Practical Optimism

Still thriving despite a long career in Medicine

David Galler

Intensive Care Specialist, Middlemore Hospital.

Clinical Lead Ko Awatea

dgaller@middlemore.co.nz @gauloir

Apacforum.com

My way

• Just surviving or a willful and optimistic engagement in Life and Work

• Off piste activities that have kept me going including:

1. Personal Wellbeing and environmental health

2. Samoa

3. The Medicine Stories project and more

Burnout

A feeling of being overwhelmed; constantly drained

Always feels like you’re cheating somebody

Demand for our time is increasing and exceeding our capacity your employer family your team yourself

“I just felt that no matter what I was doing, I was always getting pulled somewhere else,”

“It seemed like I was always cheating someone — my company, my family, myself. I couldn’t truly focus on anything.

”Work, emails, pressure, long lists that never go away, always distracted, mindlessness, sleep difficulties, feeling

overwhelmed.

Plays out more at work than home

Maaori Whakatauki

He aha te mea nui o te ao

What is the most important thing in the world?

He tangata, he tangata, he tangata

It is the people, it is the people, it is the people

The other side of the coin

A willful engagement

Workers are human beings – interesting, fallible, vulnerable, endearing, loveable …

1. To have something to look forward to

2. To have someone /some thing to love

3. To feel valued

Message to Managers and Team Leaders The way people feel at work profoundly influences how

they perform.

Employees are happy and productive when their core needs are met

1. Physical, through opportunities to regularly renew and recharge at work;

2. Emotional, by feeling valued and appreciated for their contributions;

3. Mental, when they have the opportunity to focus in an absorbed way on their most important tasks and define when and where they get their work done;

4. Spiritual, by doing more of what they do best and enjoy most, and by feeling connected to a higher purpose at work.

We live forward, but we understand

backwards.

Learning - The deep truths Maaori, Pasifica, First Nations,

Aztec, Inca, Khymer

The things that bind us to each other and to our environment.

The higher purpose to which health services contribute and allow us to see the world in a different light and to work with the forces of

nature not against them

Te Whare Tapa Wha

Sources of enduring optimism

1. Environmental sustainability Regeneration

2. Getting out of your comfort zone

3. Story telling

www.orataiao.org.nz/

Regeneration What’s good for health is good for the envrinment and vice versa

• Certified Emission Management and Reduction Scheme - CEMARS

• Range of waste reduction activities

• Energy reduction strategies

• Supply chain/procurement involvement:

Middlemore Coffee Project

• Establishing green teams/clinical champions

• Increased use/tracking of video conferencing

• Nitrous oxide/Desflurane and Sevoflurane

• Procurement and life cycle assessment of medical devices

• Promoting public transport/active travel

Despite increasing demand and activity. Looks like 23% reduction by 2017

Tonnes carbon dioxide equivalent (tCO2e) for five reporting periods across MMH and MSC Year 1 (2011/12), Year 2 (2012/13), Year 3 (2013/14), Year 4 (2014/15), Year 5 (2015/16)

2011/2012 2012/2013 2013/2014 2014/2015 2015/2016

Total carbon emissions 19,660 18,491 17,761 16,817 15,888

Certified Emissions Measurement and Reduction Scheme

Food Waste to Plate – Environmental Regeneration

• Approximately 237 tonnes of food waste is transported to landfill each year, from Counties Manukau Health.

616.85kg of carbon emissions per year

$150/tonne in collection and disposal costs paid by Counties

Manukau Health

Our plan

CMH will compost food and other organic waste in worm farms tended by inmates from WIRI PRISON

The compost and liquid fertiliser to grow seasonal vegetables.

Real hope for the future

TE HAU - A MEDICAL HUMANITIES PROGRAMME

Themedicinestoriesproject.co.nz

To see another helps us to see our self.

To see our self helps us to see another.

The state of the world …….

• Putin, Trump and the European far right of Le Pen, Wilders, Netanyahu

• Those that ban selected media outlets, accuse the mainstream media of telling lies.

• There are so many pressure points that could easily lead to an even greater conflict that will consume more and more of us, and our planet.

So, how should decent people act? What should we do?

A commitment to truth, to dissent and to each other

• To truth, because the ideal subject of the slide down to totalitarian rule is not the convinced nazi or dedicated communist, it is the ordinary person for whom the distinction between true and false, fact and fiction no longer exists or as President Obama said recently: “This practice of selectively sorting our facts is ultimately self defeating and more perilous to our democracy than any bomb.”

• To dissent because as annoying as it can be to those who pull the purse strings or hold the power, dissent can be the highest form of Loyalty and indeed for a nation, the engine room of a healthy democracy.

To each other Pastor Martin Neilmoller

First they came for the Socialists, and I did not speak

out—Because I was not a Socialist.

Then they came for the Trade Unionists, and I did not speak out— Because I was not a Trade Unionist.

Then they came for the Jews, and I did not speak out— Because I was not a Jew.

Then they came for me—and there was no one left to speak for me.

Regenerative Practice on show Apac 2017