NOVEMBER 1990, VOL 52, NO 5 AORN JOURNAL

Editorial

If you are tired of working, you are: not alone

n the 1970s, new nurses suffered from “reality I shock” because, they claimed, their academic program did not prepare them for the rigors of the real world of nursing. In the 1980s, many ambitious and motivated nurses fought against burnout. They worked too hard, held on to idealism in the face of negative conditions, and sacrifid their own emotional and physical well- being for the patients’ benefit. Now, in the 1990s, many midcareer nurses are experiencing “plateauing.”

Plateauing is when life becomes a tedious routine, and the promise for the future is only more of the same. It’s when you are tired of working. It’s not the kind of tired that’s related to what you did the night before or how many hours you stood in the OR. It’s when you feel your career is at a standstill with little opportunity for growth or movement. If you are this kind of tired, and if you are profoundly bored with your job, welcome to the plateau trap.

Judith Bardwick, PhD, author of The Plateau- ing Trap, identifies three types of plateauing- structure, life, and content.’ Structure plateauing is caused by lack of promotion in the job. This, claims Dr Bardwick, is inescapable. There comes a time when a person just can’t go any higher in an organization. Whether this person is a staff nurse, team leader, or supervisor, he or she has reached the summit of the highest available mountain.

The nurse who needs frequent promotions to feel self-worth and satisfaction in the job is vulnerable to this type of plateau trap. But frequent promotions are not realistic. At some time in

everyone’s career, promotional opportunities become limited by the organizational pyramid structure, increased competition, or both. That’s a fact of life. He lor she either has to be content with that siimmit or find another mountain to climb.

Plateauing in life I S much more serious, according to Dr Bardwick, because it involves the feeling that life itsellf is boring. Workaholics are prone to this type of plateauing because their only real passion is work. When work becomes dull, life becomes dull. The nurse who has struggled long and hard to accomplish something very difficult can experience a tremendous letdown when that challenge is ‘tinally met. Plateauing in life is a psychological c;tate, and hopefully with proper counseling, a person can overcome it.

Nurses may be more prone to content plateauing, which OCCUI’S when a person masters the job and becomes an expert. Nurses do this all the time. Think of the perioperative staff nurse or head nurse who knows everything about a specific clinical area, for example. Or the staff development instiructor who has taught cardio- pulmonary resuscitation so often that the thought of doing it one more tirne is unbearable. For this nurse, work has Income routine and unexciting, but not intolerable. This nurse has a comfortable and secure job, but he or she is bored, and everyone knvws it.

The paradox is apparent. To become an expert nurse in today’s operating room requires excep- tional hard work and specialization. But the nurse who works extremely hard for a long time in the same specialty is prone to boredom after the

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AORN JOURNAL NOVEMBER 1990, VOL. 52, NO 5

challenge is met. Don’t let it happen to you or to your staff.

Although structural plateauing is inevitable, content and life plateauing are not. The trick to avoiding the trap is to recognize the warning signs and begin another climb. You can begin by renewing that exciting sense of learning you once enjoyed. Learn something new. Be willing to embrace the risk that change brings with it and establish new challenges for yourself. The challenge may be as drastic as learning an entirely new clinical specialty, or as

low-keyed as discovering a new way to solve an old problem in your present specialty.

If you are tired of working, allow a career jolt to invigorate you. The view, once you get off that plateau, may be an entirely new landscape.

PAT NIESSNER PALMER, RN, MS EDITOR

Note

City: Bantam Books, 1988) 11. 1. J M Bardwick, The Plateauing Trap (New York

OR Environment Symposium Scheduled The American College of Surgeons, in coopera- tion with the Association of Operating Room Nurses and the American Society of Anesthesiol- ogists, is sponsoring Symposium VII on the Operating Room Environment, May 6 to 8, 1991, at the Peabody Hotel in Orlando, Ha.

Only teams consisting of a surgeon and nurse, or surgeon, nurse, and anesthesiologist may regis- ter. No individual registrations will be accepted. One registration form per team is required. Reg- istration fees are $550 for a two-member team and $825 for a three-member team. The registra- tion fee does not include hotel accommodations or airfare.

ics for discussion. In addition, teams will have the opportunity to listen to panel presentations and participate in follow-up workshops. Topics to be discussed include acquired immune defi- ciency syndrome and other infectious risks in the OR, ambulatory surgery, computerization in the OR, and assistants in the OR.

Registration is limited and will be accepted on a firstcome, first-served basis. Materials may be obtained from Jeffrey P. Knezovich, Organiza- tion Dept, American College of Surgeons, 55 E Erie St, Chicago, IL 6061 1 or by telephone at

Participants will be encouraged to submit top-

(312) 664-4050 x 361.

Therapy for Colorectal Cancer Recommended The National Cancer Institute and Ofice of Medical Applications of Research of the National Institutes of Health held a conference on adju- vant therapy for patients with colon and rectal cancer. In August, a consensus panel issued a report regarding treatment for such patients. It contains the following conclusions and recommendations.

Patients with Stage I colon and rectal cancers are at low risk of recurrence. Recommended treatment is surgical resection. No specific adju- vant therapy is recommended for patients with Stage I1 colon cancer. Patients in Stage I11 should be treated with 5-fluorouracil and levamisole. For patients with Stage I1 and 111 rectal cancer, combined chemotherapy and radiation therapy is recommended.

Patients with Stage I1 or I11 colon or rectal cancer should be included in separate clinical trials. The authors say patients with early stage disease at risk of recurrence should be identified and the benefits of adjuvant therapy examined.

Single copies of the complete NIH report can be obtained by writing to the Ofice of Medical Applications of Research, National Institutes of Health, Building 1, Room 260, 9000 Rockville Pike, Bethesda, MD 20892, or calling (301) 496- 1143.