Combating urgency culture in nursing leadership

FigureThere's a time and place for urgency, but it shouldn't be all the time and in every place. As nurses, we must maintain hypervigilance to deliver the reliable, quality, and safe patient care expected of our discipline. This hypervigilance may manifest as urgency, especially in the clinical setting. But what about outside the clinical setting? I know nurse leaders and academic colleagues who've received emails from team members or students late at night about nonurgent requests such as future schedule changes or questions that require thought, research, and follow-up. These same colleagues then received a second email the following morning (fewer than 12 hours later) from the same team member or student, looking for an immediate answer. This is unrealistic and unnecessary. Although positions in nursing, nursing leadership, and academia may commonly require 24/7 responsibility, time for sleep and recharging is critical in order to give considered responses to nonemergency demands for attention. So, what's the reasonable response in these scenarios? Fight or flight I read a great National Geographic article on the topic of urgency culture, and it triggered this line of thought.1 The author, Noma Nazish, explores the issues of burnout, always being "on," overstimulation, and unrealistic/unspoken expectations.1 Nazish connected with David Rabin, a neuroscientist and the CEO of Apollo Neuro, and highlights in the article that an overactive fight-or-flight response leads to poor health outcomes.1 This aligns with findings of poor health outcomes in nurses.2,3 It's a global paradoxical phenomenon that nurses are among the unhealthiest people in the US. Nurses are more likely to be overweight, have higher levels of stress, and get less than the recommended hours of sleep.2 Nurse leaders both within and outside the clinical setting face the temptation to "fight" the constant questioning or questioners or ignore noncritical demands (the "flight" response). How can nurse leaders triage the need to respond and then appropriately engage when immediacy is necessary? I would argue that immediate action is necessary less often than most of us think. Seeking middle ground I'm writing this as a nurse leader and a Magnet® Program Director; deadlines are critical and essential to maintaining progress in the Magnet journey to "nursing excellence." If any colleagues are reading this, of course I'm still expecting immediate replies to my emails and requests with absolutely no delays. (I'm mostly joking, colleagues!) But honestly, what are realistic and appropriate expectations for staff communications to maintain professionalism and respect for any realm outside the clinical setting? In other words, how can we be successful and respectful nurse leaders while surviving as healthy humans in a culture that's increasingly racing and rushed? Is there a middle ground? Other articles I've written have explored the need for self-care to improve health risks and enhance healthy behaviors in nurses and nurse leaders. It never dawned on me to explore how our culture impacts our overall health. So, how can we appropriately differentiate our response behaviors regarding urgent and nonurgent requests for information, including how we place demands on others and deal with those placing demands on us? The National Geographic article has some good ideas that are synergistic with the literature for improving nurse health and the advice given to us by our many mentors and colleagues. Although they aren't groundbreaking takeaways, these are good reminders for all of us. Pause and reflect. Take time to assess the scenario or request before responding. The email or text you're reading may seem urgent, but it may be a tonal issue. Perhaps we're the ones turning on our fight-or-flight response for no reason. Prioritize self. Practice mindfulness when you can, whatever this means to you personally. There's no one-size-fits-all approach to self-care, so do what works best for you. Set boundaries. Be clear in your communications. It may be okay to tell your leaders and colleagues that you don't have the capacity for a certain task now but be sure to let them know why and when they can expect an appropriate follow-up. It's also okay to sleep and wait to respond to an email once you're rested. Manage time. Block time to ensure you're managing your workload appropriately. I love using the calendar to map out my daily to-do list! Sometimes it works, and sometimes I'm less successful, but at least I start with a plan for each day. Continue the conversation I don't know what the happy medium is between overreacting and "checking out," but I do know that not all demands on leaders and staff are urgent. Some initiatives and tasks require urgency, and some don't. I believe that the more we discuss how to exist successfully in an urgency culture as a discipline, the better we'll all be.