I spent New Year’s Eve at the local hospital emergency department with She Who Shall Remain Anonymous (SWSRA). She was suffering from a debilitating medical condition which was, fortunately, non-life threatening. She is also a nurse and so has some knowledge of the best treatment for her very occasional incidents and that led us to ring in the New Year in bed 10 of the ED.
Shortly after admission, during initial diagnoses and triage She passed out and this spooked the young nurse attending Her. I was aware of similar occasions in the past and remained calm which allowed me to watch the situation unfold. I could see the surprise on the nurse’s face and she reached over and pressed the red Emergency Button on the wall above the bed.
Immediately a collection of ED nurses and doctors came running in. The degree of focused attention which they all brought to bear for the next 60 or so seconds was palpable. I could see them sizing up the situation based on the limited information available, making observations and processing the patterns from their years of experience. Whenever one of the doctors or nurses did something – calling Her name, shaking Her, etc. all of the other attendees focused on Her response. She quickly revived, the young nurse apologised to the other staff for raising the alarm, and the scene cleared.
In that short period of time I watched a number of people bring years of experience to bear and, I think most importantly, focused all of their attention on the scene – they were ‘fully present’. No one was wondering whether they needed to pick up some milk on the way home, or what the last text message might have said or whether they should complain about the Christmas bonus. The ability to focus attention is not unique to medical emergencies – I see it across all emergency services and many of the armed forces. While emergencies are often life-threatening, they are usually not life-threatening to the practitioner attending. Self preservation is not the driver for the attention which is brought to bear – it is a skill which is developed through application and experience in order to achieve the best outcome under the circumstances.
Attention and focus are also key skills for anyone working in an organisation that is looking improve responsiveness and resilience to unexpected threats and opportunities.
In my own work trying to help people deal with complex situations, I find that outside of emergency services, attention and focus remain a major hurdle. Despite most people’s stated intent of caring about performance improvement or outcomes or fulfilling accountable roles, they are rarely ‘fully present’. A crisis can be useful catalyst to encourage these skills, but a crisis is viewed as an exception and there is no business case for developing skills which are only used in exceptional circumstances.
I do see some very early recognition (or maybe I am just meeting the same niche audience that’s always been there) that attention and focus are useful skills in general – not just during a crisis. The ’emergency’ which impacted SWSRA may have looked like a crisis to the junior nurse, but to the more experienced attendees it was a normal event. If it was a real crisis, the more experienced attendees would have stepped up to another level of focus again.
The message here is the skill of applying attention and focus is not that of an on/off switch – it is an ability to be aware and apply different levels appropriate to the situation. Unfortunately, in many organisations, people do not appreciate the opportunities and threats which are present in a situation and therefore devote little to no attention.
In order to adapt to an increasingly complex environment, we need to be more observant and better able to attend to the dynamics of situations.
Exercise the unexpected.