The Battle for the Soul of Health Care

The world is now experiencing a global shortage of nurses. Explanations for this phenomenon vary. They range from gender-gap issues (95% of nurses world-wide are women), insufficient pay and recognition, quality of patient care issues, and the past decade's significant changes in the health care industry.

Author and consultant Sharon Seivert, who was once the CEO of a Group Health Plan in Minnesota, has another perspective. She states that the current nursing shortage has very deep roots indeed, and that the crisis can not be abated simply by offering nurses better hours and pay. Today's shortage, she argues, began in archetypal patterns - innate human instincts that prescribe individual and organizational human behavior and that exist across all human cultures. It is here, Seivert says, that we must find the answer for an enduring solution.

In Working from Your Core: Personal and Corporate Wisdom in a World of Change, Seivert describes The 10 Core Types that can be found around the world. These colorful characters include two that have been at war for decades - battling like Godzilla and King Kong - for the soul of health care.

That's the bad news. The worse news is that one of these two types has clearly triumphed and is in the process of driving the other out of the health care field altogether. However, Seivert does bring good news: Because The 10 Core Types exist in every human being (and in every human system), we can call upon them to deliver us from the very crisis they created.

The two Core Types that have been slugging it out for dominance in health care are the Caregiver and the Warrior. The Caregiver is the part of each one of us who wants to do good for others. This type is embodied in health care's idol Florence Nightingale, and also in Mother Teresa, the security guards at high-rise offices, and the police officers who help lost children and distraught parents find each other. In health care, the Caregiver is the part of us who calms a patient, holds the hand of an indigent man who is dying alone, or tends to the myriad day-after-day details that keep a high-risk post-op patient on the mend.

The Caregiver, however, has a tendency to give away the store, to sacrifice itself for the good of anyone in its care. Indeed, the Caregiver part of us sometimes forgets to include itself in the loop of care. And that can translate to the loss of big dollars in any business.

TA-DAH - to the rescue rides the Warrior! This Core Type is the part of us that knows how to whip things and people into shape. The Warrior's typical story includes a victim, the villain, and a hero. In the past few centuries, the Warrior's version of healing included the victim-patient, the villain-disease, and the hero-doctor. In recent years, however, the Warrior-hero in health care has become the manager who instituted changes to save the health care institutions (the victim) from bankruptcy. Unfortunately, the villain became any Caregiver who was moving too slowly or inefficiently for the Warrior's tastes.

The battle lines were drawn. The new Warriors largely succeeded in stopping the financial hemorrhaging in the health care industry. They demanded accountability and introduced cost-controls (cutting staff, increasing hours, and reducing the nurse to patient ratio). However, there were hidden costs of these often-radical changes. In many cases, patients felt that they themselves were becoming the battleground. Research indicated that they were leaving the traditional system in large numbers to try alternative treatments.

The symptoms of deep-seated problems have been there for some time. Caregivers started by complaining. (Although all healing Caregivers felt the pinch, this battle-role was most clearly played by the nursing profession, in whom the Caregiver is so strong.) If Warriors understood what a stretch it was for the Caregiver to voice a complaint, they would have paid attention then. The Caregiver, after all, was motivated by concern for the welfare for patients. When complaining didn't work, the Caregiver (very) reluctantly unionized - or simply resigned.

The Caregiver Core Type has given off many warning signals over the past decade, but because the Warrior and Caregiver live and work by such different scripts, they didn't know how to communicate well with each other. It is as if they are broadcasting on radio signals that are not on the other's reception bandwidth. For each Core Type, the other's behavior and worldview is puzzling. Without intervention that can increase their understanding of each other, they will instinctively fall back upon the old approach of: "it's my way or the highway."

This, then is Seivert's perspective on how we got into the mess we're in today. But what does she say about how can we move forward? How can we resolve this global problem? The solution, she says, lies in getting these one-dimensional archetypes to learn about - and benefit from - the wisdom of each other. Neither one holds the answer alone. The Caregiver and Warrior (who are alive and well in nurses, doctors, health care managers and other professionals) need to understand each other's gifts so they can mediate enduring solutions that are in the best interests of each other - and their patients!

And there's even more good news…. Each one of The 10 Core Types has special, even vital, gifts for the healing profession. When all these Core Types are taken together, they can provide us with the answers we so desperately need to remedy today's health care crises.