When must-have thinking was discussed in Section #20, the concept of upgrading must-have thinking to a preference was discussed. Upgrading must-have thinking to preference is far easier on you emotionally. Affirmations help you upgrade from insisting something must be a certain way to preferring it is a certain way. Thus, you assume quality control over your thinking. Affirmations are positive present tense statements which state what you want to have happen; and can give you courage and confidence. Affirmations can change your beliefs or feelings.

Some brief guidelines for writing affirmations are…
1. Keep them short and simple.
2. Keep them positive.
3. Create statements that affirm what you do want.

Gauge the specificity of your affirmation based on how it makes you feel.
Level One: For example, an affirmation might be, “Wendy will give Helen the yarn winding when she is brought back to her room after breakfast.”
Level Two: If you end up with a knot in your stomach saying, “There is no way Wendy is going to do this,” make the affirmation more general. Stating, “I see staff giving activity projects to residents.”
Level Three: If you still feel negatively, change the focus of your affirmation. State, “I see the administrator/DON/ Inservice Nurse smiling supportively as we discuss team building regarding culture change implementations."
Level Four: If you still feel negatively, change the focus of your affirmation to be more general. State to yourself, “I see the white light of love surrounding my facility.”

In order to formulate your affirmation, you may need to answer the following questions to assess what you want to have happen that isn’t happening regarding culture change or team building.

In one sentence, after my example, state what Culture Change and/or Team Building activity you want to have happen? For example, I want Mary transported to Bible study.
Your statement:

1. What do you want to do about this?
Take action beyond posting list at the nurses’ station and sending emails.
Your answer:

2. Who do you want involved?
Director of Nursing
Your answer:

3. When is the best time to take care of this?
Contact DON and ask her for most convenient time.
Your answer:

4. Deciding where to set limits?
Mary needs to be transported to Bible Study
Your answer:

5. What needs to be asked?
What is the best way to get the CNA to remember to transport Mary to Bible Study?
Your answer:

6. What needs to be said by you?
CMS Culture Change Guidelines indicate transporting is to take place.
Your answer:

7. Know your positive intentions. What is your goal and in the long run is for the best.
My goal is to have a Resident Centered program where all interested and appropriate residents are transported to activities by CNAs.
Your answer:

8. Decide on your bottom line message.
My bottom line is, if after several meetings with various nursing staff, and giving several inservice training sessions, explaining Culture Change guidelines and listing specific residents’ names to be transported; I need to speak with the administrator to make him or her aware of this area of Culture Change non compliance.
Your answer:

Mental simulation.
Put it together and do a mental simulation. “If you can see it in your imagination you can have it in your real life.” You will be closer to the ideal than if you go in to the meeting cold. Visualize mentally, record on tape recorder, role play with a friend, write it out. Create two versions - a worst possible and a best possible version. By creating a worst possible scenario of your meeting with this staff member, you can then create a backup plan. You know if the worst happens, you still have a plan. Also, spend time thinking of the best possible version of this meeting.

Perhaps the most valuable single step that anyone can take in preparation for coping with Difficult Department Members is to stop wishing they were different. This is far easier said than done.

Think of someone standing over you, pounding the table, shouting and cursing at you. If you’re like most people, you’ll sit there muttering to yourself something like: “He shouldn’t be that way!” or “Why is she acting that way? That’s not the way anyoneshould be!” Notto feel abused, not to feel that the aggressor should be different, would seem almost out of the question. The problem is this. To the extent that you are sitting there trying to wish your tormenting frog into a prince (or princess) you will be that much lessable to do just those things that might minimize that terrible behavior.

Blaming Isn’t Changing.
In situations like the above, we blame something exclusively internal on the other person. We all tend to believe that others are basically like ourselves, that they have similar values, assumptions, and feelings. Consequently, when they do not act as we expect or would like, it is “logical” to assume that their unexpected and unwanted behavior must be due to hostile intentions, a faulty personality, or just plain personal “difficultness.” As a result, we conclude that it is up to them to change.

Given this very human attribute, what else is there for us to do but plaintively wish that our Difficult Department Member were different and then feel frustrated when he or she doesn’t change? The confounding fact is that Difficult Department Members at times behave rather well. This lends temporary credibility to a belief that finally they have changed, only to have this credibility undermined when the disliked behavior shows up again. Feeling virtuous and self-righteous for having “done all I can” is very understandable, but unfortunately it won’t keep your interaction with that offensive person from falling into the same rut.

The source of the great strength with which this wish can take hold is that deeply buried sense of wishing power that is left over from the childhood of each of us. The attempt is an exercise in futility that only sidetracks you from what you can do to alleviate the situation.

Giving Up the Magical Wish.
The second step toward successful coping, then, is to give up that magical wish. When you look closely, you are likely to be surprised at how much energy you had used in the wishing. Because it is such a valuable aid to coping, in the next few paragraphs I’ll suggest some actions you can take to give up the wish that your own Difficult Department Member were different. Giving up the wish is a letting-go process. You will likely feel a sense of relief as you release this psychic wrestling hold that required great energy yet failed to make anything change.

To help yourself let go of that attempt at magical spell-casting, try to become aware of the strength of that fantasy-filled wish in your own life. It helps. You may feel it as a hope that “this time it will be different.” Or it may turn up as that feeling of disappointment and dismay when Barbara, again, brings her order book in a day late. Well, why are you so surprised? Even more to the point, why did you tell your supervisor that you would have all the orders in on the same day you set for Barbara, when you knew she was always late?

What a bitter cycle: an unrealistic hope turns to resentment only to be followed by another unrealistic hope. To see yourself in that cycle playing a part that seems out of touch with the actuality of who Barbara is can help you to choose behaviors that will be more appropriate and more likely to gain for you a better, more productive relationship with her. It is with others as they are that you must learn to cope.

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