The Grind of Impact

Lessons from the Everglades

As healthcare professionals, we often navigate a complex balance between personal motivations and healthcare demands, driven by our desire to positively impact lives. Yet, in the 'business' of our daily responsibilities, it's easy to lose sight of the actual impact we're making.

Recently, between Hurricane Helene and Hurricane Milton, I visited the Everglades National Park in Florida. This journey sparked a profound reflection on the nature of meaningful work and the often-unseen ripples of our efforts in healthcare.

As we drove through the vast expanse of lush vegetation, I was struck by an unexpected sight: research facilities nestled amidst the sawgrass marshes and mangrove swamps. These buildings, seemingly out of place yet perfectly situated, house scientists working tirelessly to understand and protect this unique ecosystem.

The gentle rain merging with the vast expanse of water during our tour filled me with profound respect and admiration. My thoughts turned to those dedicated scientists who immerse themselves in the daily grind of seemingly small, yet incredibly meaningful work. Their consistent efforts, though often invisible, compound over time to create significant impact.

In that moment, I couldn't help but draw parallels between these committed researchers and you, the tireless health professionals navigating your own careers. Like the raindrops joining the greater body of water, your daily actions, however small they may seem, contribute to a larger, vital purpose in healthcare.

The Hidden Work of Scientists and Health Professionals

The Everglades, often called the "River of Grass," is not just a natural wonder but a critical subject of study. Climate change, water management, and biodiversity conservation are just a few of the pressing issues these scientists grapple with daily. Their work, often unseen by millions of visitors, forms the backbone of our understanding of this complex ecosystem and its global significance.

This hidden work, carried out day after day, year after year, reminds us of the power of consistent, dedicated effort. It's a testament that not all impactful work is immediately visible or widely recognised.

The parallels between these scientists and health professionals prompted me to consider the inner challenges of doing work that takes time to see results - results that are never entirely within our control. Just as the researchers in the Everglades work tirelessly behind the scenes, many health professionals dedicate their lives to work that often goes unnoticed, whether it be by the broader public, managers, or healthcare users. 

Nurses providing round-the-clock care, Pathologists meticulously analysing samples, Public Health staff tracking disease patterns, Speech Pathologists assessing the cognition of an elderly resident with dementia in a long-term facility, Project Co-ordinators applying for yet another grant – all these roles and more are crucial yet frequently overlooked.

This sentiment resonates across the healthcare spectrum. The daily grind of working in our respective roles across the workstreams rarely feels groundbreaking, but it forms the foundation of our healthcare system and contributes to the overall health and wellbeing of society.

The Ripple Effect of Our Work

The true impact of our work often manifests as a ripple effect, extending far beyond our immediate sphere of influence. In healthcare, our actions can have far-reaching consequences. A primary care physician's early diagnosis might prevent a serious illness, a nurse's compassionate care could inspire a patient to make life-changing health decisions, or a researcher's breakthrough could lead to treatments benefiting millions worldwide. 

But so many of us will end the day not feeling like it’s enough, that we would be more fulfilled with having a more significant impact. Whilst this may be true, we can find value in considering the ripple effects of small consistent contributions and not just the large at-scale impact.

This concept is beautifully illustrated in Kirby Williams' journey as a Psychiatric Mental Health Nurse Practitioner (PMHNP).

Kirby's story demonstrates how our actions can have far-reaching consequences that we may not immediately see. Throughout her career, Kirby has faced numerous challenges and transitions from inpatient to outpatient settings, from clinical practice to academia, and back again. Each of these experiences contributed to her growing understanding of the broader impact she could have.

A pivotal moment in Kirby's career came when she redefined her understanding of success and impact. As she reflects, "I can't change the whole wide world, but I can change someone's world." This shift in mindset was transformative, allowing her to see the broader impact of her work, particularly in mentoring and supporting new psychiatric NPs.

The ripple effect of Kirby's efforts became evident in multiple ways:

1. In the confidence of new NPs as they navigate their first job, armed with the support and guidance Kirby provides.

2. In the renewed passion of seasoned practitioners who rediscover their sense of purpose through Kirby's mentorship.

3. In the countless patients who benefit from the skilled and compassionate care of the NPs Kirby has mentored.

As Kirby puts it, "I'm trying my best to help those PMHNP's have a more confident start, a more supported start, a more encouraging start than I had. Because even though I didn't have that, I realise what a difference that could make in a career."

This ripple effect extends even further when we consider how each of these NPs will, in turn, impact their own patients and colleagues throughout their careers. Kirby's work in mentoring and supporting new PMHNPs creates a cascade of positive change that reaches far beyond her immediate interactions.

Kirby's story reminds us that our impact in healthcare often extends far beyond what we can immediately see or measure. It encourages us to consider how our actions and choices might create positive ripples that touch the lives of patients, colleagues, and communities in ways we may never fully know. By focusing on changing "someone's world," we can indeed contribute to changing the whole wide world, one ripple at a time.

Seasons of Impact

It's crucial to recognise that impact, like nature itself, has seasons. In the Everglades, researchers might spend years collecting data before a significant pattern emerges or a breakthrough occurs. The same is true in healthcare. Some days, we might feel the immediate gratification of saving a life or alleviating suffering. Other times, our work might feel mundane or even futile.

Dr. Chris Lillis' journey as a primary care physician illustrates the concept of seasons in a healthcare professional's life, highlighting the balance between direct patient care and leadership roles.

Chris began his career in direct patient care, where he found deep fulfilment in helping individuals navigate their health challenges. However, as he became more aware of systemic issues within the healthcare system, he transitioned into clinical leadership roles. This shift allowed him to influence care delivery on a broader scale.

