1. Donnelly, Gloria F. PhD, RN, FAAN, Editor-in-Chief

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It was a particularly busy and stressful day for me: a heated meeting, a tough negotiation, and difficult decisions pending. After the meeting, one of my colleagues was particularly upset, mumbling to herself and fumbling through her large handbag resting on the table. "Can I help?" I asked. Her whole body shook "No!!" as she continued to fumble. "I'm looking for my glasses and I can't find them." "Here they are," I said, as I lifted them from a crooked finger on her left hand. She looked at me straight in the eyes and her shoulders fell in a sigh, "I am so discombobulated!!" she exclaimed.

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Discombobulated is a word that when spoken has the syllables and sound to convey what many of us experience in our daily fast-paced work environments of healthcare practice and education. We feel pressured by increasing responsibilities and tasks, driven by a "doing more with less" ethic that is bearing down on every institution. We might be waking up in the middle of the night and ruminating about staffing or financial issues, or that unpleasant interchange with a staff member. And returning to sleep is impossible because we can't stop the thoughts.


A state of discombobulation is comparable to the concept of "monkey mind." In ancient Eastern teachings, the monkey is a symbol of a restless, cluttered, unsettled mind. The monkey jumps and swings frenetically and aimlessly from thought to thought, chattering, screeching, and diffusing energy along the way. Sounds familiar? So how do we, as Bhikkhu1 puts it, deal with the monkey and meet him halfway? How can we take the "dis" out of discombobulation?


Many holistic strategies and programs can help us stay focused, centered, and relatively calm in the maelstrom of our professional lives. Meditation, mindfulness stress reduction techniques, exercise, and yoga are a few such strategies. However, they take time and investment. Of course we know that we are worth the investment, but we often need a quick and effective jump-start to send us on our way. Here are a few short-term strategies that can dramatically affect our levels of composure and rid us of discombobulation. The "minute of reality," is one such strategy, in which we stop, focus, clear our minds of clutter, put our problems in perspective, and call on our empathy for others. And then there is this simple rule:


"When there is something to do, do it!! When there is nothing to do, sit quietly, search quietly, and search inside yourself. Use the opportunity to investigate the contents of your mind."2


Make a daily appointment with yourself to apply these simple strategies to reach that centered state. Once centered, we will better serve our patients and our healthcare institutions.


Gloria F. Donnelly, PhD, RN, FAAN






1. Bhikkhu AS. Meeting the Monday Halfway. York Beach, Me: Samuel Weiser Inc; 2000. [Context Link]


2. Bhikkhu AS. Meeting the Monday Halfway. York Beach, Me: Samuel Weiser Inc; 2000:62. [Context Link]