Transcript 'Practical Approaches to Working as a Health Care
PRACTICAL APPROACHES TO WORKING AS A HEALTH CARE PROFESSIONAL: Building Resistance Staying Mindful Adding Flexibility Taking Charge of Your Health (OR…How to Prevent Burnout!) Kate M. Hathaway, Ph.D.,L.P.
Clinical Health Psychologist
BEHAVIORAL HEALTH LEARNING OBJECTIVES DPT 7100
Identify physical, cognitive and emotional ways to cope with stress Consider your view of yourself as a person independent of your work and also as a health care professional
GOALS
Identify the factors that influence stress levels in humans Identify the physical, cognitive and emotional components of stress and burnout symptoms Identify physical, cognitive and emotional ways to cope with stress Learn how to take care of your own health Consider your view of self as a health care provider
REVIEW: COMPONENTS OF STRESS RESPONSES
PHYSICAL Heart rate, breathing, muscle COGNITIVE Intense concentration on stressor EMOTIONAL Less access to emotional reactions SOCIAL More inward-focused, withdrawal from social interactions
LOOKING AT “STRESS”
Stress Is Adaptive (Survival of fittest) Can We Re-define Stress as A Learning Tool? – A Positive Experience Acceptance: Life Cannot Be Stress-free See Noble Truth #1, Buddhism!
• There has never been a time in history without war, disease, abuse, suffering • • Our colleagues are not perfect either!
Life is busy, distracting and confusing
Re-Defining: SEEING THE POSITIVES OF STRESS
POSITIVES OF STRESS: Alertness Challenge-based – increases self-confidence Learning occurs and coping improves Interpersonal problem-solving
…AND THE NEGATIVE EFFECTS OF PROLONGED STRESS?
Morbidity: Unhappiness, anxiety, strained relationships with others, “burnout” Mortality: Yep – you probably won’t live as long!
BURNOUT
Results from excessive/prolonged stress Stress can be adaptive; burnout is not Results in decreased productivity, feelings of powerlessness, isolation Signs: Extreme frustration, irritability, sadness, difficulty with colleagues NOTE: Stress and burnout are defined by the
person
, not only by the situation
GENERAL WORK-RELATED FACTORS THAT INFLUENCE BURNOUT Too many responsibilities/demands Too few responsibilities/demands Role ambiguity Lack of control (perceived or real) Lack of new challenge or diversity in work content
OTHER FACTORS: HEALTH CARE PROVIDER CHALLENGES Focus on pathology (seeing the negative) Looking to technique as solution Focus on treating disease, illness and pathology versus building health
HEALTH CARE PROVIDER ISSUES THAT INFLUENCE BURNOUT Health care perspectives Beliefs about the roles of health care professionals Beliefs about the roles of patients Beliefs about our ability to influence outcome with patients (ego-based) There is a “right” and “wrong” way to provide health care Struggles with the health care systems
ADDITIONAL CHALLENGES FOR PHYSICAL THERAPISTS Natural progression of work skills: Early focus on technique Natural progression of work relationships and habits of interacting Tendency to become or be seen as the authority on matters of rehabilitation Tendency to tire of emotional work and avoid it in working with difficult patients Tendency to care-take others and forget oneself Less desire to listen or care-take at home?
FALLACY-REALITY
“We are the experts; patients are the consumers” “We know how the brain and body work; we can offer fixes”
REALITY
Only 25% of health care is provided by the professional; 75% (or more?) is provided by the patient to him/herself Humans do not like to focus on fear or negativity (pathology) We know really very little about the brain or body and how they work, although we know more than many others
TO CONSIDER…
“I believe that every person knows more about him/herself than anyone else will ever know….” - Physically - Cognitively - Emotionally -Interpersonally
Stress management, then, is an
individual
challenge No one solution works for everyone The environment may supply the stressor; the individual supplies the coping
COPING: BUILDING PHYSICAL RESISTANCE
Increase physical strength Increase physical adaptability Increase energy Decrease toxins Build antitoxins Decrease heart rate, GI distress
PHYSICAL: At Your Desk
STRETCH!
POSTURE CORRECTION FACIAL MUSCLE RELAXATION BREATHING LIGHTING SOUND AROMATHERAPY NUTRITION, WATER
PHYSICAL: Anywhere
EXERCISE Walk at breaks? Lunch?
Less sedentary activity (decrease TV/computer?) SLEEP 8 hours? naps?
GET OUTSIDE Fresh air, new visual stimuli NUTRITION 4-6 times per day, nutritionally sound Vitamins?
