the section “Cutting your Losses” in the relationships chapter. Best of all, this project comes with a free audiobook version narrated by the author. For the three Americans who don’t have Amazon to buy a paperback or Kindle version, purchase a similar Nook/iBook/PDF here:
We were invited to talk about bullying in healthcare by our good friend and author, Kati Kleber. Increasingly, we’ve all been asked to address this by nursing students feeling powerless in the classroom and in clinical settings. Similar to interns and graduate students, the common thread is continual evaluation by others higher on the totem pole–who themselves may be bullied by their superiors. We incorporated much of the current literature in our discussion on FreshRN, and some of it is surprising (and vicious).
So are we saying that not every nurse is as virtuous as the saintly one above? Bullying is surprisingly common in helping professions, even in churches. The top five bullying behaviors nursing students experience are nonverbal innuendos, verbal affront, undermining actions, withholding information, and sabotage. As opposed to being shoved on the playground, this sometimes requires perception and awareness of the social environment to even realize it’s happening. That’s why bullying is so common and devastating in learning environments. From a personal standpoint, several of us can remember times where we had to choose between learning 100% of the knowledge we needed for the day or being charming and socially adroit, because both required total concentration.
One reason that toxic learning environments are so consuming is the concept of a “snowflake”–an overly sensitive, dogmatic person, as opposed to six sided crystalline ice precipitation. It’s important to consider how other students are being treated, and how distant reality may be from our perceptions of being bullied. This is where others come in, although Behave Wellness would be better suited for that than a college ombudsperson (what do they do anyway?) or hospital HR department. Not that anyone’s life has been changed through a blog comment, but tell us your story below and we will do our best to help. Any professionals you use should be familiar with bullying so they can give you wise and relevant advice.
The broader themes of workplace bullying, sloppy attempts at merger and acquisitions, and employee expectations of honesty are at work in this standoff between nurse anesthetists, their hospital, and the corporation that “bought” them. #Michigan68 What else would you like to know about the situation?
nursing power, practice and perspectives
Thoughts of holidays and good will toward men lead me to believe that the #Michigan68 would be successful this week in negotiating a reasonable contract with the ostensible new employer PSJ and Providence/Providence Park administrators. Not so.
It is disappointing to report that a fair and just contract was not able to be reached, and the CRNAs have pledged to keep working for the hospital system until a new vendor/contractor can be found who will negotiate with them in good faith. They are upholding the standards of nursing by caring for their patients in a professional, safe, and dedicated manner. Their fate, however, is still in peril.
Even more so now that they are individually and collectively being threatened with lawsuits MERELY FOR TELLING THE TRUTH. Well I am telling it as loud as I can, and hope you will pass this along and do the same. We MUST INSIST…
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