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Sunday, September 30, 2012

Project Pain Management: The Good, The Bad and the Useful

[Also available as a podcast]


Definition of PAIN

a : a state of physical, emotional, or mental lack of well-being or physical, emotional, or mental uneasiness that ranges from mild discomfort or dull distress to acute often unbearable agony, may be generalized or localized, and is the consequence of being injured or hurt physically or mentally or of some derangement of or lack of equilibrium in the physical or mental functions (as through disease), and that usually produces a reaction of wanting to avoid, escape, or destroy the causative factor and its effects <was in constant pain> 


b : a basic bodily sensation that is induced by a noxious stimulus, is received by naked nerve endings, is characterized by physical discomfort (as pricking, throbbing, or aching), and typically leads to evasive action
 

Source: Miriam-Webster (http://www.merriam-webster.com/medical/pain)

Everyone has experienced pain of some kind. Most project managers have experienced pain on projects as well - and if you haven't yet, you must be just getting started in your career. Pain can come in many forms - physical pain, mental distress, concern and worry over things that you may (or may not) have any control over.  In fact, pain can be good for you, as it is principally designed as a protection mechanism. Brush your hand against a hot frying pan? Your body quickly tells you to get yourself away by triggering pain sensors. Step on a nail or cut yourself? Pain tells you to stop doing what you are doing and take care of your injury.


But not all pain is the same. Some pain says "Stop that!" and yet some pain you need to ignore, like runners pushing through to get their second wind.

In early 2005, I damaged my right knee - I tore my meniscus. The pain while walking right after the injury was quite bad - but of course, I still had to walk. Before I could start Physio, I had to take a flight back to the head office. Walking from the farthest gate to the main terminal was a very, very long and painful process. From there I caught one of those courtesy trams that go from gate to gate. The entire trip was measured in short walking distances and rest spots, and Naproxen was on the daily menu for a while.

I returned from the trip to my project in the US and started Physio, which helped a lot, but I still had regular pain through the next year, if I overdid it or stood too long in one position. Once the inflammation settled down, walking was Ok - but standing was not, as it put pressure in mainly one spot. But I managed, and started to get better and much more mobile - once again measuring walks in miles/km instead of dozens of feet or minutes standing up.

In 2006 I twisted my left knee when I fell into a hole, damaging it as well. You think I would have been smarter and re-injured the bad knee, but no. The pain from this injury was quite different - and worse. Walking or standing was painful for any duration or distance. But I got along, by not walking too much and avoiding standing still for very long. I went to the doctor - and was put on a waiting list for an MRI in Vancouver. I waited for 14 months, and finally had the scan. Then I had to wait a few more months to see the specialist who went over the results. The whole time my knees (both of them acting up in sympathy for each other) limited my freedom of movement as a result of the annoying pain.

At one point I actually bought a folding cane to carry in my bag, and had to use it a few times.

When I finally met the specialist, he went over the results with me, discussed "pain management" as the only near-term option and then sent me to physio. He also gave a picture of the long-term prospects which I was not terribly happy about. I left the office feeling quite discouraged. Osteochondrital impaction? Big words for "can't fix it".

So I started physio. It made things hurt more, frankly - for a while. Then it hurt a bit less. But at the same time we were preparing to sell our house prior to moving - so I found myself up on the stepladder and tall ladder (generally, just plain upright for long periods), standing and moving as I repainted the entire inside of the house, including ceilings.

During the several weeks of prep and painting in the evenings and weekends my knees were on fire, but the job had to be done. However, after the third week I began to notice something interesting.


1) There were actually two types of pain, not just one.
2) I was hurting a bit less and less every day as I forced myself onto the ladders to paint.

By the time I went in for my followup visit with the specialist who had had little hope for me other than pain management, I was walking nearly pain-free, and not only that - I was able to stand in place for long periods as well.

Over two years of suffering, and nobody told me I just had to get off my butt and move!

Sometimes, pain is a sign to stop doing what you are doing or you will further damage things (pain #1), such as actual joint pain

Other times, it is simply a message that you need to persist, and things will get better if you push through and keep going (pain #2). This tricky type of pain was merely muscle fatigue - a sign that my knees were growing a little bit stronger again, and the next day would be a little bit better than today.

In the case of my knees, the odd bit I learned about joint mechanics is that when you exercise your muscles and tone them up, they actually pull your joints apart - reducing wear and pressure on the cartilage between the bones. If you let things go and rest because it hurts, you lose muscle tone and your joints experience more direct pressure from the weight of your body. Weird, but true.

On your projects, you will also experience two types of pain - good pain and bad pain. The key is learning to identify each type of pain and then respond to them appropriately.


Project Pain

Pain was originally designed as a simple survival mechanism. However, with higher cognitive abilities, humans brought pain into a whole new sphere. No longer would we have to simply stub our toe or hit a thumb with a hammer to feel pain, we can now suffer pain in many non-physical areas as well. We feel pain about thoughts and emotions too.

Pain is great for projects. Seriously, it is - the only reason that someone buys a product or starts a project is because they have a problem to solve. This is their "pain point". So in truth, you would not be managing a project at all if there was not a big pain somewhere that needed soothing, a substantial problem that needed solving. 


Bad Pain vs Good Pain


Bad pain we are all familiar with, most commonly in the form of injury or loss. Physical injury, financial distress, loss of a loved one, ending of a relationship, or being laid off. Bad pain is generally associated with a negative outcome. In general, we all want to avoid introducing or having  "bad" pain.
 

