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Resistance, Resilience and Recovery

Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

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Page 1: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Resistance, Resilience

and

Recovery

Page 2: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

WithHUGEthanksanddeepadmira3onforRoddyMcNidderHansHartungDavidReillyIvanRobertson

Acknowledgements

Page 3: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

AYRSHIRE AND ARRAN

Page 4: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

DOC

Job Planning

Occ Health

VBRP

BMA/MDU

Staff Care

Medical

Peer Support

Mediation

CISM

Page 5: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

ThecultureinmedicineTrained to never make mistakes predisposed to be

perfectionists and ……..

Perfectionism is a

vulnerability factor for

− depression

− anxiety

− burnout

− suicide

OreskovichM.AndersonJ.Physicianpersonali3esandburnout.2013

Page 6: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Health“A state of complete physical mental and

social wellbeing and not merely the absence of disease (WHO) or

“A child born in the year 2000

has a good chance of not dying at all”

Jaques Bergier, 1968

Chemical Engineer, Writer, spy, member of French Resistance

Page 7: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Stress

Threeintensitylevels:

Eustress=Posi3ve,mo3va3ngstress

Distress=Excessivestress

Dysfunc3on=Impairment

Page 8: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

SIXSTAGESOFBURNOUT

! simplybeing9red! exhaus9oncon9nuesintoanotherday! plas9csmileandabiCerfeelinginyourheart!  temperseemsshorterthanusual(hometoo)! emptyinside,seemtohaveforgoCenwhyyoudowhatyoudo

! youreyesdon’tsparkle,ever!dowhatyouhavealwaysdonesimplybecauseyouhavealwaysdoneit.

Michael Scott Karpovich

Page 9: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Well-being

Theexperienceofwell-beingisaboutfeelingthatyourlifeisgoingwell…..itenablesustodefinetheul3mateaimofhumanendeavortobehealthy,happy,andhavemeaningfullives.

JulietMichaelsonSeniorResearcher,centreforwell-being

Page 10: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Well-being

Page 11: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

YOUR WELLBEING?

LowEnergy

NEGATIVEEMOTION POSITIVEEMOTION

HighAnxietyAngerFearConflict

HappinessEnthusiasmJoyCrea9vityCompassion

Burnout Depression

Resigna9on InflexibleJudgement

Gra9tude

Coolunderpressure

Contentedness Harmony

STRE

SS

LOWW

ELLBEING

RESILIENCE

HIGHWELLBEIN

G

HighEnergy

CORTSOL

Adapted from https://www.heartmath.org

Page 12: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Work

“By 1960, Work will be limited to

three hours a day”

John Langdon-Davies, 1936

Page 13: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Expecta3on“a strong belief that something will happen or be the case in the future”

What was your expectation

when you started working?

http://www.oxforddictionaries.com/definition/english/expectation

Page 14: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

45percentofrespondentsdescribetheirlevelsofmoraleasbeingloworverylow,onaveragelowerthanlast3quarters(juniorsespecially)workingo]enORveryo]enoutsidetheirregularhoursGPs 77.7%Consultants 71.7%Juniorintraining 60.5%SAS 50%Onlinesurveyof2,600(approx30%return)

BMAMoraleandworkloadsurvey2016(Q2)

Page 15: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Stafford Hospital deaths 'could be repeated' in Scotland

Overseas locum doctors paid £3,000 a shift

GMC promises to review treatment of vulnerable doctors

The BBC has seen hundreds of previously secret NHS reports into serious incidents

Page 16: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Adapted from Michael J. Kaminsky, M.D., MBA Johns Hopkins University School of Medicine

It’sacycle

Resistance

Resilience

Support

Recovery

Page 17: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Resistance! theabilitynottobeaffectedbysomething,especiallyadversely

! OtherwiseknownasStressInocula3on

http://www.oxforddictionaries.com/definition/english/resistance

Professor Gordon Turnbull Lead Trauma Consultant Nightingale Hospital, adviser to CAA

Page 18: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Resilience the capacity to recover quickly from difficulties;

toughness:

the ability of a substance or object to spring back into

shape; elasticity:

http://www.oxforddictionaries.com/definition/english/resilience

Page 19: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Support

Whenpeopleareinneed(prac3calandemo3onalsupport)

!  Listening,compassion,understanding,nonjudgement...........uncondi3onalposi3veregard

! Acuppa,askingwhattheyneed,flexibility,giveandtake,apprecia3on,reduc3oninworkload/responsibility

!  (medica3on?)

