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Promoting Resident Wellness Through Better Stress Management

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Promoting Resident Wellness Through Better Stress Management Margaret Rea, Ph.D. GME Counselor UC Davis School of Medicine Why are We Concerned if Residents are Not ... – PowerPoint PPT presentation

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Title: Promoting Resident Wellness Through Better Stress Management


1
Promoting Resident Wellness Through Better Stress
Management
  • Margaret Rea, Ph.D.
  • GME Counselor
  • UC Davis School of Medicine

2
Why are We Concerned if Residents are Not
Managing Stress Well?
3
The Evolution of the Resident
November
January
September
July
4
We Want to Avoid
  • Physical Changes
  • Emotional changes
  • Maladaptive responses
  • Poor Patient Care

5
Bad Equation
  • High demands of work
  • Perfectionism
  • Feelings of lack of control
  • Few Rewards
  • STRESS

6
We Want to Avoid Burnout
7
  • Emotional exhaustion
  • Depersonalization
  • Feeling inefficient on the job

8
  • Emotional Exhaustion
  • Feeling emotionally overextended and exhausted by
    work

9
  • Depersonalization
  • Unfeeling and impersonal response to ones
    efforts

10
  • Feeling Inefficient
  • Incompetent

11
We Want to Protect Against
  • Depression
  • Anxiety
  • Substance Abuse

12
We Want You To
  • Maintain meaning and satisfaction with your job
  • Maintain and or get back some of the energy and
    enthusiasm that brought you to medicine
  • Maintain a personal life and achieve some balance
    between work and home

13
What Can We Do To Assist You?
  • We cant make the stress of residency disappear,
    but we can try to assist you in achieving some
    balance so you can maintain your physical and
    psychological health

14
How do we do that? Can we do that?
15
We Do Not Want To Cause More Stress with Stress
Management
16
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17
What Techniques Do you Currently Use to Promote
Wellness?
18
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19
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20
Unhelpful Stress Management Techniques
  • Escape through drugs and alcohol
  • Short cuts at work lying, dumping Its pending
  • Overeating/under eating
  • Taking out on others colleagues, students
  • Acting out at home

21
Can Residents Really Use Typical Stress
Management Techniques?
22
Can Residents Modify Their Style and Consider
Wellness
  • Obsessive traits
  • High to unrealistic expectations of self
  • Addiction work
  • Competition to do better than others
  • Stress is a motivator

23
Life Curriculum for Residents Duke University
ERASE
  • Exercise
  • Relaxation
  • Activities
  • Supportive Relationships
  • Emotional Expression

24
Exercise Can Residents Really do This?
25
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26
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27
Exercise Options for Residents
  • Hospital Stairs
  • Walk around hospital
  • Hospital Gym Rooms 7148 and 7156- Code 541
  • Equipment at home
  • 24 Hour Gym
  • Ramp

28
Relaxation
  • Deep breathing
  • Muscle relaxation
  • Meditation
  • Imagery/Visualization
  • Mindfulness

29
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30
Meditation
  • Focus on
  • Sound
  • Image
  • Phrase
  • Breathing

31
Time Outs
  • I pod/CD- (only for time out)
  • Power nap
  • Social Interlude call a friend,call home, grab
    coffee with fellow resident
  • Walk the perimeter or ramp
  • Library

32
Enjoyable Activities Can You Remember Any?
  • Try to remember what used to be enjoyable
  • Try and find a concrete hobby that can balance
    chaos of the hospital

33
Support Systems !!!!!!!!!!
  • Reach out to family and friends
  • Keep personal relationships intact
  • A short phone call can help
  • Form alliances with other residents
  • Consider counseling, even one session

34
Emotional Expression
  • Expressing emotions in safe and appropriate way
    leads to better coping with family, friends,
    counselor
  • Keep a journal
  • Touch base with seniors and supervisors
  • ISOLATIONPOOR OUTCOME

35
Why Consider Counseling
  • Venting to someone helps
  • Practice stress management skills
  • Problem solve
  • One session or continuing
  • Regular or intermittent

36
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37
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38
Mental Traps Keeping You From Counseling
  • Fear of exposure to fellow residents, colleagues,
    patients
  • Fear it is not confidential
  • I can heal myself
  • Fear failure

39
Avoid Trap
  • If I admit I am struggling THEY will figure out
    I really dont belong, I can do it

40
What Else Can Help?
41
Reframing World View You Have a Choice
  • We often cant change the reality, but we can
    change how we think about it
  • We can take control of how we respond to events
  • We can adopt more helpful interpretations

42
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43
  • Realism not perfectionism
  • Embrace the challenge and opportunities
  • Avoid victim interpretation

44
  • They are out to get me, they are dumping on me,
    they are slamming me
  • vs.
  • It is a bad night, how can I make things work

45
Avoid the Trap of Service PTSD
  • You begin re-living a bad service or ward
    experience
  • You then predict it will happen again
  • You become pre-occupied, expecting worse
  • You walk in with heightened arousal and stress

46
Avoid the Victim Role at Home
  • If you arrive home feeling abused, your family
    will often respond negatively
  • They want your presence so be present

47
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48

Take Charge of Your Wellness Be Mindful!!!!!
49
  • Eat
  • Laugh
  • Take a Time Out
  • Communicate
  • Get Support, Reach Out
  • Take Care of Each Other
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