Today I’m thinking about boundaries, especially in the context of the incoming holiday season. I feel very lucky in terms of both family and work boundaries: there are no major family dynamics to deal with at present (keeping fingers crossed), and my work naturally tapers off over the holidays, leaving me time for reflection and enjoyment. I realize that many of you are not in that space- you may be working frequently over the holidays and have major family responsibilities and conflicts to navigate.
My question for you is this: when you say ‘yes’, what are you saying no to?
For example, years ago, I went out on a final housecall to a family whose patriarch had died early on Christmas morning. I had spent the majority of the night with them, getting him comfortable and settled. I could have handed those final duties over to the person on call Christmas Day, but I wanted to finish that journey with them. What did I say no to? My need for rest, and being home early enough on Christmas morning to see my young children wake up and realize that Santa had indeed been there overnight.
Is there a way to say yes and still meet my needs? In the situation above, I didn’t think of other alternatives at the time, but I could have stayed home that morning, asked my on-call colleague to attend, and visited the family later in the day.
Do I always have to enforce a boundary? No! Boundaries are not meant to be set in stone- they flex and evolve with your values, needs and growth. What’s appropriate now may be different in the future. However, being consistent with important boundaries gives both you and the boundary receiver space to know and feel secure in that limit.
Sometimes, paying attention to how we’re feeling in our gut about a potential or crossed boundary is enough to enable us to act in a way that supports us. But many of us need to learn how to express boundaries, and maintain them. And in healthcare, the stakes of saying ‘No’ feel higher. If I say no, who isn’t going to get the care they need? Will I be contributing to a colleague’s burnout? What will the rest of my team/call group think of me?
Expressing a boundary can be as simple as ‘No, I’m not available.’ or ‘No, I can’t.’ Contrary to popular belief 😉 , long explanations aren’t necessary and can be counterproductive in that the other person may argue against your reasons, trying to change your mind! The key is to hold firm to the boundary you’ve just established, and if you can, try to help the other person find a different solution. Don’t let the guilt you feel in the moment make you cave! And remember that a request is not the same as an order- you have a choice whether to say yes or no, and to negotiate if that’s required.
Maintaining a boundary isn’t always easy…especially when the boundary receiver reacts negatively, and when, as healthcare professionals, we were often trained to ignore our own needs, AND we tend to be people pleasers! Remember and hold fast to your purpose! Get support for yourself from people you trust. The practice of saying no gets less anxiety-provoking with time, and the realizations that 1) no one is going to look after our needs as accurately as we can ourselves and 2) healthy boundaries help create healthy relationships.
There have been times in my life when I haven’t had the energy to establish or maintain healthy boundaries. Integrating the reality that my needs are just as important as anyone else’s has reduced the energy required, as has noticing and reflecting on the results of healthier boundaries.
When you feel frustrated, uneasy, resentful or angry about a situation, can you recognize when that might be about a boundary crossing?
If you’d like help seeing boundaries, figuring out what is preventing you from using them effectively, and taking action, please reach out for a conversation.