Keep Calm to acknowledge the stresses of clinical work to
recognise the impact clinician stress has on patients and
colleagues to look at quick and simple ways to manage our own
stress and increase our resilience to set ourselves goals to take
care of ourselves Keep Calm
Slide 4
What happens in Keep Calm? Awareness all about stress and
resilience Moan zone 5 part check up and new skills Action plan set
goals and change practice Keep Calm
Slide 5
To each one of you the practice of medicine will be very much
as you make it- to one a worry, a care, a perpetual annoyance; to
another a daily joy and a life of as much happiness and usefulness
as well fall to the lot of Man In no relationship is the Physician
more often derelict than in his duty to himself Sir William Osler
(1849-1919) Keep Calm
Slide 6
Doctors low morale BMJ news Sept 2014 Rapid pace of change -
life and medicine Radical changes to how care is given Changing and
challenging employment market Increasing public scrutiny of care
Revalidation Training changes Challenging work environment Second
victim issues Recognition of resilience skills as important Keep
Calm
Slide 7
Patient safety the human factors Stress is associated with
every high intensity people service job and its environment Action
can be taken to reduce specific stress factors if we can identify
them for the organisation and the individual How can we care and be
compassionate if we are stressed and burnt out? Keep Calm
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Burnout Loss of enthusiasm for work Cynicism Low sense of
personal achievement Keep Calm
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Your stress curve Stress Keep Calm
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Slide 11
Stress and Burnout Fatigue Sleep disturbance Health impact:
high BP, immune compromise, weight changes Irritability and poor
communication Interpersonal problems Self medicating - smoking,
drink, drugs etc Low mood, anxiety, depression Academic or clinical
dishonesty Keep Calm
Slide 12
Doctors bad habits Medical school Alcohol consumption
Socialization and exercise decrease. Stress increases, depression
and isolation increases. Clinical environment has low tolerance for
fallibility Maladaptive behaviors form easily. Going in when sick,
self-prescribing Guilt and perfectionism, thinking errors,
emotional burden Poor Habits - junk food, drinking, poor sleep
hygiene Keep Calm
Slide 13
Why start at Foundation? Massive transition in every part of
life Maximum perceived lack of control A chance to set up good
habits for a career To try to prevent burnout and disillusion Keep
Calm
Slide 14
Transition cycle - Williams 1999
Slide 15
The Moan Zone Having a moan may feel therapeutic but actually
it can wind you up or grind you down. However, it sometimes helps
to share your problems Keep Calm
Slide 16
In Groups: Safety/Chatham house rules Groups of 3/4 Stressors
and sources of stress Groups to come up with themes Back to whole
group for discussion of themes What stresses you? Keep Calm
Slide 17
Were these on your list? Technology at work Lack of time
Personality type Lack of control over situation Your
experience/lack of Patients stressed Other doctors stress Demands
of other staff Clash of values Cyberlife Family expectations and
responsibilities Finances Keep Calm
Slide 18
Resilience is. Mental toughness Psychological hardiness Coping
mechanisms BuoyancyInvulnerability
Slide 19
How resilient are you?
Slide 20
Slide 21
Take the quiz
Slide 22
Are you at risk Are there things about you that put you at risk
in relation to the stresses you will encounter as a doctor what
have you considered? Personality Family background work/life
balance Emotional Intelligence Locus of control
Slide 23
Developing internal Resources Good coping and problem solving
skills Good social support systems where pastoral as well as health
care is acknowledged Personal Attributes Internal locus of control
Pro-social behaviour Empathy, positive self image, optimistic view
& ability to organise Daily responsibilities enable individuals
to build supportive relationships with team, clients, patients and
home
Slide 24
COPERS C - choices, we cant control events but we can choose
how to react and have our own plan O - Others, friends family and
services can all help P - Proactive deal with small stuff, dont let
it get big E - Environment be sensitive to yours internal and
external R - Reflect check on your self, review how you are doing S
- Structure everyone needs some to function, what is yours
like
Slide 25
RECOVERY Wellness recovery action plan. R release your
potential E Engage with relevent services if necessary C
communicate and express yourself O take ownership of your health V
aVoid vagueness - set specific goals E evaluate your strategies R
Remember your strengths Y Your Journey, Your health, Your
future
Slide 26
Can you become more resilient? Keep Calm
Slide 27
Five systems: model for self care BodyMind Behaviour
Environment Spirit Keep Calm
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5 Star Stress Checklist Body Mind Environment Behaviour Spirit
Keep Calm
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MindSpirit EnvironmentBehaviour Keep Calm
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Your body Awareness of your physical wellbeing What goes in and
why? Stress-busting activity Rest Relaxation Keep Calm
Slide 31
Slide 32
Take the Body quiz Keep Calm
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Body Spirit EnvironmentBehaviour Keep Calm
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Your Mind Awareness of your state of mind Knowing yourself and
how to look after YOU Positive mental attitude Healthy thinking
habits Keep Calm
Slide 35
What are you like? Locus of control questionnaire Keep
Calm
Slide 36
So, which are you? If you tended towards (a) each time You have
a higher INTERNAL locus of control If you tended towards (b) each
time You have a higher EXTERNAL locus of control Keep Calm
Slide 37
Enjoyment Interest Self Esteem Sense of achievement Desire to
win InternalExternal DRIVERS Salary/bonuses Job security
Approval/praise/pleasing others Promotion A prize
Slide 38
Positive Mental Attitude Dont over think things Think and speak
positively Surround yourself with positive people Look forward Let
go of past grudges Be grateful Love yourself Keep Calm
Slide 39
Toxic thinking cognitive distortions All or nothing thinking.
