Personal Effectiveness III
Solve Problems Like an RN !
Previous in Series : Priorities
Stress and Chaos – Or Problem Solving ?
Problems and conflicts in our lives can make us feel like we're on a tight rope. We may have strong thoughts and judgments buzzing in our heads ; our feelings may whipsaw back and forth in ways that make us dizzy. We may feel like we're on a tightrope a hundred feet above the ground. And actions ? It may feel like our next step could be a calamity. And in some cases, it may actually turn out to be one !
Could it help to take some of the extreme stress out of this ? To put a safety net under all this drama ? To perhaps lower the rope we’re walking on, about 99 feet ? Or maybe just do our walking, for the sake of practice, on a line on the ground ?
There’s actually a way to do this, and it’s called problem solving. Problem solving is a human cognitive skill, one of many cognitive skills we learn in the course of growing up, that help us understand and live in our world.
A Skill You Can Learn – and Use
Typically we learn cognitive skills by seeing other people use them, or by being taught. If you haven’t learned problem solving (or any other cognitive skill) before, no worries, this happens to everyone. The important thing is that it’s something you can learn - and when you do, it can take a lot of the stress out of life.
To be truly helpful, problem solving should be systematic. One great example of a systematic approach is "The Nursing Process", used by Registered Nurses to help their patients. Another name for this process is its acronym, APPIE
To organize her work and care, a Registered Nurse
Assesses her patient, including relevant history, main symptoms, and any important emotional and social concerns he or she has.
Identifies Problems that need to be addressed.
Establishes a Plan, composed of various tasks and steps, to be carried out within a chosen time frame.
Implements the various steps as planned, and
Evaluates patient responses and outcomes, and continues this process as needed.
Interestingly, the same process can also be applied elsewhere : to external situations in life, but also to inner questions and processes - and to social situations. This nursing process has been portrayed as not just a problem solving tool, but a spiritual path. It’s worth knowing about – and it’s effective.
Identify a Problem – and Solve It Like an RN !
Think of some of the challenges (problems, conflicts, difficulties) you face in your life right now. Read these examples through carefully once. Does anything sound familiar ?
- Situations where you act impulsively, with consequences afterward.
- Situations where you’re not sure what to do, and may feel paralyzed.
- Feelings you have a hard time dealing with, such as anger, fear, guilt or shame – or possibly
even positive feelings you get carried away with.
- Situations where you have very mixed feelings, and it’s stressful.
- Harsh or upsetting thoughts you often have – thoughts about yourself, about others, or about
your life generally.
- Things you find it hard to understand and it bothers you a lot.
- Having a really hard time, and not telling people you could actually trust – not being able to ask for help when you need it.
Go through the list above and identify some problems and challenges you have in your life right now. Describe each one with a sentence or two - just write them down in short form without thinking too much.
From the list of challenges and problems you identified earlier, choose one you’d like to work on first. It doesn’t have to be the biggest or worst one in the list, just one you’d really like to make some progress with. Which challenge, problem or situation do you want to work on first ?
Learn to Solve Problems with APPIE
Next we’ll explore how to use APPIE – The nursing process. The steps of the process are adapted here for work on a personal problem. The steps for nursing care, again, were to Assess the situation of a patient ; identify a Problem or problems ; create a Plan for giving the care needed ; Implement or carry out the plan ; then Evaluate the effects of the measures that were taken. Here’s how APPIE can be used to work on a personal problem. Read through the steps one time carefully without writing anything down – for now just get an overview of what you’ll do next :
- To ASSESS the situation you chose, you'll take a first look at the problem – at exactly what it is you’re having a hard time with. What is the situation ? How long has it been going on ? Who are the people involved, and what are some typical interactions with them ? Be sure to include your feelings about things. Describe the important details as you would to someone you trust.
- You'll identify or define the PROBLEM in a single descriptive sentence. It will also help to make a note for yourself if the problem has to do with a) something you do - or not knowing what to do in some situation you face b) a particular feeling you have a hard time dealing with c) something you have difficulty understanding - or some upsetting thought you can’t shake.
- You'll create a simple PLAN for dealing with this problem. This should include a clear written statement of what you hope to accomplish - a very clear goal. It should include a series of the small, achievable steps that you’ll take to help you reach this goal. It should also include the names of people you’re going to ask for help, if you need help. And it should include a time frame – how long you’ll give yourself to reach this first goal. It’s important that all these things be written down.
