Pause Well, That Ends Well : Journal of Trauma Nursing | JTN

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President's Message

Pause Well, That Ends Well

Krichten, Amy E. MSN, RN, CEN, TCRN

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Journal of Trauma Nursing 30(1):p 1-2, January/February 2023. | DOI: 10.1097/JTN.0000000000000693
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Have you ever heard the phrase “Don't go to bed angry”? The theory behind this adage is that it is better to resolve unsettled issues so that the mind can be clear, the spirit at peace, and the physical body relaxed, encouraging a good night's sleep. The alternative is to go to bed with the conflict on your mind and tension in your body, which may negate necessary rest. I have, however, found success in doing the exact opposite. When confronted with turmoil, I seem to do much better going to bed, getting some sound sleep, clearing my brain a bit, and waking up the next morning, energized with a fresh perspective. I am ready to problem solve. Perhaps it is because I have never had any trouble falling asleep. I can sleep in a car, on a plane, during a church service, and so I have been told, during a movie. I concede that having distracting or unsettled thoughts in my brain may impact the first few minutes of the sleep process. Yet, once settled in, I fall asleep rather quickly.

The ability to pause and take time to think through my reactions has proven beneficial for me (and for those with whom I interact). When I do not take the time to pause, I have, far too often for my liking, particularly in my novice nurse days, been known to verbally react to a situation without considering the full ramifications of my words. The term snap-back has been used. Unfortunately, my quick wit led to a few circumstances where I needed to apologize and even experience corrective discipline to mitigate. The first time I was formally written up as a registered nurse was after a long shift at the triage desk in the emergency department. Patients were waiting for hours, and an angry patient came up to me and yelled at me, lamenting her wait time and the inadequacy of my nursing skills in deeming her injury to be nonurgent, thus having caused her to wait in the long line. I immediately responded, “Listen lady, I'm doing the best I can here!” From there, I almost immediately found myself in the nurse manager's office getting the “optimal customer service” lecture. In this circumstance, I did not have the opportunity to sleep on it. Still, I could have taken a deep breath, refocused, and replied more appropriately, professionally. Over the years, one of my biggest professional growth traits is being more thoughtful with my words and responses. Pausing time and thinking through responses may save hours of paperwork and service recovery on the back end.

In today's fast-paced society, where words are often expressed off-the-cuff, quickly, carelessly, and without foresight, it is far too easy to text or post a reply on social media, which may or may not have been negatively intended but is interpreted as damaging and even hurtful. Some people gain courage while typing and may submit words that they would otherwise never verbally project. The written word especially brings about a greater opportunity for misinterpretation. When typing a potentially negative message, I encourage you to pause, reread it, place it in the draft folder or consider deleting altogether. Pausing before writing or speaking to find words with a thoughtful meaning—words such as “I am sorry,” “I care,” “I am listening,” and “I am here,” can go a long way to diffuse conflict and add important context to even the most difficult conversations.

The Joint Commission's time-out and the trauma resuscitation bay's paramedic handoff are examples of how health care has embraced the advantages of pausing (Nolan et al., 2017). Research has demonstrated that pausing in these high-risk situations can diminish negative outcomes (Nolan et al., 2017). Health care professionals utilize pausing techniques to elevate care and patient safety. We need to hardwire this professional practice into our daily lives.

Kevin Cashman, the author of The Pause Principle: Step Back to Lean Forward, teaches the concept of pausing to transform leadership (Cashman, 2012). Pausing allows us to step back to move forward with greater clarity, momentum, and impact. It holds the creative power to reframe and refresh how we see ourselves, our relationships, our challenges, our capacities, our organizations, and missions within a larger context. Cashman reinforces the concept that pausing is essential to effective leadership. Managers assert drive and control to get things done; leaders pause to discover new ways of being and achieving (Cashman, 2012).

In the 2022, Society of Trauma Nurses (STN) Presidential address, I spoke on the subject of time, referencing it as measured in a year. Quoting the song “Seasons of Love” from the Broadway musical Rent (Larson, 2008), we explored how we would measure this year of our (STN) life. As my STN presidency is now in its twilight, I feel the time passing too quickly, and wish I could pause it to be able to soak everything in. While I cannot pause time, I can pause to appreciate how I am connected to STN and how STN connects me personally and professionally. I encourage you to pause and think about your STN connection and to invest time yourself by investing moments in an STN conference, committee, workgroup, journal club, or other offerings.

With burnout in health care at an all-time high, it has never been more important to reach out to our colleagues, express empathy, and normalize the acceptability of pausing. The new normal of 24/7 digital connection, coupled with multifaceted, complex pressures, raised our stress levels. Remember that everyone is going through something. Be kind to one another. Take a pause when needed. Fred Rogers said, “There are three ways to ultimate success: The first way is to be kind. The second way is to be kind. The third way is to be kind” (Rogers, 2003). As we enter the new year, may 2023 bring us the gift of time. Time to pause and time to be kind. If you are confronted with a turbulent situation and can pause, I encourage you to do so. Pause well; that ends well.


Cashman K. (2012). The pause principle: Step back to lean forward. Berrett-Koehler Publishers.
Larson J. (2008) Rent: The complete book and lyrics of the Broadway musical. Hal Leonard Corporation.
Nolan H. R., Fitzgerald M., Howard B., Jarrard J., Vaughn D. (2017). The trauma time-out: Evaluating the effectiveness of protocol-based information dissemination in the traumatically injured patient. Journal of Trauma Nursing, 24(3), 170–173.
Rogers F. (2003) The world according to Mister Rogers: Important things to remember. Hachette Books.
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