Page 20: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Recovery!  Time! Ongoingsupport(bothkinds)!  Physicalac3vityandcontactwithgreenspace! Developingownstrategies!  Socialac3vi3esandcontact! Gradualre-introduc3onofresponsibili3es/roles!  Exploringwhathappened/ishappening!  Iden3fyinglearningandstrengths

Burnoutrecovery–2days/weeksorlonger

Page 21: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Foresight Report NEF 2008

Page 22: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

BuildingResistanceandResilience

!  Star9ngwhereeachofusis.................

Page 23: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

TheFounda3ons!  Personality!  Familyupbringingandculture!  Personalcircumstancesandpressures! Workplacecultureandbehaviours!  Leadershipapproachandmanagementstyle! Meaningful,produc3vework! Generalhealthincludingmentalhealth!  Recogni3onandreward!  Supportavailablevsystemssuchasaiendancemanagement

Page 24: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

ELEMENTS of WELL-BEING

! Selfacceptance! Competence! Rela3onships! Presenceofposi3veaffect! Meaning! Op3mism! Engagement

Page 25: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Poorpsychologicalwellbeing

!  Impactongeneralillhealthandearlierdeath! HeartdiseaseBPcholesterolHRvariability! WeightDiabetes! Metabolism!  Immunityinflammatoryprocesses! Auto-immuneprocesses

Similartoeffectsofotherriskfactorssuchassmoking,diet

Diener&Chan2011

Page 26: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Posi3vewellbeing–theimpact

!  Beiermemory,mo3va3onandselfefficacy! Moreproduc3ve!  Fewerdistrac3onswithpsychosoma3ccomplaints! Moreflexibleandcrea3ve! Moreposi3vejudgementaboutothers!  Beierresponsetonega3vefeedback

Page 27: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Innerworklife-awarenessSense-

making about daily work

Motivation and

Performance

Reactions to work

AmabileandKramer,HarvardBusinessReview2007

Page 28: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

ProgressPrincipleProgress in meaningful

work

Setbacks

‘Gooddays’!  Posi3veinnerworklife!  Smallwins!  Breakthroughs!  Goalcomple3on

‘Baddays’ₓ  Nega3veinnerworklifeₓ  Smalllosses++ₓ  Carryover

JOY

Frustra9on

Page 29: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

TheEvidenceforJoyinWork

Higher performance Achievement of goals

Reduced staff turnover

Cooperation

Supportive and better relationships,

reciprocity

Initiative, ‘willing to go the extra

mile’

Higher customer satisfaction

Better financial performance

‘If you are happier in your job, you are better in your job’

Peter Warr. The Joy of Work? 2009

Page 30: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Proac3veresiliencebuildingandJoyAtWorkEmphasisonimportanceofrela3onships,trust,collec3vity HOLIDAYSEduca3onandtrainingincommunica3on,emo3onalregula3on,copingstrategies,mindfulnessInforma3onsharingandcrea3ngcondi3onsforpeopletotakeresponsibilityforowninnerworklife

Whatdoweneed?

Page 31: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Only 25%. of physicians engage in the recommended amount of exercise

(American Journal of Health Promotion, May/June 2011, Vol 25, No 5).

Howwelldoyoulooka]eryou?

50% of adults will be achieving 5x 30mins (moderate activity)

Scotland'sPhysicalAc9vityStrategyRecommendedlevelsofphysicalac3vityforthe2022target?

Page 32: Resistance, Resilience Recovery€¦ · Health “A state of complete physical mental and social wellbeing and not merely the absence of disease (WHO) or “A child born in the year

Thankyouforlistening


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