There is, however, such a thing as good pain. We are most definitely not talking about sado-masochism though - we are talking about good, old fashioned discomfort that is not associated with an injury or negative outcome. Good pain is associated with positive outcomes.

An athlete endures pain on a regular basis while running, swimming, biking or in any other sport. They know at which point they will begin to feel discomfort while they are exerting themselves, and they also know and learn to expect the signs of "good" pain compared to "bad" pain. If they start to feel bad pain, they know they need to stop, hit the benches, or let someone else win the race because if they continued, they would be seriously injured and perhaps miss the next few races or games. Good pain, on the other hand, is the wall they must pass through to reach the rewards on the other side - the second wind that lets them once again pick up the pace and win the race.

On your projects, you will come across many people who will not do something because they anticipate pain, or discomfort - they feel fine as-is and do not want to change where they are or what they are doing. It is important to remember that change of any kind can and will cause discomfort - it will cause some pain to those affected.

The problem is, people often look at all pain as being the same - "it will hurt, I will feel uncomfortable, so I don't want to do it, and I don't want to go there." I don't care what it is or what is on the other side - I just don't want to deal with the pain.


Whose Pain Is It?

On your projects, pain can be experienced by everyone at some point - the project team, the sponsor, the stakeholders, the end users or consumers - and yourself as well. The real trick is identifying the type of pain it is, who is having it - and what you can do about it. You cannot take on someone else's pain, of course - but in being aware that they are having it, you may be able to help either alleviate the "bad" pain, or help them push through "good pain" to the other side.


As all projects are change projects, most of the pain will be associated in some way with that change - and needs to be accommodated in the Change Management Plan.

(We have explored Change Management in several other articles, so we won't discuss all of the specifics again here. If you would like to read them, they are: Implementing Organizational Change? Learn How to Grow a Desert, Built to Last: Forget Waterfall, Forget Agile - Let's Talk Tectonic Project Methodologies, and Teams, People and Change: You Can't Push a String )

Pain affects different groups in different ways - and needs to be approached differently in each case.

Stakeholders and end users/consumers of the project may need to change and learn to use the new system or product. If it is entirely new, some of them may be excited, some may be neutral, and some may be unwilling to take the leap. If it is replacing something they are already using, it is likely you will have more people reluctant to change as they are comfortable just as they are, or heavily invested in the old way of doing things. If the end users/consumers have the choice of staying with the old product or moving to the new product, then you have a marketing challenge. 

However, if the directive is that they need to switch because the old product is being phased out, this needs to be included in the Change Management Plan. You need to look at the change from a pain perspective. If you know it is a "good" pain on the way to migration to a new and better solution, you will want to paint encouraging words. You may also want to point out pain of not adapting - the old solution may be decommissioned, or they may no longer be skilled or employable (the "bad" pain of not changing).

Note that "good" and "bad" pain are dependent on your perspective - some may see all pain as bad, and you will need to work with them to help distinguish the two. You cannot assume that just because you can see both sides of the pain that they will as well. You may need to do a lot of communication with different stakeholder groups to get your message across and convince them that it is "good" pain, and they can and should push through it.

Of course, you may also have cases where what is "good" for the company or the project may be seen as "bad" for an individual - for example if their job is being made redundant. If the company approach is to re-assign people to other roles rather than lay them off, you may still be able to turn a "bad" pain into a "good" pain. 

However, sometimes you will have people that will continue to see the change as "bad" pain, and you may never be able to convince them otherwise. They may solve that for themselves by leaving, or they may stay on and heckle from the sidelines. You just have to be prepared for each possibility.


The Project Team may also experience some of the same pain as end users, as they may also be users of the old and new system. However the team will also have different pain points than the end users or stakeholders. They will be dealing with a lot of change, but they will also be doing a lot of learning so that they can train and support the end users. Learning something new (and having to become an expert in it) can be a daunting challenge full of uncertainty. They also will not know what they do not know - so there can be confusion and anxiety. It is important to provide support and regular checkpoints and/or assessments to make sure that they are progressing and are understanding how to use the new tools and the system. 

Or you may simply have someone taking on a new role, and they are experiencing the pain and discomfort of uncertainty and self-doubt in the role. They may just need some mentoring and encouragement.

If any of the team are struggling, make sure to spend the extra time to figure out the gaps and support them - help alleviate their pain.

Remember - most of the pain on projects will come as a result of dealing with change. And sometimes using "bad" pain as the stick to help them get through the "good" pain to the carrot is just what the doctor ordered - it can be a "useful" pain.


Summary

My knees still have good and bad days - but mostly very good days where they don't trouble me at all - they feel like they did before either injury. I am still careful to avoid certain movements under pressure, such as a sudden twist around corners with a loaded grocery cart. But that is simply a matter of planning - today I can navigate the entire store with a full cart without undue aggravation of my knees. I am also out and walking almost every day, which keeps the muscle tone up. I definitely notice it though, if I skip walks for a number of days in a row when things are busy on a project. 

On your projects it is important to discern which type of pain it is that is confronting you. Is it a "bad" pain warning you to stop, before you cause damage or a negative outcome? Or is it the "good" type of pain, the one that tries to trick you into not moving forward, but once you do, things get better, or you grow and improve? Either way, pain can be useful teacher.

Good luck with your projects, keep that Aspirin handy, and remember to push through the "good" pain to project success.


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