COPING: BUILDING COGNITIVE RESISTANCE
Increase sense of control Increase permission for options Increase plasticity in thinking Decrease all or nothing Eliminate the word “but”
COGNITIVE: At Your Desk
INCREASE “I CAN” SENSE OF CONTROL; DECREASE “I CAN’T” STATEMENTS DECREASE “WOULD’VE,” “COULD’VE,” “SHOULD’VE” PLAN, RE-ORGANIZE, PRIORITIZE INCREASE MINDFULNESS DECREASE JUDGMENT, INCREASE ACCEPTANCE MAKE
VALUE-BASED
DECISIONS
COGNITIVE: Anywhere
MAKE
VALUE-BASED
DECISIONS INCREASE ACCEPTANCE ADMIT OWN INFLUENCE ADD CREATIVITY TO YOUR PROBLEM-SOLVING REMAIN FLEXIBLE
FLEXIBILITY
“For a mind burdened with fear, with conformity, with the thinker, there can be no understanding of that which may be called the original…” • J. Krishnamurti,
On Fear
COPING: BUILDING EMOTIONAL RESISTANCE
Be mindful Practice staying in the moment Identify feelings without judgment Practice joy
“We consider bibles and religions divine…; I say they have all grown out of you, and may grow out of you still; It is not they who give the life – it is you who give the life.
Will you seek afar off? You surely come back at last, in things best known to you, finding the best, or as good as the best – Happiness, knowledge, not another place, but this place – not for another hour, but for this hour” Walt Whitman
EMOTIONAL: At Your Desk
PRACTICE OPTIMISM FIND SMALL WAYS TO INCREASE JOY (PICTURES, TEAS, ETC.) ACCESS MEMORIES – ESPECIALLY OF TIME IN NATURE PRACTICE GRATITUDE PRACTICE KINDNESS AND GENEROSITY
EMOTIONAL: Anywhere
IMAGINE PEACE Remember that the body and the spirit do not know the difference between what is imagined and what is real….
FOCUS MORE ON CREATIVITY, LESS ON PRODUCTIVITY INCREASE SOCIAL SUPPORT PRACTICE KINDNESS AND GENEROSITY HAVE MORE FUN!!!!! LAUGHTER IS A GREAT STRESS REDUCER
REVIEW: COMPONENTS OF STRESS REDUCTION
PHYSICAL Relaxation, BREATHING Build health COGNITIVE Re-framing, re-interpreting Staying “in the moment” EMOTIONAL Peace-giving SOCIAL Support of friends, family
COMBINATION OPTIONS MUST HAVE A
PHYSICAL, COGNITIVE AND EMOTIONAL
COMPONENT Bonus points for breathing!
NO TIME PARAMETERS VARIETY IS THE SPICE OF LIFE BE MINDFUL, BE PRESENT IN THIS MOMENT AND TIME… NOTE: There are likely gender, cultural and age differences in coping…
OPTIONS FOR BUILDING EMOTIONAL AND COGNITIVE HEALTH Relaxation exercise Yoga, tai chi, qi gong Meditation Self-hypnosis Warm bath, hot tub Daily rituals: Prayer, candle-lighting, water rituals Music, sound, dancing, woohoo!
Laughter Massage Light treatments, Time in nature – nature images Story-telling or story listening Mindfulness Social support Animals, children Attention to the present moment… See CSH offerings, U of MN (www.csh.umn.edu)
NOTICE…Trends in health utilization Increased utilization of CAM Increased attention in psychological literature on “mindfulness,” mind-body interactions, cultural proficiency, optimism, gratitude and generosity DBT Meditation Yoga -- Herbal remedies -- Buddhist philosophy -- Intercultural respect
CHANGES IN HEALTH CARE THAT BENEFIT ALL
View health holistically Connect body and mind (EXERCISE) Increase positive view of experiences View experience as way of learning We learn fastest from our mistakes Increase attention to
acceptance
Increase attention to patient perspective
APPLICATION TO SELF: Looking at Ways to Reduce Burnout
View your own health holistically
Connect body and mind (EXERCISE)
Increase positive view of experiences
View experience as way of learning
Note that we learn fastest from our mistakes
Increase attention to acceptance
Practice mindfulness: Attention and Intention
Increase attention to the other’s perspective
THOUGHTS FOR HEALTH CARE PROFESSIONALS Control schedule Add “transition” time to clear head and help with preparation for next interaction (work and home) Schedule work around family? Mental health days?
Practice mindfulness: Stay in the moment when with patients and when with family and friends Ask for significant other’s wisdom, emotional support Peer review Build spiritual practice Practice non-emotional generosity Schedule breaks with purpose Walk, nap, meditate, yoga, stretch, eat
TAKE CHARGE OF YOUR HEALTH DOMAINS:
LIFE LONG LEARNING SEE TCOYH at www.csh.umn.edu
Life purpose Self-care and prevention Stress mastery Emotional health Physical activity and fitness Diet and nutrition Relationships Environment
SUMMARY
Stress is adaptive; burnout is not Our responses to life challenges are influenced by our
perspectives
(cognitive), our
emotional reactions
and our
habits
To build personal health and resistance (and reduce burnout) address all aspects of health
ASSIGNMENT
Look at the eight domains of health Self-assess Designate a plan for yourself to build health in EACH of these domains