Being Your Best

Strategies to prevent burnout, manage fatigue, and maintain optimism in the face of adversity

Objectives

Explore internal responses to external factors that affect our ability to perform our jobs well

Learn ways to adapt to and manage internal and external factors in our lives

Learn strategies to support our peers in their efforts to adapt/manage stressors

What is Stress?

A specific response by the body to a stimulus that disturbs or interferes with the normal physiological equilibrium of an organism

Physical, mental, or emotional strain or tension

Stress is difficult for scientists to define because it is a subjective sensation associated with varied symptoms that differ for each of us

Stress Physiology

Fight or flight response triggered by epinephrine, norepinephrine, cortisol, and growth hormone Increased heart rate, blood pressure Vasoconstriction Increased respiratory rate Sodium retention Insulin resistance Hyperglycemia and on and on….

Signs of Job Stress

Apathy Negativism Low morale Boredom Anxiety Frustration Fatigue

Depression Alienation Anger Irritability Physical problems

Headaches GI problems

Absenteeism

How to Manage Stress

Increased stress increases productivity – up to a point, after which things rapidly deteriorate

That level also differs for each of us You can learn how to utilize and

transform stress so that it will make you more productive and less self-destructive

Stress Management

Keep your job in perspective Work to live, don’t live to work

Take time away from work Plan vacations and time away from work

Minimize clutter Take control of your space

Share your stress Talk to someone you trust

Stress Management

Or don’t share it Avoid sharing your stressors if it will only

add to the problem Know who your friends are

The Buddy System can be a lifesaver Use humor Have realistic expectations Stay positive; avoid negative attitudes

Can I manage my job stress?

You’re the only one who can manage your job stress!

Share your positive strategies with peers and managers

It’s up to you to make things happen, don’t allow things to happen to you

Speak up to be a problem solver

Strength Through Teamwork“Friends Don’t Let Friends Work Alone”

Keep your work patient focused Strong teams provide better patient care

Use your team/build your team Watch for signs of stress in team mates Offer help throughout the day Ask for help when you want it

Communicate! “Listen” to nonverbal cues Share your feelings of frustration before

they affect your work

Keep a Healthy Perspective

Remember why you chose your career You help others every day You are smart; you are talented You like the challenge of moving others

toward wellness You have the power to change lives Make your own life be what you want it

to be

Combating Stress with Exercise

Physiology: exercise helps remove the byproducts of the stress response

Regular exercise helps maintain homeostasis

Exercise is a socially acceptable means to release negative energy Anger, hostility are toxic Dump those emotions!

Benefits of Exercise

Moving meditation Repetitive motion that can alter the state of

consciousness Jogging, swimming, hiking, bicycling

Improved self esteem and self efficacy Muscle tension reduction Endorphins released after 20 minutes

Euphoria Analgesic

And That’s Not All!

Physical challenges keep work stress in perspective

Generally found to improve sleep Physical fitness leads to optimal organ

function Improved resiliency Quicker recovery

Which Exercise for Me?

Something you like Something non-competitive Three time per week at a minimum Something aerobic, something non-

aerobic Both have their virtues and benefits Cross train!

Sexual activity counts

What is Fatigue?

Weariness from bodily or mental exertion Temporary diminution of the irritability or

functioning of organs, tissues, or cells after excessive exertion or stimulation

That weighty feeling that makes it hard for you to make it through your shift

Costs of Fatigue

Significant nursing error rates occur with 12 hour or longer shifts Rogers, Whang, Scott, Aiken, Dinges, 2004

Sleep deficit may lead to: Decreased alertness Problems completing tasks Irritability Unsafe actions Unsafe decision making

National Sleep Foundation

Costs of Fatigue

100,000 motor vehicle accidents/year 1,500 deaths in the U.S. $18 billion annual loss in productivity in

the U.S. $12.5 billion per year in personal and

property loss

Who’s protecting our patients?!

Physiology of Fatigue

Fatigue: a physiological state related to sleep, sleep loss, circadian rhythm

Maximum sleepiness 3-5 am or pm

Studies show as little as 2 hours of sleep loss leads to: Decrease in alertness Worsened mood

Physiology of Fatigue

Sleep loss of just 2 hours can decrease performance Degraded judgment Degraded situation awareness Degraded decision making Decreased memory Slowed reaction time Decreased concentration Fixation

Contributing Factors to Fatigue

How long someone has been at a task How long someone has been awake Progression of effects of fatigue

Errors of omission Errors of commission Micro sleep

Periods of sleep lasting seconds to minutes

Results of Fatigue

Adults require 6-10 hours of sleep in a 24 hour period Jha, Bradford, and Bates, 2004

After 2 nights of missed sleep, cognitive performance can decrease 40%

Being awake for 24 hours is equivalent to a blood alcohol level of 0.1 %

Sleep deprivation brings risk to those around you

Combating Fatiguein Yourself

Schedule adequate time for sleep Put yourself to bed! Plan your breaks during the work day Avoid working longer than 12 hour shifts Avoid working longer than 40 hour

weeks

Combating Fatiguein My Workplace

Develop schedules that improve safety and quality of care

Develop schedules that promote adequate rest periods

Ensure staff breaks Avoid excessive workloads Encourage teamwork Build efficient work environments

What is Burnout?

Fatigue, frustration, or apathy resulting from prolonged stress, overwork, or intense activity

The result of unmanaged fatigue and stress

The result of unmanageable fatigue, stress, and workload

When you think about a job change

Burnout Prevention

Take care of yourself Eat well, exercise, sleep adequately

Take time out during your day to take deep breaths

Maintain adequate hydration Stretch your back muscles

“Close your spine” Fight fatigue; manage stress

Burnout Prevention

Use your EAP resources Call 214-648-5330 These services are free Consults are confidential This department is very helpful!

Talk to your manager You are valued Your manager wants to help you be your

best Our patients deserve the best

References

Tabone, “Nurse Fatigue: The Human Factor”,Texas Nursing, 2004

Dictionary.com Unabridged (v 1.1)Based on the Random House Unabridged Dictionary, © Random House, Inc. 2006

Alspach, Core Curriculum for Critical Care Nursing, 2006

Hansen, “Managing Job Stress” Quintessential Careers, 2007

Exercise as a Stress Management Modality, Optimal Health Concepts, 2007