Achieving Your Better Self:A Proactive Approach to Minimize

Stress & Burnout

Presented by: Dr. Robert Figlerski, Director of Behavioral Health ServicesTeam Health, Inc., New York RegionOffice: 914-949-1199email: rfiglerski@ipc-hub.com

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Caregiver Burnout

Compassion Fatigue

Empathy Exhaustion

Stressed Out

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Physiological, Psychological, Personal & Interpersonal Factors

Contributing to Burnout

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Evolved Brain

Exec &

Social

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It All Starts Here

Structure of a typical neuron

Soma

Dendrites

Axon

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Evolutionary Integration of Brain Function

IPC, Healthcare

Brainstem(Reptilian Brain)

Limbic System

(Mammalian Brain)

Brain Structure

Evolved versus Primitive Brain

Stress Hormone... fright, flight, or fright

Survival instinct shapes perceptions and exaggerated threats…suppresses our “Better Angels”

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Adaptation/Evolution

Parasympathetic… “rest & digest”

Sympathetic… stimulating activities.. “Fright or Flight”

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The Stress EffectNegative Emotions

Heart RateBlood PressureHigher Blood SugarImmune SuppressionAdrenaline and Cortisol

Recovery period (adaptation) bring you back to a baseline state… positive emotions help manage reoccurrence of stress states

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Formulas of Adaptation

(Stress/Adaption) + Recovery = Growth

(Stress x Maladaptive Response) + Reoccurring Stressors = Burnout

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Successful Adaptation

Courage to be yourself...vulnerability is not weakness

Have honest communications

Deal with unpleasant situations quickly and directly

Courage to say “No” and sometimes “Yes”

Courage to trust

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Strategies That Fail

Denial and Avoidance

Substance Use

Anger/Rigidity

Working harder…not smarter

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Effectively Dealing With Stress/Burnout

Save a Career

Save a Family

Save a Life

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Common Risk Factors in theSkilled Nursing Environment

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Contributions to Burnout Compensation seen as unfair

Unreasonable work hours

Too much overtime & after hour work demands

Employee role poorly linked to corporate strategy

Negative workplace atmosphere

Technology insufficient* McKnight's Senior Living (Lois Bowers, 3/6/2017)

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Nursing Home Environment

Tends to Demand ReactionsMore Than Thought…The Work Environment

To Often Tells Us We Are Not GoodEnough…Sets Up for a Never Ending

Battle of Proving We Are!

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Characteristics of a Stressful Facility

Failure to Recognize SuccessBlaming Rather than TrainingPunishment versus RewardAbdication versus DelegationFire of the Day ManagementFrozen in PlacePoor Communication..Management by Surprise

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The Goal

Accurate Self-Assessment of Our Performance

Minimize Our Distortions Shaped by Reactivity

Teach Our Selves to Strive for Competence…not Perfection

Set your own measures of success

Resist internalizing unfair criticism or negative assessments

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Strategies To Be Your Own

Best Coach

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Psychology

• Historically dominated by its focus on mental illness, not much focus on being satisfied with life or happy.

• Took for granted that “normal” is a natural occurring process when the right variables are present. Abnormal was a result “off course”.

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Positive Psychology

That being happy and living a full life is an active process that embraces a set of beliefs, values, and behaviors which

counter negative emotions and stress

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Self-Determination Theory Need to feel capable/competent

Need to feel authentic in life

Need to feel connected to others

*Tribe: On Homecoming and Belonging,Sebastian Junger, Hachette Book Group, 2016

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Overview of Positive Psychology

• Pleasant Life (enjoyment)How people enjoy relationships, hobbies, interests, entertainment, etc…

• Good Life ( engagement)Looks at the beneficial effects of immersion, absorption, and flow individuals feel when optimally engaged in activities they value

• Meaningful Life (affiliation)

How people derive a sense of well being, belonging, meaning, and purpose from being part of and contributing back to something bigger than themselves (social groups, organizations, traditions, etc.)

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Seligman’s Well-Being Theory: PERMA

Positive Emotions

Engagement

Relationships

Meaning

Accomplishment

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Character, Strength , and Virtues Handbook

• Wisdom & Knowledge

• Courage

• Humanity

• Justice

• Temperance

• Transcendence

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Wisdom and Knowledge

• Creativity

• Curiosity

• Open-mindedness

• Love of Learning

• Perspective

• Innovation

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Courage• Bravery

• Persistence

• Integrity

• Vitality

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Humanity

• Love

• Kindness

• Social intelligence

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Justice

• Citizenship

• Fairness

• Leadership

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Temperance• Forgiveness

• Mercy

• Humility

• Prudence

• Self-control

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Transcendence

Appreciation of Beauty & Excellence

Gratitude

Hope

Humor

Spirituality

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The Results of the Gratitude Visit

People who were identified as being clinically depressed showed an improvement in mood to the degree they were measured as non-depressed following their Gratitude Visit.

This effect lasted for 4 to 6 weeks before they returned to a depressed state.

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INTERPERSONAL STRATEGIES

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Goals to Aspire to & Habits to Develop Implement a personal strategy of kindness and resist

negativity

Don’t tolerate individual or group interactions which demean others

See the best in people and help left them to a higher level of performance ... Are you mentoring someone?

Accept without judgment

Forgive more…don’t hold grudges

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Interpersonal Habits

Direct and Honest Communication

Implement Consequences in a Fair Manner

Accept you do not have control of other’s reactions to consequences

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Personal Strategies

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Make a Habit of Personal Care

Sleep

Exercise

Nutrition

Relationships

Personal Growth

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Proactive Strategies

Put yourself in new situations and seek beauty and meaning

Reflect on your life and seek a more ideal self

Practice gratitude

Keep in mind the Big Picture, don’t dwell on small struggles

Work to maintain a compassionate heart

Analyze your self-defeating thoughts and habits

Remember not every situation requires an opinion or a response

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Habits to Develop With Patients

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Proactive Strategies

Define your role in their life and don’t exaggerate your importance

Work smart and hard, but invite others to join you

Train yourself to remain positive or neutral no matter what the patient presents

Keep focused on care routine, care planning, and team work

Refuse to participate in contaminating the care environment

Accept that the patient’s suffering and anger may be beyond your control to remedy

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Big Picture…The Really Big Picture!!!

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Our Sun

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Summary

Humans are more rare than galaxies

Because the Universe is so empty of life, live is very precious and it follows that how we choose to live our day and treat others is an incredibly unique and rare moment.

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Summary & Questions

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