horizon conflict article header
Marcie Hopkins, U of U Health
Four Ways to Manage Our Horizon Conflict
As pandemic restrictions continue to lift, we in health care find ourselves in a fix. While some take extended vacations, others continue to work their tails off. The Resiliency Work Group's Megan Call and Mari Ransco share a metaphor—the horizon conflict—to help explain how to manage this moment.

magine you’re standing on a cliff with your colleagues, looking out at the sea. Some of your colleagues have their binoculars pointed straight down at the beach. You may be looking out at a ship on the horizon. Others are looking past the horizon. We experience a "horizon conflict" when we take responsibility for different horizons. 

In health care, we’ve long managed these conflicting views. There are those of us who care for the patient right in front of us; those of us planning for the patient three, five, or 10 years from now; and those of us toggling back and forth between both ways of seeing. But the conflict continues to be jarring as we work our way out of the pandemic. While some are ready to move on and get back to life as usual, others are overwhelmed, unable to return to pre-pandemic priorities. It's important to acknowledge and support both. 

We can acknowledge and recognize.

We can recognize that we have different horizons and different responsibilities. We can respect those horizons with simple tools that nudge us forward together.

1.    Life is different since the last surge.

Think how far we’ve come. Our knowledge gains have been astounding. We have a vaccine that is highly protective and widely available. Our ability to acquire PPE and use evidence-based safety protocols removes much of our initial worries. We also know how to work effectively from home. Still, it’s easy to slip back into the same feelings we experienced before  and view our current progress as one-step forward, two-steps back.

Turning our focus to acknowledge what is similar and what is different since the previous surge can help us anchor our perspective in the present. Taking time to recognize small wins, and indeed tremendous gains, can help us feel more empowered and better equipped to work with our current struggles instead of getting caught up in the past.

2.    It is tempting to place blame. 

Beware of the temptation to place blame on others for our current circumstances. For example, it is going to be easy for those who are vaccinated to blame those who are not vaccinated. This “us vs them” binary thinking undermines our ability to build trust, address our present crises, and move forward together.

To quote James Baldwin, “Where all human connections are distrusted, the human being is very quickly lost.” As we continue to interact with one another, it’s important to catch ourselves before we slip into shame and blame mode. This may require more effort and intention from us in the moment; however, in the long run, each small, thoughtful action adds up and contributes to a culture of safety and well-being. 

3.    Reconnecting with our values helps.

We can act on important values during times that feel uncertain and unchartered. Values are one-word descriptors that help us identify how we want to treat ourselves, how we want to interact with others, and how we want to engage with the world. 

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The nice thing about acting on values is that we can reconnect with them any time. If we find ourselves behaving in a way that is incongruent with our values—such as losing our tempers or shutting down—all we have to do is return and reconnect with the value that is important to us. For many of us, “patience” is an important value to muster right now, which includes being patient with ourselves as we try to be more patient and understanding with others.

4.    Tap into your inner survivor. 

In the book “Deep Survival” author Lawrence Gonzales describes ten common characteristics among people who cope with and survive the most harrowing experiences. Most of us would likely benefit from adding one or more of these strategies to our coping repertoire for the upcoming weeks and months.

  1. Believe from within – believe in ourselves; that we have the capacity to do what we need to do.
  2. Stay calm – a place we can return to and work from; worry, angry and frustration is going to happen but we return to a place of calm.
  3. Think, analyze and plan – reflect on what was helpful during the last surge both during work and outside of work; make a plan for what to do
  4. Pace, take small steps – break weeks, days, hours down into small tasks; it’s easy to get overwhelmed when taking everything in at once. 
  5. Celebrate successes – recognize and savor the small victories (it does help); look outside yourself for inspiration and sense of community
  6. Play – allows to the problem-solving part of your brain to have a rest and facilitates creativity, which we need
  7. Notice the beauty  – moments of awe help give us a sense of more time and that we are connected to something larger than ourselves
  8. Believe you will succeed – acknowledge the difficulties while keeping a long-term view in mind; one day this will all be over.
  9. Focus on essentials – go back to basics, reduce unnecessary meetings and tasks, take things off your plate and others in order to take care of just the essentials. 
  10. Connect to others – remind yourself of the individuals who are important to you and keep you going. 

When distress is high, get help. 

This past year, binge watching episodes of Ted Lasso brought much needed laughter and a sentiment worth sharing: “I promise you, there is something worse out there than being sad. And that is being alone and being sad. Ain’t no one in this room alone.” No matter where you are on the horizon, you are not alone. 

Check-in on your staff and colleagues to see how they’re doing. If you are feeling alone, it doesn’t mean you are alone. We’re here for you.

Individual Actions Peer/Leader Actions
  • Get help sooner than later (see below)
  • Beware of catastrophic story-telling
  • Practice small acts of self-care
  • Check-in regularly
  • Validate emotions
  • Normalize experience
  • Self-disclose if appropriate
  • Ask how getting support and if it is enough
  • Help connect to resources (below)


Huntsman Mental Health Institute (HMHI) Resources

  • Email: hmhioutpatientpsychiatry@hsc.utah.edu
  • Crisis Line: (801) 587-3000 (24/7)
  • Warm Line: (801) 587-1055 (8 a.m. - 11 p.m.)
  • Same-day Psychiatry Clinic: (801) 585-1212
  • Mobile Crisis Outreach Team: (800) 273-8255 (TALK)

EAP Crisis Line: (801) 262-9619

Resiliency Center: (801) 213-3403, resiliencycenter@hsc.utah.edu

This article originally posted July 9, 2021. It has been updated to reflect current events.


Megan Call

Licensed psychologist, Director of the Resiliency Center, University of Utah Health

Mari Ransco

Senior Director of Patient Experience and Accelerate, University of Utah Health

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