from sick care to health care-leadership does matter
TRANSCRIPT
From Sick Care to Health Care
Resistance Recovery
Resilience
John Robertson -FORTLOG Services -not for public use without written permission
Coming together is a beginning;
keeping together is progress;
working together is success.
Henry Ford
It matters what leaders do, or don’t do
Gruenter & Whitaker
What is Stress?
"The nonspecific response of the body to any demand made upon it" (Selye)
"Demands on the person which tax or exceed his/her adjustive resources" (Lazarus)
"A particular relationship between the person and the environment that is appraised by the person as taxing or exceeding his/her resources and endangering his/her well-being"
John Robertson -FORTLOG Services -not for public use without written permission
EUSTRESS vs. DISTRESS
Two intensity levels of stress: EUSTRESS & DISTRESS
Eustress = Positive, motivating stress
Distress = Excessive, debilitating stress
John Robertson -FORTLOG Services -not for public use without written permission
TWO TYPES OF DISTRESS
Cumulative Stress (“Burnout”)
• slow erosion of functioning
• cynicism
• incomplete work
• lateness
• impulsive need for change
• chronic physical illness
“Critical Incident”
(Traumatic)
• normal coping overwhelmed
• adaptive functioning interrupted
• symptoms of posttraumatic distress evident
DEFINITIONS
CRITICAL INCIDENTS are unusually
challenging events that have the potential to
create significant human DISTRESS and
can overwhelm one’s usual coping
mechanisms.
John Robertson -FORTLOG Services -not
for public use without written permission
Culture and Norms why crisis intervention causes a response
Beliefs, Thinking, Values, Feeling
Doing
Laws and customs; Rituals; language; ways of life; Techniques; methods
NB – conscious, easily changed, explicitly learned, objective knowledge
Visible
Norms; roles; beliefs; philosophy
Values, attitudes; tastes; desires;
assumptions; expectations; myths
Invisible
NB – unconscious, difficult to change, implicitly learned, subjective knowledge
What kind of leader are we? From Peter Urs Bender Leadership from Within
The leader-from-without
• Says one thing, does another
• Leads through fear and control
• Sees separate interests
• Tries to hold on to power
• Wants things done his/her way
• Tells others what to do
• Sets unrealistic deadlines
• Is externally motivated – money, power, fame
• Is driven by fears and pressure
• Disregards/ puts down feelings
The Leader-from-within
• Walks the talk
• Leads with trust & by example
• Sees shared interests
• Shares power; empowers others
• Encourages personal initiative
• Invites ideas and feedback
• Sets reasonable deadlines
• Is internally motivated – values & principles
• Seeks satisfaction, well-being
• Sees caring / feelings as essential
John Robertson -FORTLOG Services -not for public use without written permission
Developing the Leader within you The Position Myth
POSITION
PERMISSION
PRODUCTION
PEOPLE
DEVELOPMENT
PERSONHOOD
Role
Results
Relationship
Reproduction
Respect
John Robertson -FORTLOG Services -not for public use without written permission
AUTHENTICITY – AVAILABILITY, ACCESSIBILITY –Character -winsome – MENTOR – from both leaders and to others
To live one’s life in such a way that we would be willing to sell our
parrot to the town gossip
COMMITMENT - PLAN 4 Values, an equipper a candle loses nothing by lighting another
ENTHUSIASM - Passion -vision, Inspiring –caught not taught SHEPHERD – ones that show the way because they go the way [not
a rancher who drives the animals!]
SERVICE = SERVANTS = SERVANTHOOD – disciplined
in one’s time/talent/treasures, proactive – It would be my pleasure vs. Its not my job
Defining Leadership ACES
John Robertson -FORTLOG Services -not for public use without written permission
Healthy Human
–aka resilience
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A + B + C = D [for Resilience] Attitudes + Beliefs + Connections = Definition of new Norm
Attitudes;
• Physical
• Emotional – Emotional regulation
– Delay gratification
– Realistic high self-esteem
– Creativity, sense of humour
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Beliefs;
• Cognitive – high EQ
– speaking and reading skill
– capacity to plan
– problem solving ability
• Spiritual
– Faith that one’s life matters
– Seeing meaning in life, even pain and suffering
– Sense of connection with humanity
John Robertson -FORTLOG Services -not for public use without written permission
Connections;
• Social/relational – Secure attachment
– Basic trust
– Ability to recruit others for help & support
– Positive peer relations [address toxic types]
• Moral
– Ability and opportunity to contribute to others
– Engage in socially and/or economically useful tasks
John Robertson -FORTLOG Services -not for public use without written permission
Note: Positive Definition +
Achilles' heel issues
Positive definition
• Positive [not against this/that; don’t like this/that…]
• In our control –
• Environment – thinking about the impact of doing what is of
value, priority – how will affect family, work, friends…
• SMART Goals/Objectives
Achilles Heels
• DIY approach is preferred
• Individual expectation of self is out of kilter with
their individual capacity
• Beliefs not integrated wholly – [head to heart] John Robertson -FORTLOG Services -not for
public use without written permission
Coping – Self, Peer and Family care
• See handouts
• Pre-incident preparation
• During incident intervention
• Post incident support & follow through
John Robertson -FORTLOG Services -not for public use without written permission
CRISIS INTERVENTION
• An active, short - term, supportive, helping
process.
• Acute intervention designed to mitigate the crisis
response.
• Not psychotherapy or a substitute for
psychotherapy
Goals:
1. Stabilization
2. Symptom reduction
3. Return to adaptive functioning, or
4. Facilitation of access to continued care
(adapted from Caplan, 1964, Preventive Psychiatry) John Robertson -FORTLOG Services -not
for public use without written permission
Critical Incident Stress (CIS)
is also known as
“Post Traumatic Stress,”
which is not the same as PTSD.
CIS is a normal response
of normal people to
an abnormal event
John Robertson -FORTLOG Services -not
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PTSD
A. Traumatic event
B. Intrusive memories
C. Avoidance, numbing, depression
D. Stress arousal
E. SX > 30 days
F. Impairment
John Robertson -FORTLOG Services -not
for public use without written permission
Elements of CISM (Everly & Mitchell, 1999)
• Pre-incident education, preparation
• Demobilizations (large groups of public safety)
• Crisis Management Briefings (large groups primary,
secondary, or tertiary victims)
• Defusings (small groups)
• Critical Incident Stress Debriefing (CISD; small
groups)
• One-on-one crisis intervention
• Family CISM
• Organizational intervention / consultation
• PASTORAL CRISIS INTERVENTION
• Follow-up and referral John Robertson -FORTLOG Services -not
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SIGNS AND SYMPTOMS OF DISTRESS
I. COGNITIVE (Thinking)
II. EMOTIONAL
III. BEHAVIORAL
IV. PHYSICAL
V. SPIRITUAL
John Robertson -FORTLOG Services -not
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Terminology
• Resistance
• Resilience
• Recovery
• Stress
– Eustress
– Cumulative
– Critical incident
– Distress
• leadership
• Compassion
– Fatigue
– Satisfaction
• Vicarious Stress
• Burnout
• Support Network
– Family
– Peers
– Friends