When Things Seem to Be Speeding Up, Pause

The pace of life feels like it is constantly increasing. Research has shown that pace of life can differ by cities and countries, with a faster pace in areas where the climate is colder, there is more economic productivity, and the culture is more individualistic (ie, where there is more focus on individuals or nuclear families vs a collective orientation).¹ Based on their findings, Levine and Norenzayan¹ proposed potential predictors of an increasing pace of life as well as both potential positive and negative consequences. Do you hear colleagues, friends, and family (or yourself) commenting on how busy they are? Does that sense of urgency stem from our own expectations and those placed on us, as well as from the expectations we place on others to meet our needs or timelines?

Long and colleagues² studied the concept of pace of life in the context of the hospital setting, examining associations between the pace of life in a hospital and patient and staff outcomes in 4 large hospitals from varying geographic and economic locations in Sydney, Australia.² The authors evaluated perceptions of pace, transactional pace, and walking pace as well as culture, patient safety, and staff well-being. Although there was little variation in the pace measures across the hospitals, there was a significant difference in perceptions of pace between clinical staff (particularly nurses) and nonclinical staff. Perceptions of higher pace significantly predicted negative organizational culture, lower job satisfaction, and higher levels of burnout; there were no significant predictions between perceptions of higher pace and patient safety. In addition, perceptions of pace differed significantly by clinical setting (eg, emergency department vs palliative care setting), although those differences in perceptions did not result in significant differences in staff well-being.² While more research is needed to fully explore pace of life in hospital settings, participants reported that fast-paced environments impacted cooperation, coordination, and the culture of teamwork.  

When you feel overwhelmed or pressured at work, what actions do you take to meet expectations of yourself or others? Do you take strategic "shortcuts" in your work? Do you alter your communication style? Do you recognize the fast pace and take actions to be more focused or purposeful in your work? When things seem to be moving too quickly, it might be a good time for a brief pause—similar to a procedural timeout. It may feel like wasting precious time, but self-reflection, knowing our own responses and instincts, can help us know the best actions to take. Pause to review the patient situation to ensure you are considering all pertinent evidence. Use colleagues as consultants if evidence doesn’t seem to align. Use technology as it is designed to promote safety even it might take additional time, simultaneously recognizing that technology is not infallible. And finally, avoid minimizing the need for communication during fast-paced interactions. Communication and teamwork are even more important in acute care settings when the pace is fast, because the potential for miscommunication may be higher. Miscommunication can lead to inaccurate interventions or misunderstood responses. Purposeful communication through standardized communication methods, listening attentively, and confirming interventions based on verbal interactions can all facilitate safety. Working to establish a manageable pace of life in our settings is essential in today’s health care; it requires diligent collaboration and negotiation, which takes time. It is imperative in the meantime for individuals to be proactive in developing strategies to maintain focus and purpose in a fast-paced environment. 

Mary Fran Tracy, PhD, RN, APRN, CCNS, FCNS, FAAN