Join the 100 Top Squiggles of Nursing project

In my July 12, 2010 Meta-Reflections post, I commented on the squiggle sense and the complementary nature of nursing phenomena. I was delighted and surprised when David A. Engstrom, PhD, creator~designer of The Squiggle Sense blog and co-author, along with J.A. Scott Kelso, PhD, of The Complementary Nature, contacted me and invited me to be interviewed! We exchanged many an e-mail and now that interview is posted on the Squiggle Sense blog!


Dr. Engstrom also posted a comment to my July blog post, in which he extended an invitation to the nursing community to participate in the 100 Top Squiggles of Nursing project, part of his effort to gather the 100 top squiggles in a variety of disciplines. I think this would be a very interesting exercise that would add to our understanding and appreciation of the complementary nature and dynamics nurses negotiate on a daily basis.


So, here is the plan. I invite all my nursing colleagues to use the comment feature provided at the bottom of this blog post (click on the word “comment”) or send directly to me (dpesut@iupui.edu ) a list of squiggles you notice in your practice, education or research contexts. I, in turn, will pass them along to Dr. Engstrom, and we will slowly but surely build a list of the top 100 squiggles in nursing! For example, a few of my candidate squiggles of nursing are: nursing~negligence; suffering~succorance; health~illness; mindfulness~mindlessness.


What complementary pairs or “squiggles” has your squiggle sense perceived and acted upon? Participating in this project is easy. All I need are your squiggles, but if you care to spend a few minutes to let us know why you chose your particular candidate(s), please do so.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Becoming wholehearted

Recently, I became aware of the work of Brené Brown, PhD, LMSW, who studies wholeheartedness. The evolution and development of her interests and research career is enlightening and inspiring. For a quick introduction to her work, check out this TED video, where she talks about the power of vulnerability and the importance of human connection. What is most fascinating to me is that she began studying wholeheartedness as a result of her research interest in the concept of shame. I struggle with issues of shame. Everyone does. Brown’s definition? Shame is the intensely painful feeling or experience of believing that we are flawed and, therefore, unworthy of love and belonging.

Brown makes the following points about shame. We all have shame, and it is one of the most primitive human emotions we experience. The only people who do not have shame lack the capacity for empathy and human connection. We are all afraid to talk about shame. The less we talk about shame, the more control it has over our lives. Shame is the opposite of owning our story and feeling worthy. Shame is different than guilt, which is about doing something bad. Shame is a belief that I am bad and not enough.

It was through her study of shame that Brown discovered wholehearted people, individuals who had developed shame resilience. Men and women with high shame resilience have four things in common. They understand shame and recognize what messages and expectations trigger shame for them. They practice critical awareness by reality-checking the messages and expectations that tell us being imperfect means being inadequate. They reach out and share their stories with people they trust. They speak shame. They use the word “shame.” They talk about what they are feeling and ask for what they need.

As I reflect on my nursing career, I realize that many of the dysfunctional dynamics I have observed in individuals, groups and organizations oftentimes involve issues of and responses to shame. I wonder what would happen if we started talking about shame and the effects of shame in our personal and professional lives?

Antidotes to shame involve the following: cultivation of authenticity, self-compassion, a resilient spirit, gratitude and joy, intuition and trusting faith, and creativity. Developing shame resilience also includes letting go of exhaustion as a status symbol and productivity as self-worth. It involves cultivating calm and stillness, and letting go of self-doubt and “supposed-to.” It involves cultivating laughter, song and dance, and letting go of being cool and “always in control.”

If you want to learn more about wholeheartedness and developing shame resilience, check out Brown’s work. She is delivering important messages to the world about the power and value of vulnerability, compassion, courage and connection. Nurses everywhere will benefit personally and professionally from her wisdom, advice and careful attention to the research available on the subject of wholeheartedness and authenticity. Developing shame resilience is a practice worth pursuing.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Gremlins and grace: Challenges for a new year

As the holiday season and another year came to a close, I reflected how, in the recent past, my gremlin kept surfacing to influence, hamper and interfere with my thinking, doing and relating. One of my colleagues suggested I read Rick Carson’s book, Taming Your Gremlin. I did, and it has given me new ways to monitor, notice and respond to my personal gremlins.

As we begin a new year, I think it is a good time to take stock, reflect and consider how best to tame one’s gremlins. According to Carson, taming one’s gremlin involves the process of noticing and choosing—
moment-to-moment—light over darkness, good over evil and the love that sustains over the fear likely to destroy. If you have one or more gremlins that need taming, explore Rick Carson’s website and learn more about gremlin taming.

Of special note are his tips for taming gremlins. Pictures people have created that visually represent personal gremlins of many types and varieties is available in his Gallery of Gremlins. Feeling creative about describing your personal gremlin? Perhaps you will want to respond to Carson’s invitation to draw and submit a picture of your own gremlin to his Gremlin gallery?

Gremlins often take charge of the chatterbox inside our heads. Gremlin taming is one way to manage the chatterbox. Another way is to create a state-of-grace document for yourself and with others.