Chris maintained a connection with patient care while taking on leadership responsibilities, creating a unique challenge. Chris found himself balancing administrative duties with direct patient interactions, but he viewed this as a strength rather than a burden. Medicine, in particular, has structures and systems to support this approach, unlike many other professions in healthcare.

His journey also included a season of consulting, where he leveraged his expertise to guide health startups. At the time of our conversation, Chris was contemplating a return to clinical settings in a leadership role, illustrating the cyclical nature of his career. "Every day I survive, I get a little bit older. I realise that you have to keep a good perspective that slow changes are incremental," he reflects.

Chris's experience serves as a reminder that each season in our career has its own form of impact. Whether we are directly caring for patients, leading teams, or innovating within the healthcare system, the key is to recognise the value in each phase and remain open to new opportunities for impact as they arise.

Understanding these seasons can help us maintain perspective and resilience in our careers. It's about recognising that while the nature of our impact may change, our ability to make a difference remains constant, adapting to the needs of each new season in our professional journey.

Collaborative Efforts and Cumulative Impact

Both in the Everglades and in healthcare, significant achievements are rarely the work of a single individual. They are the result of collaborative efforts and cumulative impact over time. Tesiah Coleman's journey exemplifies this principle, particularly through her advocacy work and the creation of "Togather."

At the heart of Tesiah's mission is a commitment to health justice, which she believes can only be achieved through collaboration. After experiencing systemic challenges during her nursing education, including racism and inequities, Tesiah channelled her frustrations into action by founding "Students for Racial Justice in Healthcare." This initiative aimed to create a supportive community for students facing similar obstacles, emphasising the importance of collective voices in advocating for change.

As she transitioned into her role as a nurse practitioner, Tesiah continued to prioritise collaboration. Working in community healthcare, she served diverse populations, including monolingual Spanish-speaking patients and those from marginalised backgrounds. This experience reinforced her belief that addressing health disparities requires a team effort. "I want to help fix the problems I'm seeing in the world. I want to be part of the solution," Tesiah explains, highlighting her dedication to working alongside others to create meaningful change.

The culmination of her advocacy efforts is the launch of "Togather," a platform designed to foster collaboration among healthcare providers working in various aspects of health justice. Tesiah describes it as a community that provides the training, support, and resources needed to navigate the complexities of healthcare. "Together is about providing the training that you need to get ready for that marathon, about providing the support and cheering on the sidelines," she says.

Through "Togather," Tesiah aims to break down silos in healthcare, encouraging professionals from different backgrounds to collaborate and share their experiences. She understands that the cumulative impact of these collective efforts can lead to significant advancements in health equity and patient care. "I knew I wanted to create a community of folks who had been working in health justice in different ways," she explains, emphasising the diverse approaches needed to tackle systemic issues.

Scale Versus Proximity of Impact

As health professionals, we often feel the pressure (internal and/or external) to do more, to make a bigger impact. This desire can often lead to exploring pathways beyond direct patient care which often have limited carer advancement options. One of the key challenges in this journey is the time it takes to see the results of our decisions. When we work directly with healthcare recipients, feedback is often immediate; we can witness the effects of our care in real-time. However, as we move into leadership, advocacy, or consulting roles, the time between implementation and observable impact can stretch significantly. This delay can lead to feelings of disconnection and uncertainty about our contributions.

So whether you are considering change or reflecting on changes you’ve made, here are a few considerations that can help:

1. Acknowledge the Time Lag: Understand that the nature of your impact may change, but it doesn’t diminish your contributions. Recognising that meaningful change often takes time can help you maintain perspective.
   

2. Stay Connected to Your Purpose: Regularly revisit the reasons you entered healthcare. Keeping your core motivations in mind can help you stay grounded, even when immediate feedback is lacking.
   

3. Seek Out Healthcare User Stories: Actively engage with the individuals or communities you serve, even if indirectly. Hearing their stories can remind you of the real-world impact of your work and help bridge the gap between your current role and direct care.
   

4. Cultivate Collaborative Relationships: Build networks with colleagues who share your commitment to your impact goals. Collaboration can provide a sense of community and shared purpose, reinforcing the idea that you are part of a larger effort to improve health outcomes.
   

5. Reflect on Your Influence: Take time to consider the broader impact of your work. Ask yourself:
   

   • What is the true extent of my current impact, including ripple effects I might not see?

   • How does my work contribute to the larger goals of my organisation or the healthcare system?

   • What would be the cost – personal, professional, and to those I serve – of changing course?

   • How can I amplify my impact in my current role?

6. Evaluate Organisational Culture: Assess whether your current or prospective organisation prioritises meaningful impact and aligns with your personal values. Consider:

   • What systems are in place to measure and communicate the effectiveness of your role?

   • Does the organisation actively promote initiatives that resonate with your commitment to person-centred care?

   • How does leadership support efforts that align with your goals?

7. Embrace Flexibility: Be open to adjusting your approach as you navigate your career. If you find yourself feeling disconnected, explore opportunities to re-engage with direct care or community initiatives, even on a volunteer basis.

Final Thoughts

Like the scientists working diligently in the heart of the Everglades, we, as health professionals, are part of a larger ecosystem of care and impact. Our work, whether immediately visible or not, contributes to the health and well-being of individuals and communities. By recognising the value of consistent effort, understanding the seasons of impact, and appreciating the cumulative nature of our contributions, we can find renewed purpose and satisfaction in our careers.

As Tesiah Coleman wisely advises, "Be comfortable changing how you're doing something. The why and the purpose of what you're doing may stay the same, but how you achieve that purpose can change. Be okay with that because it will change."

In the end, our impact as health professionals may not always be immediately apparent. But by staying aligned with our sense of purpose and remaining open to new paths of influence, we can create ripples of positive change that extend far beyond our immediate sphere, making a dent in the areas that we care about.