Four Fears that Block Great Ideas - Emerging Nurse Leader

By Rose O. Sherman, EdD, RN, FAAN

“What great thing would you attempt if you knew that you could not fail.” Robert Schuller

In his groundbreaking book The Innovator’s Prescription, Clayton Christensen proposed that today’s health care system screams for disruptive innovation. Despite the need, developing new innovations is not without challenges. It can be difficult to get nurses to think creatively. One negative byproduct of our recent focus on evidence-based ideas is that truly creative thinking is often not grounded in current evidence.

In a fascinating article in this month’s Harvard Business Review, innovation experts Tom and David Kelly talk about their work at Stanford to guide students and leaders globally to be more creative. Rediscovering the creative confidence that they had in childhood is a first step. They have found that people have the following four fears that block creative thinking:

Fear of the Messy Unknown

Creative thinking in problem solving needs to include a willingness to move outside our box to examine the problem from the viewpoints of others and through a lens you might not ordinarily use. We can use emergency room throughput time as an example because this is a major problem in many hospitals today. The authors would suggest that part of a creative solution to this problem would be to actually spend a few days in an emergency room with patients in a non-clinical capacity. They propose that if you do this, you will find the unexpected which they call the messy unknowns that won’t come from task forces or chart reviews. Finding the messy unknown throws a wrench into our belief system and this is why we often try to avoid it.

Fear of being Judged

Most people at some level do care deeply about what others think of their ideas. As an outcome, we often stick to safe suggestions and ideas. The authors suggest that you can’t be creative if you are constantly self-censoring yourself. They suggest that if you do have a great new idea then introduce it by saying, “this is just my opinion and I want help.”

Fear of the First Step

Creative efforts are hardest at the beginning. This is true whether you are trying a new recipe or writing a paper for school. The authors suggest that you take things step by step and give yourself a self-imposed deadline. Their mantra is “don’t get ready, get started.” Your anxiety level will build if you stall on implementing your ideas.

Fear of Losing Control

The best creative efforts are usually done collaboratively. I recently spoke with a nurse leader who engaged her staff to develop a new clinical ladder. She laughed as she told me, ” I told the staff to think outside the box and they did…..way outside any box I had in mind. Their ideas were really interesting and different. I lost complete control of the process but the outcome was so much better.” The authors suggest that losing control in the creative process can be difficult but the creative gains can more than compensate.

You may look at this advice and think that it is great in principle but won’t work in practice. But consider the achievements of the two authors Tom and David Kelly. They are the founders of IDEO – a global design consulting firm that many would agree is the most creative in the world. Although most of their work involves creative designs for consumer goods, they have also worked with large health systems such as Kaiser Permanente on a Nurses Knowledge Exchange project. They believe that the ability to be creative starts with creative confidence developed from overcoming the fears that block great ideas. This is good advice as we move forward in a time when health care reform will demand our best creative efforts.

Read to Lead

Christensen, C. (2009) The Innovator’s Prescription: A Disruptive Solution for Health Care. New York: McGraw-Hill.

Tom and David Kelly (November 15th, 2012). The Fours Fears Blocking You from Great Ideas. Podcast Interview with the Harvard Business Review.