PRACTICAL APPROACHES TO WORKING AS A HEALTH CARE PROFESSIONAL: Building Resistance Staying Mindful Adding Flexibility Taking Charge of Your Health (OR

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PRACTICAL APPROACHES TO WORKING AS A HEALTH CARE
PROFESSIONALBuilding ResistanceStaying
MindfulAdding FlexibilityTaking Charge of Your
Health(ORHow to Prevent Burnout!)

• Kate M. Hathaway, Ph.D.,L.P.
• Clinical Health Psychologist

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BEHAVIORAL HEALTH LEARNING OBJECTIVESDPT 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

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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

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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

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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

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Re-Defining SEEING THE POSITIVES OF STRESS

• POSITIVES OF STRESS
• Alertness
• Challenge-based increases self-confidence
• Learning occurs and coping improves
• Interpersonal problem-solving

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AND THE NEGATIVE EFFECTS OF PROLONGED STRESS?

• Morbidity Unhappiness, anxiety, strained
  relationships with others, burnout
• Mortality Yep you probably wont live as long!

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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

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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

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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

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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

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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?

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FALLACY-REALITY

• We are the experts patients are the consumers
• We know how the brain and body work we can
  offer fixes

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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

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TO CONSIDER

• I believe that every person knows more about
  him/herself than anyone else will ever know.
• - Physically
• - Cognitively
• - Emotionally
• -Interpersonally

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• Stress management, then, is an individual
  challenge
• No one solution works for everyone
• The environment may supply the stressor the
  individual supplies the coping

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COPING BUILDING PHYSICAL RESISTANCE

• Increase physical strength
• Increase physical adaptability
• Increase energy
• Decrease toxins
• Build antitoxins
• Decrease heart rate, GI distress

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PHYSICAL At Your Desk

• STRETCH!
• POSTURE CORRECTION
• FACIAL MUSCLE RELAXATION
• BREATHING
• LIGHTING
• SOUND
• AROMATHERAPY
• NUTRITION, WATER

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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?

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COPING BUILDING COGNITIVE RESISTANCE

• Increase sense of control
• Increase permission for options
• Increase plasticity in thinking
• Decrease all or nothing
• Eliminate the word but

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COGNITIVE At Your Desk

• INCREASE I CAN SENSE OF CONTROL DECREASE I
  CANT STATEMENTS
• DECREASE WOULDVE, COULDVE, SHOULDVE
• PLAN, RE-ORGANIZE, PRIORITIZE
• INCREASE MINDFULNESS
• DECREASE JUDGMENT, INCREASE ACCEPTANCE
• MAKE VALUE-BASED DECISIONS

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COGNITIVE Anywhere

• MAKE VALUE-BASED DECISIONS
• INCREASE ACCEPTANCE
• ADMIT OWN INFLUENCE
• ADD CREATIVITY TO YOUR PROBLEM-SOLVING
• REMAIN FLEXIBLE

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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

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COPING BUILDING EMOTIONAL RESISTANCE

• Be mindful
• Practice staying in the moment
• Identify feelings without judgment
• Practice joy

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• 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

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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

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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

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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

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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

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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)

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NOTICETrends in health utilization

• Increased utilization of CAM
• Increased attention in psychological literature
  on mindfulness, mind-body interactions,
  cultural proficiency, optimism, gratitude and
  generosity
• DBT -- Herbal remedies
• Meditation -- Buddhist philosophy
• Yoga -- Intercultural respect

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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

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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 others perspective

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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 others wisdom, emotional
  support
• Peer review
• Build spiritual practice
• Practice non-emotional generosity
• Schedule breaks with purpose
• Walk, nap, meditate, yoga, stretch, eat

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TAKE CHARGE OF YOUR HEALTH DOMAINSLIFE LONG
LEARNINGSEE 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

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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

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ASSIGNMENT

• Look at the eight domains of health
• Self-assess
• Designate a plan for yourself to build health in
  EACH of these domains