The five components of a state-of-grace document are: 1) the story of me/us, 2) interaction styles and warning signs, 3) expectations and core values, 4) questions to return to peace, and 5) short- and long-term agreements. A state-of-grace document can become a blueprint for positive healthy relating. Creating a state-of-grace document for yourself and with those you care about provides a stimulus for conversation, dialogue and understanding.

Learn more about these documents and consider how gremlin taming and grace can be incorporated into your personal and professional development plans for the new year, 2011.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Paradoxes of group life: Is the profession of nursing caught in a self-referential bind?

Group life is permeated with contradictory thoughts, actions and emotions. Groups bound together by a purpose often spend time trying to negotiate and unravel the contradictory forces associated with relating to each other in a meaningful way. Such negotiations often result in a paralyzing circular process of conflict, enmeshment and paralysis rather than reflection and transformational dialogue. Smith and Berg (1987) in their classic work, Paradoxes of Group Life, note that making the invisible, paradoxical nature of group life visible helps unravel some of the paradoxical dynamics of conflict.

Clustered under the three essential group concepts of belonging, Smith and Berg identify tensions associated with identity, involvement, individuality and boundaries. Under the concept of engagement, they discuss tensions and issues associated with the dynamics of disclosure, trust, intimacy and regression. The issue of speaking in group life is explained in the dynamics of individual versus collective voice, authority, dependency, creativity and courage.

Group life revolves around several paradoxical tensions. Consider the complementary dynamics associated with tensions between the individual~group, self~other, conscious~unconscious processes, dependence~independence, stuckness~movement, framing~reframing, participation~control, disclosure~non-disclosure, fear~courage, isolation~intimacy, belonging~not belonging, splitting~connecting, and issues of introjection~projection.

Smith and Berg suggest the dynamic responsible for the paralysis and difficulty in group life is a “self-referential bind.” They write: “When a social entity uses itself as a mirror through which it judges what it is like, it often only sees those parts of itself that confirms what it wants to know, that is, that it will enable it to remain as it wants to be. Systems that are self-referential create binds for themselves that are difficult to get out of” (1987, p 48).

The bind that groups create is the paradox that emerges as a result of projections and introjections as groups engage in splitting and fractionation around issues of identity (we-they) and issues related to errors of logical type. Projections are defined as taking something from the inside and mapping it to the outside. Introjections are the mapping of outside onto the inside. Projections and introjections are forms of displacement, where some dynamic that belongs in one place is moved to another.

When the projection~introjection dynamic is co-mingled with subgroup formation in group role taking, collective splitting results in social interactive processes that are paradoxical and paralyzing. Multiple frames create conflicts that appear to be irresolvable and foster double-bind situations that elicit multiple contradictions and meanings. Framing and reframing these contradictions in different ways leads groups to developmental insights that evolve the group beyond intractable, paralytic dynamics. Reframing changes the meaning, content or context of a situation so people develop new insights about intentions and actions.

So, as I witness the dialogue and debate surrounding the Advanced Practice Registered Nurse (APRN) consensus model, and ponder consequences of the Essentials of Doctoral Education for Advanced Practice Nursing on the future of master’s degree education, and consider services the profession will provide to the public, and explore the fifth iteration of the Draft Masters in Nursing Education Essentials document, I ask myself: As a profession, are we caught in a self-referential bind? How might we reframe all of the contradictions in such a way that we gain insights that move us beyond intractable, paralytic dynamics?

What do you think?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

The squiggle sense and the complementary nature of nursing

I once heard a quote and am not sure to whom it is attributed: “Life is bipolar and everything contains its opposite.” I have had my share of challenges trying to negotiate and reconcile what seem to me oppositional issues in my own life. I now have a new understanding of the complementary nature of polarities and paradoxes.

The squiggle sense has been proposed by scientists J.A. Scott Kelso and David A. Engstrom to represent the complementary nature and coordinated dynamics of opposites that, in fact, are components of a greater dynamic process. Such coordinated processes are linked to the way the brain processes information and engages in sense making. Kelso suggests the tilde or squiggle (~) as the symbol of the complementary nature that relates contrarities, opposites and their kin. Think about the squiggle sense and the complementary nature of nursing.

For some time, I have suggested there is a complementary nature to nursing and that the opposite of nursing is negligence. Thus, the squiggle sense of this would be nursing~negligence. I believe most nurses have a well-developed sixth sense about the complementary nature of nursing care. Now we have a way to represent—and perhaps make explicit—our squiggle sense of complementarity in terms of patient-care needs. Other complementary pairs relevant to nurses and the care they provide also come to mind.

Consider the complementary pair of any nursing problem with its opposite or desired nursing-sensitive outcome. For example, pain~comfort, anxiety~ anxiety control, impaired mobility~mobility, body~mind and self-care deficit~self care. In fact, one of the essential aspects of nursing is management of the complementary nature of human responses to health~illness situations. I wonder what would happen if nurses moved away from the development of problem lists and began to identify and note the complementary nature of each identified problem in terms of its coordinated opposite. We would then be identifying problems~outcomes and, perhaps, have a new appreciation of nursing care responsibilities in light of the squiggle sense of issues presented by individuals, groups, families and communities.

