Enhancing Emotional Resilience in Nurses to Avoid, Reduce and Reverse Burnout

Transcription

1 Enhancing Emotional Resilience in Nurses to Avoid, Reduce and Reverse Burnout February 11, 2017 MNDAKSPAN Conference Karen D. Lloyd, PhD, LP

2 HealthPartners Integrated health care delivery and health care financing system Founded in 1957 in Minnesota s Twin Cities as a cooperative Largest consumer-governed, non-profit health care organization in the nation Founded to make healthcare affordable

3 22,500 employees 1,500,000 members 1,000,000 patients

4 Our Hospitals Our Clinics 28 1,700 physicians 50 primary care locations Regions 454-bed, level 1 trauma Methodist 426-bed, acute care Lakeview 97-bed, acute care Hudson 25-bed, critical access Westfields 25-bed, critical access Amery 25-bed, critical access Urgent Care locations 8 Urgency Room level of care 9 Urgent Care + Retail Clinic level of care

5 Our Agenda Part 1 Stress, Burnout and Compassion Fatigue Stress is normal Metaphors for stress, burnout and compassion fatigue Theory and process of burnout

6 Our Agenda Part 2 Holistic Health and Well-Being Adequate restful sleep Healthy Thinking Avoiding, Reducing and Reversing Burnout Action planning Techniques for habit creation

7 Surveys of American Adults Gallup RWJ/NPR/Harvard 56% are THRIVING 41% are STRUGGLING 49% had a MAJOR STRESSOR in the past year 3% are SUFFERING 26% had a GREAT DEAL of stress

8 I I really don t have much stress

9 Sometimes eyestrain may be an issue

10 Sometimes a nap seems to be in order

11 So what s in this presentation for ME? Hopefully developing a new healthy habit

12 Stress is Normal Unmanaged Stress is Harmful

13 Stress is Normal Negative Positive Unanticipated or unpleasant events Desired or pleasant events

14 Stress is Normal Adaptive coping Maladaptive coping Helps solve or deal with the issue Avoids or compounds the issue Improves you Undermines your health

15 Reduce maladaptive coping & Increase adaptive coping How to achieve a healthy lifestyle Knowledge + practice = becomes automatic habit days to make a habit Result: Ability to cope with expected or unexpected stress, situations, demands or responsibilities

16 QUIZ TIME

17 Adaptive or Maladaptive?

18 Adaptive or Maladaptive?

19 Adaptive or Maladaptive?

20 Adaptive or Maladaptive?

21 Impact of Unmanaged Stress Physical health Mental health Emotional well-being Roles and responsibilities Personal and professional relationships Functional capacities at work and home Spiritual well-being Ability to give back to the community

22 Professional Burnout and Resilience Individual characteristics Job characteristics Culture characteristics

23 Characteristics and Stages The compulsion to prove oneself Ambitious and driven Working harder Trying to be irreplaceable Neglecting personal needs Making little time for self care, personal enjoyment, family or friends A classic book exploring a theory of burnout Psychologist Herbert Freudenberger Burnout: The High Cost of High Achievement, 1980

24 Characteristics and Stages Displacement of conflicts Ignoring needs to the point of physical consequences Revision of values Devaluing self care, personal enjoyment, family or friends, becoming numb Denial of emerging problems Becoming moody and intolerant or irritable, while blaming bad moods on work pressure

25 Characteristics and Stages Withdrawal Social isolation sometimes using alcohol or drugs for relief from obsessive work Obvious behavioral changes Coworkers, family and friends see behavior changes Depersonalization Loss of hope, feeling of going through the motions

26 Characteristics and Stages Inner emptiness Compensatory acts such as overeating, excessive use of alcohol or sex mask feelings of emptiness Depression Characterized by exhaustion, hopelessness, indifference, and belief that life has no meaning Burnout syndrome Physical and emotional collapse

27 Stress is a storm

28 Burnout is a forest fire

29 Compassion fatigue is a wasteland

30 Have you ever felt? Punished by the wind and rain of the storm which is stress? Consumed by the wildfire that is burnout? Desolate from the bleakness of compassion fatigue?