- The next step will be to IMPLEMENT your plan : to carry out your steps, one by one. To keep getting things done, and also not put yourself under too much pressure, you'll do well to break the work up into one day assignments for yourself. Then, if you should fall off your schedule, take care not to beat yourself up - just go back to doing these steps you chose, to solve the problem you chose, because it’s important to you to solve it.
- Once you’ve gathered information, identified problems, planned and carried out steps, it will be time to EVALUATE. How well have the steps you took helped ? Are you making progress in some areas ? Do some need more work ? You'll review and ASSESS the situation as it is now, to begin a new cycle of APPIE. Again you'll commit each step in the process to writing, as this lends both clarity and strength.
Use APPIE to Solve a Problem of Your Choice
Look back to your problem list, and the problem you chose to solve first. If it’s still the one you want to address first, solve it systematically using the steps above. Be thorough and don’t hurry – as they say, anything worth doing is worth doing right.
- ASSESS the situation. Describe it in it’s important details, using the guideline questions above. Spread the basic information out before yourself, as you might tell it to someone you trust. Identify and include your feelings, but for the moment make no judgments. Just gather the important information – what it means can wait for now.
- Identify the main PROBLEM or problems this situation gives rise to for you, again using the guidelines above. Any problem you can have will break down into one predominantly of thoughts or understanding, difficulties dealing with feelings, or difficulties choosing the right thing to do (including gaining control of impulsive actions). Note which of these areas this particular problem belongs to.
- Using the guidelines above, create a thoroughgoing PLAN of action, including your specific goals in this matter, a series of specific steps you will take, a time frame/timetable for your actions, and who you will ask for help, if needed.
- Implement your plan, again using the guidelines provided, reviewing your progress as you go, and keeping notes on it for yourself.
- Evaluate the outcome of your effort according to the guidelines, including a written record of their effectiveness. Complete this review and use what you’ve learned to ASSESS your situation as it now stands – and continue to a next cycle of APPIE as needed.
Jeff Smith RN (Retired)
Next in series : Activism 101 : An Activist's Toolbox
Solve Problems Like an RN !
Previous in Series : Priorities
Stress and Chaos – Or Problem Solving ?
Problems and conflicts in our lives can make us feel like we're on a tight rope. We may have strong thoughts and judgments buzzing in our heads ; our feelings may whipsaw back and forth in ways that make us dizzy. We may feel like we're on a tightrope a hundred feet above the ground. And actions ? It may feel like our next step could be a calamity. And in some cases, it may actually turn out to be one !
Could it help to take some of the extreme stress out of this ? To put a safety net under all this drama ? To perhaps lower the rope we’re walking on, about 99 feet ? Or maybe just do our walking, for the sake of practice, on a line on the ground ?
There’s actually a way to do this, and it’s called problem solving. Problem solving is a human cognitive skill, one of many cognitive skills we learn in the course of growing up, that help us understand and live in our world.
A Skill You Can Learn – and Use
Typically we learn cognitive skills by seeing other people use them, or by being taught. If you haven’t learned problem solving (or any other cognitive skill) before, no worries, this happens to everyone. The important thing is that it’s something you can learn - and when you do, it can take a lot of the stress out of life.
To be truly helpful, problem solving should be systematic. One great example of a systematic approach is "The Nursing Process", used by Registered Nurses to help their patients. Another name for this process is its acronym, APPIE
To organize her work and care, a Registered Nurse
Assesses her patient, including relevant history, main symptoms, and any important emotional and social concerns he or she has.
Identifies Problems that need to be addressed.
Establishes a Plan, composed of various tasks and steps, to be carried out within a chosen time frame.
Implements the various steps as planned, and
Evaluates patient responses and outcomes, and continues this process as needed.
Interestingly, the same process can also be applied elsewhere : to external situations in life, but also to inner questions and processes - and to social situations. This nursing process has been portrayed as not just a problem solving tool, but a spiritual path. It’s worth knowing about – and it’s effective.
Identify a Problem – and Solve It Like an RN !
Think of some of the challenges (problems, conflicts, difficulties) you face in your life right now. Read these examples through carefully once. Does anything sound familiar ?
- Situations where you act impulsively, with consequences afterward.
