Resilience and Sustainable Work Practices by Dr Bronwyn Avard

Resilience & Sustainable work practices

Dr Bronwyn Avard

Life is supposed to be fun.

It’s not a job or occupation.

We’re here only once and we

should have a bit of a laugh.

Billy Connolly

• Burn-out & compassion fatigue

• Resilience

• Sustainable work practices

Psychological Distress in Australian Doctors

2013

“Mental health issues are

the single most pervasive

health issue affecting doctors”

Keeping your Grass Greener

Australian Medical Association

But the perceived stigma associated with the issue has limited our progress in addressing these issues

Most suffer in silence

Why are we at such high risk?

• Specific stressors

– Academic & clinical

• Workload

• Team environment with you always as the leader

• High stakes decisions (>108 per day)

• Ethical dilemmas

• Balancing teaching with clinical demands




– Life

• Personal events – relationship issues

• Time & energy demands – less time for health-promoting activities such as socialisation & exercise

• Lack of time for hobbies

• Sleep deprivation

• Financial




– Life

– Support & role models

• Competitive professional environment

• Boundaries with work colleagues

• Colleagues/seniors/mentors who are burnt out , stressed or depressed, modelling cynicism & unhealthy behaviours




– Life


– Conflict

• ICU is an environment where conflict is not uncommon

• Other staff, colleagues, executives, other teams




– Life


– Conflict

– Exposure to death & human suffering

• Lack of opportunities for debriefing

• Needing to “hold it together” and support the rest of the team

Beyond Blue

National Mental Health Survey of Doctors, 2013

“The question that faces the current generation is whether to be part of a constructive change to the future of medicine or

whether to allow history to repeat itself through a culture of denial and self neglect”

Craig Hassad

Preventing compassion fatigue

• Awareness

• Balance

• Connection

Saakvitne & Pearlman

Personal

AWARENESS

Self Reflection

BALANCE

Physical, Mental, Emotional

Hobbies, Laughter, Sleep

CONNECTION

Family, Friends

Professional

AWARENESS

Peer group support

e.g. Balant group

BALANCE

Alternating btn tasks & recovery; Time out from

complex work; Boundaries

CONNECTION

Debriefing

Time to “talk shop”

Organisational

AWARENESS

Safe working environment

Audits

BALANCE

Appropriate time for admin tasks & professional

development

CONNECTION

Productive teams

Networking, conferences

Personal

AWARENESS

Self Reflection

BALANCE

Physical, Mental, Emotional

Hobbies, Laughter, Sleep

CONNECTION

Family, Friends

Professional

AWARENESS

Peer group support

e.g. Balint group

BALANCE

Alternating btn tasks & recovery; Time out from

complex work; Boundaries

CONNECTION

Debriefing

Time to “talk shop”

Organisational

AWARENESS

Safe working environment

Audits

BALANCE

Appropriate time for admin tasks & professional

development

CONNECTION

Productive teams

Networking, conferences

• Be mindful of what is causing your stress

– We can get caught up in the work & just 'push on’ rather than trying to reduce our stress & workload

– But stress is just your perception of how much control you have over a situation

– Anxiety & stress come when it seems like you are not in control of everything you think you should be

Resilience

Characteristics of a Resilient Person

• What makes a resilient person?

• Why can one person “bounce back” from adversity when another cannot?

Characteristics of a Resilient

Person

Cognitive strategies and Problem Solving Skills

Social Competence and communication

Autonomy

Sense of Purpose

Protective Factors

• Factors which enhance one’s ability to remain resilient even when experiencing some of the risk factors

Protective Factors

Sense of belonging

Positive environment (feedback and encouragement)

Opportunities for success

Recognition of achievement

CREATING A RESILIENCE MAP

Resilience map

ME

Resilience map

• SELF CARE

ME

Self-care

Relax and sleep

Talk rationally to yourself

Get organized

Exercise

Reduce time urgency

Watch your habits

Talk to friends

Quiet time

Ask for help

Use support groups

Spoil yourself

Focus on the positives

Eat healthily

Resilience map

• WHY?

ME

Resilience map

• VALUES

ME

Resilience map

• BOUNDARIES

ME

Professional boundaries

• Often established by professional societies

• IC-5 : “Guidelines on the Health of Specialists and Trainees”

• IC-6 : “Guidelines for the relationship between fellows, trainees and the healthcare industry”

Personal boundaries

Helpful boundaries

Define what you may and may not do to or for others

Define what you will permit others to do to you or for you

Keeps you from being exploited and feeling resentment and other negative emotions

Protects you from someone else’s negative thinking or behaviour

Less helpful boundaries

Going against values or rights to please others

Allowing others to exploit or abuse you

Exploiting others

What is your role?

What are the implications if boundaries become blurred?

• For you?

• For others in your/ their life?

Resilience map

• SUPPORTS

ME

Involving your support network

Benefits include less load and responsibilities for you

Less emotional stress when you know someone is supporting you

Time for you and your own needs

Increased mental and physical health and wellbeing

IT ‘s GOOD FOR THE MOST IMPORTANT PERSON -

YOU!

AVAILABLE SUPPORTS

What is an Employee Assistance Program?

A benefit which is available to assist employees and their

immediate family members

to resolve personal or work-related difficulties, and to

promote wellbeing through professional counselling.

Key Features

of the EAP

It is a free, voluntaryservice

It is a strictly confidential service which includes:

• No names on reports and invoices

• All PPC Worldwide staff are bound by code of conduct, written consent is required to release information

• The EAP contract stipulates a high level of confidentiality

Short termcounselling/coaching

(face to face, telephone, on-line)

For all employees & your immediate

family

Personal Affirmation

Provides a quick way of re-focusing

Helps you maintain your boundaries

Taps into your personal motivation

Focuses on what you are achieving

Eg. “I am responsible for providing assistance, it is up to the individual what they do with that.”

Resilience exercise

PHYSICAL MENTAL

MOOD SOCIAL

SUSTAINING YOUR CAREER

Individual- Mindfulness - Stress management - Small group discussions

Organisational- Acknowledge prob- Improve efficiency & reduce clerical work - Cultivate sense of community at work - flexibility & work-life balance - align to stated values & mission

• Regular re-prioritisation

– Annual reflection on values, resilience mapping, priorities etc

– Diary management/time management including regular breaks

• E.g. lunch time walks

• Regular long breaks from the workforce

– Many of us are staff specialists and often have the opportunity to do this

– In some Enterprise agreements, there are clauses about purchased leave

?consider negotiating purchasing an extra 4 weeks of leave each year & take 3-6 months off every 4-5 years

• Start the conversation….

– Talk with your seniors

– Talk with your peers

– Talk with your juniors

Lets change this for the future Intensivists!

To my future self….

What to stop?

What to adopt/start?

What to keep doing?

Resilience and Sustainable Work Practices by Dr Bronwyn Avard

Health & Medicine

Transcript of Resilience and Sustainable Work Practices by Dr Bronwyn Avard