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I first heard it earlier this year at the conference, and Speaker John Houghton was sharing and I followed up with him afterwards about where this exercise came from. And he wasn’t sure that he could find who to attribute it to either. But I want to share it with you and take it a step further than he did. Because it really, really resonated with me.

And it starts by asking yourself this question, what do you want? And if you’re at a safe point where you can take something out and, and write, I’d love for you to do that. If you need to pause this and come back to it or listen now and come back to this again, in the future. I really want you to engage with this exercise.

So first, what do you want, say, write down I want and then write in what is your desired transformation, your goal, what you want to happen, could be a big thing. It could be a small thing, personal or professional. So I’ll give an example from my own clinical practice, I want to take great care of my patients. So write down I want and then your desired transformation.

And then I want you to write, but to be UT. And then next to that, I want you to put whatever’s in the way, the obstacle or excuse that maybe you’ve shared with yourself, you’ve given to others as to why you can’t do this, why you haven’t done it to this point. Because if it wasn’t there, probably already would have achieved that.

So I want to take great care of my patients, but I get 15 minutes, 15 minute visit slots, and my patients have complex needs, and often require the use of interpreters to communicate well with them. To write down what your obstacle, the thing that is keeping you from achieving what you want.

So then I want you to look at your paper, wherever you’re taking notes and say, Okay, I want this desired transformation. But then I want you to take and cross out the butt, cross out the butt, and change it to n and change it to n and I want this desire transformation. And this obstacle or excuse that you previously offered is still there. And then write the word so and then next.

So I want you to write down what you will do. What will you do? Even though that obstacle is still there? What will you do? For me, I want to take great care of my patients. And I get 15 minute visit slots. And my patients have complex needs and often require interpreters. So I will have my staff set up the interpreter tablet before I go in the room. I will huddle before clinic with my team so that we’re on the same page more often. I’ll work to obtain questionnaires in my patients’ preferred languages.

So now you have I want this desire transformation and this obstacle or prior excuse is still there. So what will you do? And this is where I then said, This is really helpful. And yet, I want to take it a step further. I want you to write after what you’ll do. I want you to write because I want you to write because and then fill in your core priorities.

For motivation, your reason for wanting to get that desired transformation, to keep doing something that’s so what will you do, even though there’s that obstacle, because willpower alone cannot be the driving force. When I was going through burnout, my first year out of residency, I was pushing, pushing, pushing. And it wasn’t enough to sustain the work, the level of work that I needed in order to keep up.

So for me, I said, I want to take great care of my patients, and I get 15 minute visit slots. My patients have complex needs and require interpreters. So I’ll have the interpreter tablet set up before going in the room, they’ll huddle with clinic, with my team before clinic and obtain questionnaires and my patients for languages. Because I believe each patient is valuable, regardless of where they’re from, or the languages they speak.

It’s important to see that thing that’s getting in the way, you can either see it as an obstacle, or as an excuse. So when we started this exercise, we had the butt. And it often portrays the circumstance, what’s currently there, as an excuse, something you can’t get past leads to a certain amount of resignation, a decrease in actions that are helpful or positive, for production productive, often keeps you in victim mode. Like I can’t, I can’t do this, because on the other hand, seeing it from I want

this and there’s this thing that’s been in the way it sees the circumstance, the situation as still an obstacle.

But maybe it’s something that could potentially be overcome, or worked around, or even if it’s not going to change, there’s still an intentional action, and intentional thought that you are able to move forward with. This ultimately, uses your core motivation, your priorities, rather than just willpower. Ultimately, this restores your agency saying, I can do this, I can make a difference for myself, for my patients, or my family, for what’s important to me.

So I want you to really take a moment to pause this episode and look over what you’ve read, and look over what you’ve written and see how this may not have been your story. This may not have been something that you had taken the time to see a wave. These obstacles are still there. But there are still things that I can do to move forward. Because whenever that is your core, my priority, your core motivation.

And so when you think about this, it’s important to note that sometimes these thoughts, these thoughts that come up. We kind of judge ourselves. We think, really, why did I think that? Here we go again, why did I do that? And yet, normalizing those thoughts. having compassion for yourself, is about acknowledging? Well, of course, my brain thought that thought that in that situation, there was an expected response to whatever that stress was.

That trauma, that code I went to, whenever it was, others would often think similar things. Like I said, we’re often our own worst critics. When my patients come in, especially my teenagers, many times they tell me, they’re struggling with something. They’re stressed about something. And I can tell that they’re beating themselves up. Then I then walk them through the same process. I say, let’s say your friend is struggling. They just failed a test. They forgot a deadline and didn’t turn in their paper or an application for something. They came to you and said, Hey, I’m really down this was going on, how would you respond to them? Especially if they were blaming themselves and couldn’t see a way forward.

I often get some sort of empathy. Do some empathetic response or something that’s thoughtful and caring. And then reiterate to them that this is the same response to you yourself need from yourself. And ultimately, from there, we’re able to work through a little bit of what seems to be keeping you from giving that same encouragement to yourself that you would have been so quick to give one of your friends so these thoughts that come up, they’re often really sneaky. They can be just kind of automatic. Just there in the background, someone cuts you off, someone sends you a nasty email. It can lead to frustration, anger, anxiety, stress, shame, the more rather than just pushing these feelings away, or looking to change your circumstances, it’s important to sit with the feelings, to experience them to allow them, give yourself space, to then be able to have an intentional thought to make an intentional decision.

The example that I want to share with you is sometimes these thoughts and these feelings, it’s not always what you think it is. So my wife and I were talking about wooden trunk that had been in my family for a little bit, and it came from my grandma. It was kind of a general woodstain. And my wife said, we should paint it. And I said, No. And she definitely has the design sense in our house. And I do not. But I was pretty consistent that I didn’t want to paint it.

I only realized later, because I was getting some coaching that really it wasn’t about the trunk itself. It was about the fact that I miss my grandma. She lived till her mid 90s and just passed away in the past year or so. And I missed her. And so thinking about painting the trunk, Maeve, I have thoughts about my grandma. So this is part of the automatic thoughts. That by feeling that sadness, that I missed her that grief, I was able to then engage with my wife differently. And myself differently, say, of course, you Mr. Grandma. And because of that, you thought, no, we shouldn’t, or she shouldn’t say that or she’s.

And really, I needed to look at my own thoughts, my own feelings and to allow myself to feel that grief. And then to be able to say, okay, I can move forward. And we didn’t paint the trunk, but it also didn’t get a prominent place in our decor. So it’s currently assisting with some of our storage. So once you’ve felt those feelings, it’s important to think, Okay, what intentional thoughts can be helpful for me, can help you take that next step. Maybe it’s simply, I can take a next step. Maybe it’s, I can take good care of my patients. I can finish my charts in the room. I’m a good medical assistant. I’m a good nurse. I’m a good doctor, manager, good leader.

Maybe it’s that I am a leader. One thing that I found particularly insightful, and just poignant for me was I got this little gift from my employer. And it’s this little metal, leather. Just kind of like keychain thing that says, you make a difference. And I saw that and it really resonated with me and I was like, Yes, that’s what I want to be about. And even though they’ve gotten me this fleece jacket or whatever else in the past, this