Why not explore the complementary nature website and see how the theory of coordinated dynamics resonates with your own thinking, personal experience and the practice of nursing. The squiggle sense mission is to provide an “evolving online resource for the study and appreciation of a sixth sense of the complementary nature, and its philosophical~scientific grounding in coordination dynamics, the science of coordination.” Nursing is grounded in the science of coordination. I hope you accept the invitation to explore the complementary nature site and reflect on how coordinated dynamics might influence your thinking, doing and nursing practice.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Strengths and values

People who know me are familiar with my enthusiasm for a strengths-based approach to personal and professional development. Personally, I belive every nurse in the world ought to know their signature strengths. Such strengths-based knowledge supports learning in service of caring.

Do you know the constellation of character strengths you possess? There are a couple of ways to learn about and maximize your strengths skill set. I invite you to take some time to explore the VIA Institute on Character. It evolved as part of an evoluationary vision connected with developments in the field of positive psychology. Since its inception, the institute has focused on classification, testing and research related to character strengths. These classifications include cognitive, emotional, interpersonal, civic, self-control and strengths attuned to connections with the larger universe in which we live and make meaning.

Do you have a cluster of strengths related to the acquisition of knowledge? Strengths that fall under this category include creativity, curiosity, judgment and open –mindedness, love of learning and mastery of providing perspective. Courage is the category of strength that includes bravery, perseverance, honesty and zest. Humanitarian interpersonal strengths include the capacity to love and be loved, coupled with kindness and social intelligence. Commitments to building community involve the civic strengths of justice, teamwork, fairness and leadership.

Temperance, as a strength, modulates and works against excess and includes the value set of self-control, prudence, modesty and humility, as well as forgiveness and mercy. Finally, strengths that help us transcend and find meaning in the larger universe include appreciation of beauty and excellence, gratitude, hope, humor and spiritual consciousness, supported by faith or purpose. Wouldn’t it be great to know what your character strengths and values are? Such self-knowledge enables one to be clear about personal and professional contributions to the nursing care enterprise.

Once upon a time, you could take the brief version of the Character Strengths profile for free. A recent visit to the VIA Institute on Character revealed they no longer offer that service as an option. However, they do have a number of free resources. Check out the research studies. Perhaps the most useful resource is "340 Ways to Use VIA Character Strengths." As you consider some of the suggestions about using and developing your strengths, share your plans with a friend or colleague, and invite them to develop their strengths. Contemplate how development of your individual strengths contributes to your leadership in the greater community where you live and work!

For Reflections on Nursing Leadership, published by the Honor Society of Nursing, Sigma Theta Tau International.

What is MOJO? And have I lost it?

Not very long ago, I thought I had lost my MOJO. So I was really excited to read Marshall Goldsmith’s latest book, MOJO: How to Get it, How to Keep It, and How to Get It Back When You Need It. I really enjoyed reading this book, and I gained new insights into myself and people with whom I work. I now believe I understand and know how to better self-manage the four keys to MOJO—identity, achievement, reputation and acceptance. Goldsmith defines MOJO as “the positive spirit toward what we are doing now that starts from the inside and radiates to the outside.” He and his team have actually developed a MOJO Survey to help people discern their level of MOJO, which is defined in terms of short-term satisfaction (happiness) and long-term benefit (meaning). The results of the survey make explicit the dynamics of a person’s relationship to any activity. The categories are: surviving, sacrificing, succeeding, stimulating and sustaining. How do you recognize people with MOJO? People with MOJO take responsibility, move forward, run the extra mile, love doing it, appreciate opportunities, make the best of it, are inspirational, grateful, curious, caring, have zest for life and are awake! In contrast to MOJO, there is NOJO, which is defined as “that negative spirit toward what people are doing now that starts from the inside and radiates outside.” People with NOJO play the victim, march in place, are satisfied with the bare minimum, feel obligated to do it, tolerate requirements, endure it, are painful to be around, are resentful, uninterested, indifferent, Zombie-like and asleep. Goldsmith makes a distinction between professional MOJO, which is powered by the ingredients of motivation, knowledge, ability, confidence and authenticity, and personal MOJO, which is powered by happiness, reward, meaning, learning and gratitude. He has even developed a MOJO scorecard for people to track and rate their MOJO, based on the activities in which they engage every day. This is a very revealing exercise, if you decide to do it! Finally, he provides people with a MOJO tool kit comprised of strategies and techniques as well as principles and practices. These strategies help in the management and development of one’s identity. There are also clues and tips about how best to support achievement and reputation. Finally, the advice and wisdom about accepting change and influencing what you can while letting go of what you can’t change was significant and resonated with me. So, now I am on a MOJO recovery program and that positive inner spirit is beginning to radiate outward once again! Thanks, Dr. Goldsmith!

For Reflections on Nursing Leadership, published by the Honor Society of Nursing, Sigma Theta Tau International