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The 5-Second Rule for Intentional Caregiving

021114-intentional-caregiving-in-the-nicuYou’ve likely been at a party or maybe in your own kitchen and heard someone say, “Oops! 5-Second Rule!”

They say this after dropping a piece of food on the floor that they still want to eat. The myth of the ‘5-Second Rule’ is that it isn’t contaminated if it’s on the floor for 5 seconds or less. (Turns out someone actually studied this. Google it for fun.)

For years I’ve talked about redefining this rule for the purpose of intentional caregiving. And let me be clear, it has nothing to do with food, contamination or myths. It has to do with you. You as caregiver, healthcare professional, NICU parent – anyone who opens portholes or hovers over warmers to care for infants.

Like any intensive care unit, the NICU is a busy place. We’re so used to the beeps, shrill rings, alarms and bustle, that we rarely notice the effect it has on us. Not to mention the personal stress, worry or anxiety we may have carried in from home that day. Oh, and the ever under-estimated effect of caring for sick or fragile infants and their families on a daily basis.

Like it or not, we hull that stress to the bedside, like actual baggage that we’ve strapped to our backs. Some days that baggage may be the weight of a purse, other days, the weight of four hard shell suitcases and a carry-on. Just depends right?

Maybe you just paid the first round of college tuition, lost a best friend to cancer, or forgot to pack your daughter’s lunch. It’s all there.

You have 20 patients on your list for today. You must prioritize them until you have better staffing. You have to meet productivity standards or you’ll feel, well, unproductive.

You’re supposed to attend rounds to contribute to the plan, but that would mean sacrificing several RVUs or productivity units and you don’t want to get a warning that you’re not meeting standards. MORE SO, you would sacrifice seeing infant Jones (we’ll call him Joseph) who needs you badly. This feels worse than being labeled unproductive.

Three residents stop you to ask what think of their patients. Now you’re running late for Joseph’s session and if you don’t see him during this care time, you may not get to see him at all today.

Your pace quickens. Your mind is racing. And it’s just 7:14a.m.

As you approach Josephs’ bedside, it’s apparent that he needs some help. He’s just wrangled himself out of his CPAP gear, the prongs are now on his cheek instead of in his nose and he’s moving frantically inside the incubator.

It’s tempting to jump right in. To open those portholes, put your hands on him and help him settle down.

But don’t. Not yet.

If you jump right in, you might as well take off all that baggage and shove it into the incubator with Joseph. My guess is he won’t like that. Besides, there’s no room in there for it. Especially that last bag, the old one that you’ve been lugging around since the 9th grade.

Instead, invoke the 5-Second Rule of Intentional Caregiving. Yes, I made this up. No, it’s not evidence based. But it’s humane. I promise.

Take just 5 seconds. Wait. Take one deep breath. Set your intention for what you’re about to do with Joseph. Simple stuff like, “Joseph, my intention is to provide you with safe and effective care.” “My intention is to support your development.” “My intention (if parent) is to just be your mom today and leave all the worry outside for later.”

I might be criticized for saying that 5 seconds of anything can make a difference for Joseph or for you. But I dare you to try it today. All day.

I bet the Josephs in your life will notice. They don’t have the capacity to accept your stress. You have the CHOICE to leave it outside the bedspace. It will wait for you. This takes practice.

And here’s the cool part- do this over and over, and you begin to SEE Joseph differently, and see yourself as PART OF the healing process. You also become a different person at the end of the day – you’re not so exhausted from carrying all that weight. Whew! You have something left for your family when you walk through the door and everyone needs you, yet again.

This is not fluff or sentimentality.

It’s Joseph.

And he says thank you.