D A N D O H E R T Y R N , M S N , C E N

HOW TO OUTSMART YOUR NEGATIVE BRAIN

Christiana Care Health Systems

Disclosure Statement

• Faculty/Presenters/Authors/Content Reviewers/Planners disclose no conflict of interest relative to this educational activity

Successful Completion

• To successfully complete this course, participants must attend the entire event and complete/submit the evaluation at the end of the session.

• Society of Trauma Nurses is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

LEARNING OBJECTIVES

• Identify how stress can cause the brain’s negative bias

• Discover the negative outcomes of utilizing “reactive” coping strategies

• Develop initial strategies to overcome the stressful effects of working in emergency nursing

• Apply strategies to separate work from home • Modify their thoughts process to outsmart their

negative brain

COST TO THE BRAIN

• Burnout

• Compassion fatigue

• Vicarious trauma

BURNOUT

•

COMPASSION FATIGUE

VICARIOUS TRAUMA

• Not PTSD

Affects not just us

THE BIG ISSUE

• Lack of control and uncertainty

• Do not know the beginning or often do not see the end (fragmented care)

WHAT HAPPENED HERE ?

ANSWER

It’s not my journey

OUR 1ST INEFFECTIVE STRATEGY

Withdrawal/Detach

• Brain upset

• No one will listen• Where do your stories go• Sliming colleagues

OUR CONFUSION

• Compassion• Seeing someone suffering and wanting to

help• Empathy

• Seeing someone suffering, taking on part of that suffering and wanting to help

OUR 2ND FAVORITEINEFFECTIVE STRATEGY

What do you do in your free time?

Idle brain/negative

brain

12 minutes

Missed opportunity

Fake fun vs. Trick the brain

EFFECTIVE STRATEGIES

• Tracking & monitoring all the external trauma exposure you are unconsciously absorbing

• Use low impact debriefing (give warning)

• Practice engaging with others--try to refocus and also monitor where your thoughts wander off to (spend more than 12 min)

• Trick the brain into having fun

• Try to keep in mind the definition of compassion

• It’s not my journey

• Don’t veg out but if you do recognize the negative thoughts

SIGNS/SYMPTOMS

Physical PsychologicalExhaustion (tired vs. depleted) ExhaustionInsomnia DistancingHeadache Reduced sympathy & empathySusceptibility to illness Cynicism & embitterment

ResentmentAnxiety/irrational fearsDepersonalizationIntrusive imagesLoss of hopeDifficulty separating work from personal lifeFailure to nurture and develop non-work related aspects

Behavioral Drugs & alcoholAbsenteeism/presenteeismAnger/irritabilityExaggerated sense of responsibility (I can’t let people down, I can’t leave, people are counting on me)Avoidance behaviorsImpaired decision makingForgetfulnessInterpersonal relationshipsNegative self- image (feeling unskilled at this job, whether you are good at this job)

• Feeling depleted

• Negative self image

• Intrusive images/thoughts

• Difficulty separating work from personal life

HOW GOOD WAS YOU DAY?

147 83 49

20 60 17 19

24 19 14 0

LAZY BRAIN

• Over generalizes

• Can’t multi-task (which is good news)

NOSEY BRAIN

EFFECTIVE STRATEGIES

• Giving your compassionate voice some air time• Have a symbolic transition ritual that you are no

longer a nurse• Don’t allow the negative/dead people into your

home • Do something selfish for your self• Choose not to have an opinion• As you drive home remind yourself of three things

you did to make someone feel better• Take 20 seconds to let that positive experience

register in your brain

HAPPY HORMONE-DOPAMINE50%/10%/40%

HAPPY HORMONE-SEROTONIN

THE PROBLEM

Adrenaline and Cortisol

(Half-life)

THE PROBLEM

I feel here

I think here

I thinkhere

I feelhere

Brain wants to know 2 things

Limbic System want to know 3 things

Meditation

5 things see, hear & feel

Breath in & out 30 seconds

Mindfulness

EFFECTIVE STRATEGIES

• 5 thing you see, hear feel

• Breath in and out for 30 seconds

• Be compliant vs. non-compliant with your self-care

• 95% of our reactions are automatic (don’t always act on what the limbic system says; listen a bit more to the pre-frontal lobe professor...no one is wanting to eat you

• You don’t have to like everyone or fake being happy or nice to rude people/pts…all you have to do is be pleasant and efficient

• Be like Mandy---play a lot!

• Dopamine (something to look forward to every 8 weeks, accomplish a goal), oxytocin (connect with people, touch someone), endorphins (exercise) and give someone some serotonin,

QUESTIONS?