Sasha K. Shillcutt, MD, MS, FASEAssociate Professor

Vice Chair of Strategy and InnovationDepartment of Anesthesiology

Resilience: Falling Down

and Launching Forward

Review how failure can lead to resilience

Define resilience and how to overcome burnout

and professional failure

Understand tips for building professional resilience

OBJECTIVES

Post Stress Event

THE

YOUNG

PROFESSIONAL

Flexible

Brilliant

Efficient

Die Hard

Heroic

THE

YOUNG

PROFESSIONAL

But is this professional well?

FAILURE:

The Pathway to Burnout

Loss of Work Control #1

Work Compression

⬆️STRESS

Exhaustion

Cynicism

Inefficiency

BURNOUT

DEPERSONALIZATION

PATHWAY TO BURNOUT

Haramati A et al Medical Teacher, 2017

Maslach, Leiter Medical Teacher, 2017

Conflict in ValuesLack of Control

Absence of

FairnessHigh Workload

Maslach, The Truth About Burnout

Insufficient Reward

Lack of Community

JK ROWLING

REJECTED BY 12

PUBLISHERS

40$ MILLION

SALES

M JORDAN

9,000 MISSED SHOTS

300 GAMES LOST

26 WINNING SHOTS

MISSED

GREATEST BB OF ALL

TIME

10,000 FAILED ATTEMPTS AT

THE LIGHTBULB

1,093 PATENTS

T EDISON

accept defeat: the neuroscience of screwing up

check your assumptions

seek out the ignorant

encourage diversity

beware of failure blindness

25% more likely to take breaks throughout day

7% more likely to walk

5% more likely to take a lunch

35% more likely to take breaks “just to relax”

Women Young Professionals:

Slower to Advance.

More likely to Burnout.

Source: Captive Network, www.forbes.com, why millennial women are burnout out at work

PHYSICIANS PHYSICIANS SUICIDE RATE

20% 50% 2.3x

Experience Mental Health

Problems over their Career

Report CURRENT Burned Out

(2016)

Women Phys = 2.3 risk;

Male Phys = 1.6x risk

Case Study: Medicine

Zwack, Schweitzer 2013

Burnout Has Impact.

BurnoutStress

Overengagement Disengagement

Overreactive Blunted

Urgency & Hyperactivity Helplessness & Hopelessness

Loss of Energy Loss of Motivation

Anxiety Disorders Detachment/Depression

Physical Damage Emotional Damage

Stress and Burnout in Ministry

BURNOUT

RESEARCH

SATISFACTION

ENGAGEMENT

TURNOVER

ORGANIZATIONAL

EFFECTIVENESS

Griffeth et al 2000,

Koys 2001,

Posdakoff et al 1994

BURNOUT

Vicious Cycle

Slow, Continuous DepletionDaily Stressors

Erosion of Control

Physical, Emotional Exhaustion

Energy Savings Measure

Physical InactivityLoss of Endorphins

Withdrawal

Depression

Social WithdrawalDanger/Red Zone

How do we RESIST?

Bounce Back

Toughness

Positivity

Mental Stability

Self-esteem

Self-respect

WHAT IS RESILIENCE?

• Ideologic existence

• Unaffected by trials

• Never experiencing

professional failure

• Untouched by stress or

hardships

• Painless

WHAT IS RESILIENCE NOT?

PEOPLE

RESILIENT

Experience Failure

Experience Loss

Experience Stress

Feel the Pain of Loss

JUST AS MUCH AS NONRESILIENT PEOPLE

R E S I L I E N C E I S D Y N A M I C .

GROWTHMINDSET

FIXEDMINDSET

W H A T I S Y O U R M I N D S E T ?

LOOK FOR THE LESSON

BE VULNERABLE/SHARE

INTERNAL CHECK

OWN STRENGTHS

SO YOU’VE FAILED.

CREATE A PLAN

A Morin. 5 ways resilient people use failure to their advantage, Forbes

Components

Confidence

Social Support

Adaptability

Purposefulness

Cooper et al: Building

Resilience for Success,

2013

RESILIENCE?WHAT MAKES

Institutional

Wellbeing Institutional Metric

Ensure Culture is Positive

Allow Employees to do what THEY deem meaningful

Balance Autonomy with Standardization

West Dyrbye Assoc Chiefs Leaders in Internal mEdicine, The leadership Forum Sept 2017

Self Care

Connection

Self Talk

Individual

WORK42%

LIFE21%

SLEEP29%

OTHERS4%

SELF CARE

4% THE REALITY:

A DAY IN YOUR LIFE

10 HOUR WORK WEEK

5 HOURS OF LIFE WORK

(COMMUTE, SHOWER, EAT)

7 HOURS SLEEP

1 HOUR OTHERS

1 HOUR SELF CARE

JUST ADD WATER…RIGHT?

RESILIENTsuccess at work

SUCCESSin life

WELLBEINGsuccess at home

WHAT ARE

YOU GOING

TO REMOVE?

QUESTION:

THE NEXT MOVE

WHAT BRINGS

YOU JOY?

QUESTION:

THE NEXT MOVE

Even 20% FTE roles

of personally meaningful work

can mitigate burnout

WHO DO YOU

CONNECT WITH?

QUESTION:

THE NEXT MOVE

Expect Failure.

Bounce Up.

QUESTION:

THE NEXT MOVE

RECOGNIZE

See Burnout Coming

Recognize Signs in

Yourself

SELF CARE

Practice Self Care

Exercise

Unplug

CULTURE

Connect with Others

Define Your Own

Success

Boundaries

IN SUMMARY

Realistic Expectations, Embrace Failure

L E T ’ S T A L K

Q 1 . W H A T I S Y O U R

F A I L U R E H A N G U P ?

Q 2 . W H A T I S Y O U R

F A I L U R E M I N D S E T ?

Q 3 . W H A T W O U L D Y O U

S A Y T O Y O U R F R I E N D ?

Your Brain At Work: Strategies

for Overcoming Distraction,

Regaining Focus, and Working

Smarter All Day Long

D. ROCK

Grit: The Power of Passion and

Perseverance

DWECK

Mindset: The New Psychology

of Success

DUCKWORTH

The Happiness Advantage

S. ACHOR

SUGGESTED READING

References

Epstein RM and Krasner MS. Physicians resilience: what it means, why it matters, and how to promote it. Acad Med

2013:;88:301-303

Freischlag JA and Silva MM. Bouncing up: resilience and women in academic medicine. J Am Coll Surg 2016;in press

Jensen PM et al. Building physician resilience. Can Fam Physician 2008;54:722-729

Mills J and McKimm J. Resilience: why it matters and how doctors can improve it. British J Hosp Med 2016;77:630-33

Shanafelt TD and Noseworthy JH. Executive leadership and physician well-being: nine organizational strategies to

promote engagement and reduce burnout. Mayo Clin Proc 2016;1-18

Shanafelt et al. Burnout and satisfaction with work-life balance among US physicians. Ann Inter Med 2012

Swenson et al. Phis-Organization collaboration reduces burnout. J Healthcare Management April 2016

Zwack J and Schweitzer J. If every fifth physician is affected by burnout, what about the other four? resilience strategies

of experienced physicians. Acad Med 2013;88:382-389

Contact Me

Twitter: @rubraveenough

www.becomebraveenough.com