- Situations where you’re not sure what to do, and may feel paralyzed.
- Feelings you have a hard time dealing with, such as anger, fear, guilt or shame – or possibly
even positive feelings you get carried away with.
- Situations where you have very mixed feelings, and it’s stressful.
- Harsh or upsetting thoughts you often have – thoughts about yourself, about others, or about
your life generally.
- Things you find it hard to understand and it bothers you a lot.
- Having a really hard time, and not telling people you could actually trust – not being able to ask for help when you need it.
Go through the list above and identify some problems and challenges you have in your life right now. Describe each one with a sentence or two - just write them down in short form without thinking too much.
From the list of challenges and problems you identified earlier, choose one you’d like to work on first. It doesn’t have to be the biggest or worst one in the list, just one you’d really like to make some progress with. Which challenge, problem or situation do you want to work on first ?
Learn to Solve Problems with APPIE
Next we’ll explore how to use APPIE – The nursing process. The steps of the process are adapted here for work on a personal problem. The steps for nursing care, again, were to Assess the situation of a patient ; identify a Problem or problems ; create a Plan for giving the care needed ; Implement or carry out the plan ; then Evaluate the effects of the measures that were taken. Here’s how APPIE can be used to work on a personal problem. Read through the steps one time carefully without writing anything down – for now just get an overview of what you’ll do next :
- To ASSESS the situation you chose, you'll take a first look at the problem – at exactly what it is you’re having a hard time with. What is the situation ? How long has it been going on ? Who are the people involved, and what are some typical interactions with them ? Be sure to include your feelings about things. Describe the important details as you would to someone you trust.
- You'll identify or define the PROBLEM in a single descriptive sentence. It will also help to make a note for yourself if the problem has to do with a) something you do - or not knowing what to do in some situation you face b) a particular feeling you have a hard time dealing with c) something you have difficulty understanding - or some upsetting thought you can’t shake.
- You'll create a simple PLAN for dealing with this problem. This should include a clear written statement of what you hope to accomplish - a very clear goal. It should include a series of the small, achievable steps that you’ll take to help you reach this goal. It should also include the names of people you’re going to ask for help, if you need help. And it should include a time frame – how long you’ll give yourself to reach this first goal. It’s important that all these things be written down.
- The next step will be to IMPLEMENT your plan : to carry out your steps, one by one. To keep getting things done, and also not put yourself under too much pressure, you'll do well to break the work up into one day assignments for yourself. Then, if you should fall off your schedule, take care not to beat yourself up - just go back to doing these steps you chose, to solve the problem you chose, because it’s important to you to solve it.
- Once you’ve gathered information, identified problems, planned and carried out steps, it will be time to EVALUATE. How well have the steps you took helped ? Are you making progress in some areas ? Do some need more work ? You'll review and ASSESS the situation as it is now, to begin a new cycle of APPIE. Again you'll commit each step in the process to writing, as this lends both clarity and strength.
Use APPIE to Solve a Problem of Your Choice
Look back to your problem list, and the problem you chose to solve first. If it’s still the one you want to address first, solve it systematically using the steps above. Be thorough and don’t hurry – as they say, anything worth doing is worth doing right.
- ASSESS the situation. Describe it in it’s important details, using the guideline questions above. Spread the basic information out before yourself, as you might tell it to someone you trust. Identify and include your feelings, but for the moment make no judgments. Just gather the important information – what it means can wait for now.
- Identify the main PROBLEM or problems this situation gives rise to for you, again using the guidelines above. Any problem you can have will break down into one predominantly of thoughts or understanding, difficulties dealing with feelings, or difficulties choosing the right thing to do (including gaining control of impulsive actions). Note which of these areas this particular problem belongs to.
- Using the guidelines above, create a thoroughgoing PLAN of action, including your specific goals in this matter, a series of specific steps you will take, a time frame/timetable for your actions, and who you will ask for help, if needed.
- Implement your plan, again using the guidelines provided, reviewing your progress as you go, and keeping notes on it for yourself.
- Evaluate the outcome of your effort according to the guidelines, including a written record of their effectiveness. Complete this review and use what you’ve learned to ASSESS your situation as it now stands – and continue to a next cycle of APPIE as needed.
Jeff Smith RN (Retired)
Next in series : Activism 101 : An Activist's Toolbox