Everything is all good, or all bad. No grey areas
Overgeneralization. One bad thing happens, the world is ending
Disqualifying the positive. You cant accept anything positive ever
happening Mental filter. You filter out all good qualities so you
can focus on the negative Jumping to conclusions. You interpret
everything in a negatively with no evidence Catastrophising or
minimization. You blow minor things out of proportion Emotional
reasoning. If you feel bad, everything is bad. Should statements.
You try and mold the world to your vision of reality. Labeling and
mislabeling. You believe the overgeneralizations and make them
reality in your own mind. Personalisation. You take things
personally. You become very defensive at even the slightest
perceived criticism. Keep Calm
Slide 40
Reframing thoughts SituationFeelingsThoughts /Beliefs
Challenges and Alternatives Action What happened or is happening
How do you feel about this? Why do you feel like that? What
thoughts are making you feel the way you do? How rational are your
thoughts and beliefs? Are there any thinking errors? Is there
another way to think about this? What is your best course of
action? Keep Calm
Slide 41
Your mind Keep Calm
Slide 42
Mindfulness moments Keep Calm Stay Safe
Slide 43
Take the Mind Quiz Keep Calm
Slide 44
Mind Body Spirit Environment Keep Calm
Slide 45
Your behaviour Awareness of your own behaviour Being proactive
spotting tricky situations Practicing people skills Managing
pressure Forming healthy habits Keep Calm
Slide 46
Parent Adult Child Nurturing parentControlling parent Adaptive
childNatural child Lets try this. Yipee No, please Do this...Stop
that Its OK . Keep Calm
Slide 47
Which mode are you in? Keep Calm
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CAN YOU STAY IN ADULT AT WORK? Keep Calm
Slide 49
SBAR
Slide 50
Whatever the situation Lose the emotion - it is not helpful
Think about your own feelings and their impact on your behaviour
What impact are you having on your colleague The only person's
behaviour you can change is your own Keep Calm
Slide 51
Take the Behaviour quiz Keep Calm
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Mind Body Spirit Behaviour Keep Calm
Slide 53
The Environment How does your environment affect you? Notice
the world around you Creating calm around you Home and work
environment Leisure and pleasure - your choice Friends and family -
your network of support Keep Calm
Slide 54
Take the Environment quiz Keep Calm
Slide 55
5 Star Safety Mind Body EnvironmentBehaviour Keep Calm
Slide 56
Your Spirit Are you comfortable with who you are Core values
know yourself Life purpose Random acts of kindness Are you part of
something bigger Happiness habits and gratitude Keep Calm
Slide 57
Carneys moral compass What do I believe in so much I will take
a stand on What are my skills and energies and leadership traits
What does my perfect world look like How do I want to contribute to
it What brings me joy What will make me feel free and healthy What
do I want to learn What is my unique calling purpose 5 years on
what will I be proudest of What is on my bucket list Keep Calm
Slide 58
Well-being exercise Write down 3 things that went well in last
day Why were they positive? Discuss with partner Keep Calm
Slide 59
How happy are you? Oxford Happiness Questionnaire Keep
Calm
Slide 60
Take the Spirit quiz Keep Calm
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Mind Body Spirit EnvironmentBehaviour Keep Calm
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Take some time now to make an action plan for YOU Keep
Calm
Slide 63
Set your own goals One SMART goal for each of the 5 Star Safety
areas S - specific M- measurable A - attainable R - relevant T -
time bound Keep Calm
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Summary Stress awareness 5 check points Practice Keep Calm
Slide 65
No time prescription for health Physical: the 7 minute exercise
regimen Cognitive : 5 min mindfulness technique Happiness: 3 things
you are proud of achieving today Random act of kindness Do
something unusual: clean teeth with other hand Learn a new skill
Purpose Keep Calm
Slide 66
MindSpirit EnvironmentBehaviour Keep Calm Body Keep Calm
