“We can work through any transition!”

Because of HIPPA I can’t openly thank the patient who inspired this posting today, but you know who you are….


Transitions are tough.  Most people don’t like them.  Usually I think of transitions when it comes to relating to my children, but once again I’m seeing how the lessons I’ve learned during my last 12 years of motherhood serve me well in other areas of my life.  I have been blessed with four very “spirited” children.  Now to those of you who are familiar with Raising Your Spirited Child by Mary Sheedy Kurcinka 1998 you will know that “spirited” is a much more positive word for “difficult”.  The cover of the book describes it as “a guide for parents whose child is MORE intense, sensitive, perceptive, persistent, or energetic.”  I always marveled at those parents that could take their babies and toddlers to restaurants.  Parents that could put their baby in a carrier and watch a movie REALLY blew my mind.  My kids have always demanded center stage.  As babies they’ve needed to be held, walked, sung to, and danced with.  As toddlers they’ve been able to blow any other kids’ tantrums out of the water.  Happily, by grade school age they’ve all managed to “pull it together” and become what I like to call “civilized human beings”. 🙂


Now I don’t think anything happens by accident.  I think my children are growing up into well adapted human beings because I improved my ability to navigate transitions.  One of the main things Kurcinka’s book taught me was how to anticipate and then manage transitions.  My favorite example was getting my daughter ready to go to day care when she was 4 years old.  This used to be a NIGHTMARE.  Almost every stage of the process was accompanied by a tantrum.  After reading Raising Your Spirited Child I recognized these morning battles for what they were – a transition from home, mom, and dad, to daycare, where she would stay for 11 hours.  I subsequently implemented a strategy I learned from the book of printing from the internet pictures of the various tasks we had to complete before getting out of the house in the morning (getting dressed, brushing hair, brushing teeth, etc.).  Each night I started having my daughter lay the pictures out in whatever order SHE chose to complete them in.  The next day we woke up and immediately looked at the pictures to remind us of what we had to do.  Miraculously, the tantrums decreased almost 100%!  


I’ve also learned about managing transitions because I have 3 boys who stutter.  We work with Kristin Chmela who is an extraordinarily gifted fluency specialist, and Megan Carick, OT who I’ve nicknamed “the child whisperer” because of her remarkable instincts when working with children.  Both Kristin and Megan have helped me to see that my boys’ fluency is dramatically affected by the way we manage transitions.  Under their tutelage I have learned an incredible amount about navigating change. 


In my opinion, these are the five most important rules to follow in order to have a successful transition:

1. People need to be prepared and given time to assimilate to the transitions they are faced with.

2. People can only accommodate to change if they feel like they are part of the process.

3. Nobody reacts well when they feel like their power is taken away from them.

4. Communication is the key to successfully moving through any transition.

5. Nobody wants to be unreasonable, and everyone simply wants to be understood, respected, and listened to. 


I call on these principles to help me to successfully navigate times of change and conflict regardless of whether it is with my family, my patients, my staff, or a doctor I’m trying to shepherd through the transition from paper to electronic medical records.  Thank you to all of my patients that are being patient enough to work through this transition with me.  In the words of my unnamed patient, together “we can work through any transition!”


About Kara Nance MD

Kara Nance, MD FACP currently works in private practice in Rolling Meadows, IL. Dr. Nance approaches the care of her patients with a very holistic attitude that targets the many factors that contribute to overall wellbeing. She is a mother of 4 young children, and often brings her personal life experiences into play when helping her patients solve problems relating to life balance. In addition to her clinical practice, Dr. Nance is passionate about electronic medical records and the establishment of electronic health exchanges. She consults with local physicians, hospitals, and medical groups about transitioning over to electronic medical records. Kara also participates in advocacy activities relating to primary care. As a Fellow in the American College of Physicians and a member of the ACP's Northern Illinois Council, Dr. Nance frequently travels to Washington to lobby for important issues in health care reform.
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