31 We are Always on the Continuum Stress Burnout Compassion Fatigue Our obligation is to know where we are and take action to get ourselves into a better zone

32 Burnout Continuum Avoid Reduce Reverse

33 Strategies for Self-Care What are the daily steps that are fundamental to personal and professional resilience?

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35 Building Resilience Physical activity: minimum 30 minutes walking 5 or more days per week Nutrition: 5 8 servings fruits and veggies 1 serving = 2.8 oz (small banana, medium apple or small carrot) Avoid tobacco And tobacco exposure Avoid Alcohol Misuse Upper limits of low risk drinking: Men 4 drinks on any single day / 14 total in a week Women 3 drinks on any single day / 7 total in a week Get Adequate Restful Sleep Practice Healthy Thinking

36 Sleep is Not a Luxury, It s a Necessity 30% of adults don t get 7-9 hours of rest STROKE Sleeping less than 6 hours per night may increase the risk of suffering a stroke 4.5 times for middle aged otherwise healthy people (University of Alabama in Birmingham study). DIABETES Sleep deprivation affects the way the body processes insulin and increases the risk of becoming diabetic (University of Chicago study). OBESITY Sleep deprivation also has been shown to correlate with higher BMI. Very short sleepers are up to 50% more likely to be obese than people who sleep 7-8 hours. MEMORY Cognitive issues including the inability to form short-term memory in seniors is linked to sleep loss. Rest plays a crucial role in how the brain processes and stores memories, crucial for learning in people of all ages. All information from CDC

37 Sleep is Not a Luxury, It s a Necessity ALZHEIMER S Lack of sleep has been associated with increased beta-amyloid deposition in the brain, a key symptom of Alzheimer s disease (Johns Hopkins Bloomberg School of Public Health study). HEART DISEASE Heart disease risks increase significantly, with a 48% increased chance of experiencing a heart attack or heart issues among people who sleep less than 6 hours (European Heart Journal). HIGH BLOOD PRESSURE People sleep less than 6 hours per night are at increased risk for developing or worsening high blood pressure (Mayo Clinic). MORTALITY People with chronic short sleep of 6 hours or less have a greater chance of dying from all causes, as do adults who sleep over 9 hours. PUBLIC HEALTH HAZARD- Nearly 17% of fatal vehicular accidents are thought to be due to falling asleep while driving. All information from CDC

38 Sleep Tips from CDC Sleep Regular Hours Even on weekends Get Adequate Number of Hours 7-9 hours recommended Make Sure Your Bed is Comfortable Mattresses over 5-10 years old No Big Meals Before Bed Even mild discomfort interferes with sleep Get Daylight and Exercise Helps both quantity and quality of sleep

39 Sleep Tips from CDC Cut Caffeine Not just for senior citizens! Restrict late afternoon and evening use takes 5-6 hours to eliminate 50% of caffeine, 8-10 hours to eliminate 75% from your body Avoid Nightcaps Alcohol faster sleep but interferes with staying asleep No Screens (TV, laptops, smartphones) Within an hour of bedtime Avoid Napping Napping reduces quantity and quality of sleep

40 Healthy Thinking Evidenced based Easy habit to make Part of a healthy lifestyle

41 Negative self talk Subtle Prevalent Pervasive High achievers may be at risk

42 Building Healthy Thinking Skills Based on Cognitive Behavior Therapy Works for ALL ages, ALL roles, ALL levels of expertise Negative self talk is just a habit Can be learned and practiced Skill building: Awareness Practice Mutual support Personal action plan

43 Break Your Unhealthy Habit STOP: Negative Self Talk ASK: Is it Literally True? REPLACE: A Literally True Statement

44 Let s Practice Together

45 When healthy thinking replaces negative self talk Reduced stress Less irritation Reduced anxiety Less anger Less sadness

46 Impact of Negative Self Talk What we think has a major impact on how we feel Under stress we experience negative self talk Negative self talk is just a habit but it creates more stress

47 What do you say when you re stressed?

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50 Healthy Thinking Raise awareness Learn skills Practice skills to create a habit

51 Less Negative Self Talk

52 Let s PRACTICE Together

53 Your Action Planning Focus? Physical Activity: minimum 30 minutes walking Nutrition: 5 8 servings fruits and veggies Avoid Tobacco Avoid Alcohol Misuse Get Adequate Restful Sleep Practice Healthy Thinking

54 Choose kindness. Be kind to yourself. You can search throughout the entire universe for someone who is more deserving of your love and affection than you are yourself, and that person is not to be found anywhere. You, yourself, as much as anybody in the entire universe, deserve your love and affection. Buddha

55 Karen D. Lloyd, PhD, LP Thank You! Questions and Comments?