Transcript Resilience, Stress and Burnout

Resilience, Stress
and Burnout
Steve Blades, GP Tutor,
Appraiser and Executive
Coach
Aims
Appraisers will be more able to
 Promote resilience in doctors
 Recognise signs of stress and burnout
 Help doctors to understand the causes of
their stress
 Promote change to reduce stress
What is Resilience?
A set of flexible cognitive, behavioural and
emotional responses to acute or chronic
adversities which can be unusual or
commonplace
 These responses can be learnt
 Coming back from adversity (not bouncing
back)
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(Neenan, 2009)
Coping with pressure
Thinking
 Behaviour
 Health related activities
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The Power of Thinking
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“Man is disturbed not by things but by the
views he takes of them” (Epictetus, AD 55135)
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“My life has been full of terrible
misfortunes most of which have never
happened” (Michael de Montaigne)
Strengths underpinning resilience
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High frustration tolerance
Self acceptance
Self belief
Humour
Perspective
Curiosity
Adaptability
Meaning
Behaviour
Support networks
 Reflection
 Assertiveness
 Avoid procrastination
 Develop goals
 Time management
 Work – life balance
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Health Issues
Alcohol
 Caffeine
 Exercise
 Nutrition
 Smoking
 Relaxation
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What is Stress?
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“Stress occurs when pressure exceeds
your perceived ability to cope” (Palmer
and Cooper, 2007)
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“The adverse reaction people have to
excessive pressures or other types of
demand placed on them” (Health and
Safety Executive)
Model of Stress
External pressure or life event
Perceived as stressful
Stress response: psychological, behavioural and physiological
Reappraisal of the situation
Stress responses fail to remove or modify causal factor
Physical and/or psychological illness
Palmer and Cooper, 2007
Stress Arousal Curve
Performance
Pressure
Causes of Stress
Work
 Relationships
 Health
 Housing issues
 Financial issues
 Bereavement
 Carer issues etc. etc.
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Stress and Doctors
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Excessive workload
Dealing with suffering and constant demands
Dealing with uncertainty
Dealing with one’s own mistakes or fear of them
Lack of professional support
Externally imposed change
Boredom
Reluctance to seek help
Causes of Stress at Work
1.
2.
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6.
Demands
Control
Support (Manager and Colleagues)
Relationships
Role
Change
Health and Safety Executive Management Standards
Stimulus and Response
Stimulus
Gap = Choice
Response-ability
Response
The ABC Model
A – Activating event or situation
B - Beliefs about the event
C – Consequences
emotional, such as anxiety or anger
behavioural such as aggression or avoidance
physiological such as palpitations, shaking
Unhelpful thinking patterns
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All or nothing thinking
Labelling
Overgeneralisation
Disqualifying the positive or focusing on the negative
Magnification or minimisation
Thoughts and feelings equalling reality
Using should, must or ought statements
Use of dramatic language
Personalisation
Mind reading or predicting the worst
Perfectionism
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High standards and conscientiousness
Self criticism
Chronic doubt and guilt
Exaggerated sense of responsibility
High demands of others and difficulty delegating
Procrastination
Frustration with inefficiencies
Mindset (Carol Dweck)
Fixed mindset
 Growth mindset
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Implications for feedback
Burnout
Maslach’s triad of burnout
Emotional
exhaustion
Depersonalisation
Reduced accomplishment
Role of Appraisers
Listening ear
 External view
 Promote resilience
 Recognise stress and help identify causes
 Develop action plan
 Signpost to other resources
 Recognise sick doctors
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Problem or Puzzle?
Advice giving doesn’t work 
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Suggests one is wise and sensible and the
other is weak and needy
Undermines partnership
‘Why don’t you …? …Yes, but …?
It discourages person taking responsibility for
themselves
If advice is taken, goes wrong – it’s your fault!
Unlikely you tell them anything they didn’t
know
The Coaching Spectrum
NON-DIRECTIVE
LISTENING TO UNDERSTAND
PUSH
solving
someone’s
problem for
them
REFLECTING
PARAPHRASING
SUMMARISING
ASKING QUESTIONS THAT
RAISE AWARENESS
MAKING SUGGESTIONS
GIVING FEEDBACK
OFFERING GUIDANCE
GIVING ADVICE
PULL
helping
someone
solve their own
problem
INSTRUCTING
TELLING
DIRECTIVE
M Downey, Effective Coaching 2003
Further Reading
Developing Resilience by Michael Neenan
 How to deal with stress by Stephen
Palmer and Cary Cooper
 Mindset by Carol Dweck
 The Chimp Paradox by Steve Peters
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Contact Details
[email protected]
 07764196398
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