Taking Care of Oneself: For Yourself, Your Fellows, and Your Programs
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Joint presentation by Christian Sinclair and David Giansiracusa at the 2007 AAHPM Fellowship Directors Conference in Chicago, IL
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Taking Care of Oneself: For Yourself, Your Fellows, and Your Programs
- 14. Workload Control Values Fairness Community Reward Work
- 53. “ I had never heard of caregiver burnout raised as a possible temporary insanity or diminished capacity defense, so it sort of caught my fascination a little bit and off we went exploring the idea. ” -David E. Kelley TV Writer/Producer
Notas del editor
- 2 nd bullet is worded oddly Detachment and Depersonalization Which Leads to Poor Patient Care
- WHAT CHARACTERIZES JOB ENGAGEMENT? Vigor: -energy and resilience -great effort in one’s job -not easily fatigue -persistence in face of difficulties Dedication: -strong involvement in one’s work -feelings of enthusiasm and significance -sense of pride and inspiration Absorption: -pleasure with total immersion in one’s work
- I. Exhaustion Experienced, but also Prompts action to distance oneself emotionally and cognitively from one’s work as a way to cope with work overload II. Cynicism/Depersonalization Coping mechanism to put distance between oneself and recipients of service-ignore qualities which make recipients unique and engaging people (cast them as impersonal objects) (Distancing occurs among people working in a wide range of organizational and occupational settings) III. Inefficacy/Reduced Sense of Personal Accomplishment May develop in parallel, rather than sequentially with exhaustion and depersonalization Contributor: Lack of relevant resources rather than work overload and social conflict (Institutional factor) Distinction Between Burnout and Depression Burnout only involves person’s relationship to his or her work Depression globally affects a person’s life (Maslach 1996)
- Item # 2 - time, role on health care team Item 4 - (“get the DNR’)
- Changed numbering/wording Resident Self-Reports of Suboptimal Care “ Discharged patients to make the service ‘manageable’ because the team was so busy.” “ I did not fully discuss treatment options or answer a patient’s questions.” “ I ordered restraints or medications for an agitated patient without evaluating him or her.” “ I did not perform a diagnostic test because of desire to discharge a patient.” (Shanafelt, AIM , 2002) Resident Self-Reports of Suboptimal Patient Care Attitudes Experienced “ I paid little attention to the social or personal impact of an illness on a patient.” “ I had little emotional reaction to the death of one of my patients.” “ I felt guilty about how I treated a patient from a humanitarian standpoint.” (Shanafelt. AIM , 2002)
- (Orientations-UC Berkeley and MSKCC) Bueraucratic fxns - (conflict with individualistic spirit and values)
- Workload (emotions inconsistent w/ feelings) Control (responsibility without capacity) Reward (lack of social-not appreciated) Community (unresolved conflict w/ others) Fairness (unfairness upsetting and exhausting; fuels cynicism) Values (in conflict with ones values) (Maslach and Leiter. The Truth About Burnout.)
- Complexities of Roles of Mismatches Not clear how much of a mismatch people are able to tolerate: May depend on: -Particular area -Pattern of other areas For example, with meaningful rewards, enjoyable working relationship with colleagues, feeling that work is appreciated, people may tolerate much greater workload (Maslach and Leiter. The Truth About Burnout)
- Item # 2 when family are not present, when patient not fully awake
- Enrich ourselves through relationships ∙ Family ∙ Friends ∙ Patients and their Families ∙ Colleagues ∙ Experience of others
- Frank Ostaseski: “Find quiet amongst the midst of things.”
- #2 - and new learning
- Enahnce our skill
- Commonweal: Institute for the Study of Health and Illness (ISHI) retreats with Rachel Naomi Remen Item 3 changed from: One way may be just looking differently at the work we do and the people we care for
- of Patients, Their Families, and our Colleagues
- Ask about emotional stamina Attend to your own neds/lossess Set appropriate goals Personal support system Who’s your mentor
- Ask about emotional stamina
- Ask about emotional stamina
- Cases are after this slide….make screen blank
- Preventative medicine