E D I T O R I A L

Find Yourself in the Neutral Zone?

s managed care increasingly has restricted the use k f hospitals for all but acute interventions, hospital administrators have responded by trimming their payrolls. In 1995, the number of hospital employees dropped 1.6%-the largest decline in a decade (Segal, 1996). This is bad news for women in general and nurses in particular, because health care has provided relatively well-paying jobs with good benefits for one seventh of the employed women in the United States and one fifth of the employed African American women (Segal, 1996). To make matters worse, there is strong evidence that the jobs lost in health care will not be replaced by new positions in other job markets (Rifkin, 1995).

The changes in health care are part of the larger social landscape, and we have no direct control over them. For many of us, however, these changes will cause professional and personal transitions.

In his best-selling book, Managing Transitions, William Bridges (1991) reminds us that change causes transition. Change is external, but transition is internal. Change is situa- tional, whereas transition is psychological.

One of the most difficult periods for people who are making transitions is what Bridges (1991) calls the neutral zone: It is the time when you must let go of one trapeze with the faith that a new one is on the way. In health care, this is the time between letting go of the fee-for-service trapeze with the faith that a managed care (or capitation) trapeze is on the way. It may be the time between losing one job and finding another.

The neutral zone is a period of waiting and confusion, but not inactivity. As Ralph Waldo Emerson said, “This time, like all times, is a very good one, if we but know what to do with it” (Emerson, 1837/1963). Two things we can do are understand the new world and prepare to participate in it. Both of these efforts-understanding and preparing-re- quire learning.

Learning is essential to responding well to the changes in health care and nursing. If you find yourself in the neutral zone-waiting and confused--one of the most productive uses of your time is to improve your learning capacity. Lau- rence Boldt (1993) discusses Learning how to learn in his unconventional career planning guide, Zen and the Art of Making a Living. He suggests that the only thing standing between you and your next career move is ignorance: “What you don’t know (knowledge and shlls) and who you don’t know (contacts). The remedy for both is learning” (p. 457).

Boldt (1993) offers six strategies for improving your learning capacity. First, focus. To train for a new career, pick an area that you can love and “keep loving it until you are on

intimate terms, until it whispers all its secrets” (p. 459). Be single-minded in your pursuit of knowledge and skills in this area. Don’t scatter your attention and interests.

Second, be open. To learn, begin by admitting your ig- norance. Be accepting of yourself for not knowing what you’ll need in the new labor market. Don’t waste energy by denying that you need new knowledge, blaming others for your situation, or pretending you don’t care about job secu- rity or advancement.

Third, reflect. To feel confident about learning a new role, take stock of what you have learned already. This will assure you that you can learn more. Be secure in your ability to learn. Don’t waste time doing nothing about a lack of train- ing or experience.

Fourth, observe. To understand the new order, practice looking at processes and patterns. Be an active listener and a creative reader, careful to “chew each bite of knowledge you take and minimize the indigestion of confusion” (Boldt, 1993, p. 465). Don’t expect to learn when you are talking.

Fifth, model. To tap into the knowledge that others have, seek role models and mentors. Be a pupil. Don’t be too proud or too shy to ask people who know where health care is going and how to get there from here.

Sixth, practice. To learn a skill, practice it. “Anything worth doing,” notes Boldt (1993), “is worth doing poorly at first” (p. 468). Be willing to make mistakes. Don’t demand perfection of yourself before you’ll act.

Faced with change and transition? Find yourself in the neutral zone? Becoming reactive, bitter, and depressed won’t help. Focus instead on accepting responsibility for your situ- ation, expanding your learning capacity, and planning to put yourself where you want to be.

Karen B. Haller, RN, PhD Editor

References Boldt, L. G. (1993). Zen and the art of making a living. New

York: Penguin Group. Bridges, W. (1991). Managing transitions: Making the most of

change. Reading, MA: Addison-Wesley. Emerson, R. W. (1963). The American scholar. In W. H. Gilman

(Ed.), Selected writings ofRalph Waldo Emerson (pp. 223- 240). New York: NAL Penguin. (Original work published 1837).

Rifkin, J. (1995). The end of work: The decline of the global la- bor force and the dawn of the post-market era. New York: G. P. Putnam’s Sons.

Segal, D. (1996, April 21). In medicine’s reshaped world, the ax hits women harder. The Washington Post, p. H4.

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