Just Get Over It

Article Outline

• Being Stimulated
  • Wonder
  • Pride
  • Shame
  • Memory
  • Imperatives
  • Obstacles and Dangers
  • Priorities
• Stealing the Process
• Copyright

What does this really mean?

—Daniel J. Pesut, PhD, RN, PMHCNS-BC, FAAN

November 2009 at the 22nd Annual ANAC Conference

I wish you had all been at the Saturday morning plenary session during the 2009 ANAC conference in Jacksonville, but I know that the economy and a number of other factors kept many of you away. If you weren't there, you missed a great presentation by Daniel Pesut, PhD, RN, PMHCNS-BC, FAAN. Dr. Pesut is a nurse and a futurist. He pays attention to what's going to happen and how that will affect nursing, health care, and a whole host of things. I learned a lot from the talk. Actually, it would be more accurate to say that Dr. Pesut stimulated a whole host of new ideas and images for me. I have to admit that some of those ideas were a bit overwhelming, and I'm not sure that I'm cut out to be a futurist. The good news is that I really don't have to be. Dr. Pesut said that “only” 20% of the time, 20% of the people need to focus on the future. I emphasize “only,” because that still means more of us need to pay attention to what is coming up. So I'm writing this to get the word out to all of you creative visionaries: Get started, nursing needs you, people living with HIV need you, and ANAC needs you.

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Being Stimulated 

I most appreciated two things about Dr. Pesut's presentation: (a) he asked us to focus on our own organization and then (b) he gave us time, space, and a process to do just that. In a plenary session with 300 people in the room, he gave us the gift of 30minutes to think and talk about ANAC. Benedicta (Bene) Kumahia was my partner for that exercise. She and I discussed a wide range of issues, and I really had to work hard to keep up with her.

Here is how Dr. Pesut brought structure to what could have been total chaos: He asked us to discuss questions in seven areas, and he limited our time for each area. The areas and their associated questions were as follows.

Wonder 

If a time traveler from 50 years in the future could give you the answer to one question, what would it be? Bene and I wanted to know what nurses were doing in the future and how/if we had found the cure for HIV.

Pride 

If you were looking back 10 years from now and telling the tale of ANAC's greatest success, what would the story be and why? I thought we should be most proud of having transitioned to a nurse-managed organization, but I suppose that we should really just be proud that we had a group of dedicated founders who made ANAC happen at all. Bene said we should be proud of all the people we have touched at home and abroad.

Shame 

If you were looking back 10 years from now and telling the tale of ANAC's greatest failure, what would the story be and why? I heard a lot of people struggling with this one and even saw some blank stares. But Bene and I came up with several issues: not being a big enough voice in advocacy and policy discussions, not being at the critical tables to have that voice, and—on occasion—allowing petty personal issues to get in the way of progress.

Memory 

What does ANAC need to forget? What does ANAC always need to remember? The second question was not hard for us: We agreed that ANAC needs to remember why we are here, the patients who need our support, and the amazing and wonderful colleagues we get to work with in ANAC. The first question was harder. I came to the conclusion that we shouldn't forget anything. I kept thinking of what George Santayana said: “Those who cannot remember the past are condemned to repeat it.” I thought, “If it was so bad that we have to forget it, then why would I want to take a chance on having to repeat it?” I'm going to return to this issue later.

Imperatives 

What are the most important strategic decisions we will have to make as an organization? I don't think Bene and I had too much difficulty with this one. We thought that ANAC would need to make some good decisions about funding, increasing membership, funding, policy, funding, global concerns, funding, and, well, to be frank, funding.

Obstacles and Dangers 

What will prevent us from succeeding? What are the greatest risks and dangers? I think one important thing here would be to know exactly what we're using to measure success. I made the offhand statement that if someone found a cure or an absolute way to prevent HIV, the existence of ANAC would be threatened. We wouldn't need an organization for nurses in HIV care if HIV didn't exist. On the other hand, wouldn't that be the ultimate success? Isn't that what we would all like to see? Of course, we discussed the economy, failure to embrace new innovations, and the loss of our nonprofit status. So there are a lot of potential pitfalls out there.

Priorities 

If you had the power to do one thing for ANAC, what would it be and why? Based on all of the discussions leading up to this final question, it shouldn't be surprising what Bene and I wanted to do. We wanted to ensure stable funding. We wanted to maintain and expand our group of dedicated members. We wanted to get nurses at the most important decision-making tables, not only for HIV issues, but also to contribute to all of health care reform, policy, and capacity building. I added that we needed to honor our past and learn from our history.

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Stealing the Process 

As an educator I have one guiding principle: To be a better educator, you need to watch what other teachers do, steal the best parts, and change those parts to fit the context of your teaching events and your own personal style. So I stole Dr. Pesut's exercise, and I have used it successfully (with liberal revisions, of course) several times. It is a great exercise to help people think through important issues like writing a competitive continuing grant application, for instance!

The thing I changed the most was that one little question: What does the organization need to forget? As I said earlier, I don't think people and organizations should forget their histories. I think we should remember them, honor them, learn from them, and use them to make improvements. That being said, I do think there are some things we really need to get over. When I used (stole) the exercise the first time, I was relieved to see that the participants in that session easily came up with some good points, including (a) we need to get over expecting to be treated differently because we work in HIV care (also known as AIDS exceptionalism)—health care reform may demand this; (b) we need to get over the funding question—it's not going to get better anytime soon and we need to deal with it; and (c) we need to understand that we and our colleagues are getting older and won't be around forever. I like that last one, because I am getting older and I know I will have to move aside before too much longer. Understanding that fact of life reinforces the need to attract and mentor newer, younger, more energetic, and better educated nurses to fill the gaps left as we all move on.

Of course, Dr. Pesut didn't ask the people at the plenary session to think about the things that ANAC needed to get over, so I didn't get to explore those ideas with Bene. But I have thought about it—a lot—since the session. I think we need to get over our failures and figure out how to do better in the future. This is especially true for me when I think about being at those decision-making tables. Related to this, I know I personally need to get past my (constant) whining about nurses being ignored by policy makers, physicians, and others who have been endowed with and/or taken and built their own power. It would be better to use my energy to figure out how to stand up and help nurses get the attention and credit they deserve as the largest and most holistic of all health care professions.

I also think that we need to get over our historical memories of questionable decisions, mistakes, personal grievances, hurt feelings, embarrassments, and general goof-ups. We need to forgive each other and ourselves for the lapses in judgment, perceived slights, and just plain stupid things that have been said and done. I see these problems all the time. They seem to happen a lot with people who are passionate about an issue, and the members of ANAC are nothing if not passionate!

The nature of human intercourse is that it is not smooth; people always find ways to create havoc and do things that are just plain wrong. It is important to acknowledge those problems, to seek forgiveness, and to work on making things better. But at some point you have to move on. Give it up. Get over it.

I'd like to leave you with a couple of other questions that I wish we had discussed in Dr. Pesut's session. Here are the things I think we need to talk about: What if ANAC hadn't been there for this epidemic? What if you hadn't been here for this epidemic? And isn't our mere presence, not to mention our abundant passion and care, worth celebrating? I think so, and I think we need to focus on that as we move forward.