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The Art of Appreciation–Why Saying ‘Thank You’ Matters

“Showing gratitude is one of the simplest yet most powerful things humans can do for one another.”
–Randy Pausch


I recently had my last ‘official’ day at Camp. It was bitter-sweet, leaving me feeling blessed to have participated, but also sad that it is ending. On my departure, I received a little notebook. In it was more than 20 entries, all from staff that I had worked with throughout the years, thanking me for my leadership, my kindness, and my service. Each entry is about a paragraph, describing how my presence changed Camp for the better.

I was deeply moved, and become emotional just thinking about what a gift it was for me. It is also an indication of how my dedication affected those around me. I am struck by the number of people that felt compelled to contribute, but also how good it feels to be affirmed for the work I put in. I always felt buoyed by the job itself, not thinking I needed any acknowledgement to feel as though I had done an excellent job.

In reflection on my experience, I realize that sometimes it is important to receive acknowledgement for the work we do, even if the work itself is a source of deep gratification. Appreciation can act as a signal to keep us going, it gives us strength when times are tough. It reminds us of our value.

This experience, and how profound the appreciation felt, has me thinking about my other job. In the hospital setting, (unlike Camp) people don’t make or receive ‘warm fuzzies’ on a daily basis and it is a lot harder to feel appreciated and encouraged that the job you are doing is a good one.

Often we do receive feedback in ‘real time,’ but the majority is focused on what we have done wrong or informing us if a family was dissatisfied with their visit. While necessary and helpful, it can have the opposite effect of appreciation, making us feel inadequate or ‘not good enough,’ and likely adds to our feelings of burnout.

There is rarely spontaneous and unsolicited positive feedback or anything resembling what I received from Camp. I receive about one complaint every 3 months or so, and about one compliment a year.

I try to continue to have a good attitude and I think I do my job with joy, but I now wonder if the lack of appreciation taints how I operate when I get there.

If the complaint/compliment situation is applied to everyone that works in the ED, every one of my colleagues is lacking good positive appreciation. Could it affect how they walk into work every day? Is it possible that a feeling of being unappreciated could alter how one treats others while at work?

Now knowing what it feels like to be appreciated, I think we all need more of it to survive in the healthcare field. To help pull us from a place of negativity and bring us back to remembering why we care so much, why we do the jobs that we do. I don’t think it matters who the appreciation comes from, just that someone else notices our efforts.

What would happen if we all showed a little more gratitude to our co-workers? What would that look like?

I believe it is possible to make this happen, but it would necessitate a little culture change, more awareness of how our environment effects each of us, and a daily conscious effort to be a part of the solution. Moving in this direction could impact the way we view our jobs collectively, and also make it an easier place to be. If each person was feeling more appreciated and that the job they did individually mattered, would our busy and stressful times feel less awful?

It is extra challenging because the environment we work in is a breeding ground for frustration. When we are frustrated, it is very hard to think about thanking someone. In reality, this is the time it is MOST important that we learn to do so.

I find it is often easier to get frustrated by the delay in a patient going to the floor than it is to thank a resident for spending time to explain a test to a parent or telling my charge nurse that I appreciate her for navigating the disposition of a psych patient.

When frustration instead of gratitude becomes the go-to emotion, the entire department can feel the ripple of this. Have you ever noticed how it feels to sit next to someone who is angry or allowing their frustration to consume them? It is as though their whole being is vibrating with negativity. This negative energy can be suffocating and repulsive, and it can make others feel negative as well.

On the other hand, do you know what it feels like to sit next to someone who is emanating gratitude? The calm energy exuded can be a welcome reprieve from the chaos of the environment. I actively seek these people out and try to emulate them.

In an effort to be in a place of gratitude prior to every shift, I have developed a habit of slowing down, breathing deep, and entering a mental state of compassion. I want to make sure that my frustration about traffic or my irritation over my messy house doesn’t cloud my interaction with my patients or colleagues.

It is important to me that I practice in this way, but I am also very aware that when the pressure is on (busy ED, high acuity, and stressed out colleagues) even I can get pulled out of my appreciative state fairly easily. Couple that with an email about a patient complaint and I am totally in a downward spiral, trying desperately not to allow frustration to overwhelm me.

I realize that the way out is to consciously choose to respond differently. If instead of feeling frustrated by the volume of patients, the angry parent or the know-it-all resident, I re-channel my energy to focus on what is going well, I feel better. The volumes stay the same, and the parent does not miraculously become happy with the care, but I change. Changing our perspective can subsequently change the lens through which we look at life. The chaos then feels less chaotic, and the areas of frustration feel less frustrating.

Which means, become appreciative! Focus on the team. Don’t let the negativity bring you down. Who can you thank? Who is doing an excellent job? Can you be the one who provides your co-worker’s daily dose of appreciation?

I am working on this in my own life, trying to call out my physician colleagues when I truly feel as though I am being supported, thanking my nursing staff when they go extra lengths to calm a family, or my residents when they work  hard to keep the ED flow moving. By taking an active role in giving others a ‘thank you,’ or taking time to genuinely appreciate their work, we might actually be able to change the way our workplace feels, especially in the stressful moments.

Recognizing the importance of appreciation and saying ‘thank you,’ is a good reminder for me on how I need to lead and model behavior. Knowing how good it feels to be appreciated, I can then make sure I shower people with it when I think they do a good job. Or if I am grateful for something they have done for me. If warranted, I will send an email to my co-worker’s supervisor, and make sure my colleague is also included in the email.

Can you imagine what it would feel like if we all did this? The ripple effect is real, so if you participate just a little, change will occur.

How do you like to be appreciated? How do you like to appreciate others?