Trade offs
When the word ‘priority’ came into the English language in the 1400s it meant the first thing. Thing not things. Singular. The word ‘priorities’ did not exist. Can we really have more than one thing first?
You are one single doctor alone on the night shift.
Three patients need your attention.
Which one are you going to see first?
There has to be a first one. Obviously you want to see them all immediately. (And clearly there is a systemic problem. I mean, why are you alone on the ward? What is being done about that? These systemic questions are important but don’t help solve the problem in front of you.) Right now, in the middle of the night, you must pick one patient to see before the others. You must choose who waits.
Clinicians are forced to make non-ideal decisions about who to treat first all the time (more than ever in our overwhelmed UK system). Doctors and vets learn to make these decisions throughout their training and their careers. They learn to apply a set of criteria quickly to triage a situation. It may never be comfortable, but clinicians become adept at making trade-offs. Either this or that.
But most of us do not have the same training in making trade-offs. We live in a frenetic-paced world, responding to multiple demands without a system or a training programme to deal with them.
In the 1900s, the singular ‘priority’ was pluralised and priorities became a word. Priorities. What are your priorities? No longer your first thing but your first things.
As soon as we can pick more than one, we get ourselves into trouble. Because we try to pick all of them. And if you put everything first, nothing is first anymore.
Think of the meetings full of people half there while they do something else at the same time. Badly. We can split our attention, but we can’t do anything well like that.
We need to make a conscious decision to stop it. We need to start making trade-offs. Choosing this or that. Which is incredibly hard, because:
We don’t see other people making trade-offs. We see them doing it all.
Our senior leaders are uncomfortable with trade-offs. They have priorities.
We don’t want to let anyone else down
We don’t want our decision to have unintended consequences
We don’t want to miss out.
But if we don’t make trade-offs, we burnout or end up not doing anything as well as we might. It takes great courage to make trade-offs. To name your priority. To say no.
But if you go for a walk today, up on a hill somewhere with the wind in your hair, I’ll bet you know exactly what you need to say no to. Deep down. However hard or scary it might be to actually put into practice, I bet you know.
Do it. Go for the walk. When you know what you need to say no to, text someone. Text someone who loves you, who will help you say no.
And then breathe a little deeper because you just made space for the priority. The very first thing. Go you.
