Resident Wellness

Dr. Jagdish R. Vankar

Dept. of Psychiatry,

Pramukhswami Medical College, Karamsad

Learning Objectives

About Stress & Burnout Causes of burnout Warning signs & symptoms Preventing burnout Overcoming burnout

Stress

Stress is the spice of life……

Would you enjoy a life

Without runs, hits or errors?

Stress

Stress: Non-specific physical and psychological reaction to issues and event

arising from one’s own environment

Stressor: An external event which brings about stressful response

So what is the difference between stress and burnout?

Stress is when you are drained and still able to recover between shifts

Burnout begins when you are drained and not able to recover between shifts

There is more to life than increasing its speed.

– Mohandas K. Gandhi

Causes of burnout

Work-related causes Feeling like you have little or no control over

your work Lack of recognition or rewards Unclear or overly demanding expectations Doing work that’s monotonous or

unchallenging Working in a chaotic or high-pressure

environment

Lifestyle related causes Working too much, without enough time for

relaxing and socializing Being expected to be too many things to too

many people Taking on too many responsibilities, without

enough help from others Not getting enough sleep Lack of close, supportive relationships

Personality related causes Perfectionist tendencies; nothing is ever good

enough Pessimistic view of yourself and the world The need to be in control; reluctance to

delegate to others High-achieving, Type A personality Type D personality

Shanafelt, T. D. et. al. Ann Intern Med 2002;136:358-367Top line no burnout n=27Bottom line met criteria for burnout n=87

Relationship of burnout to self-reported suboptimal patient care practices and attitudes

Lets measure your personality type

ScoringScore Type Implication

>110 Type A1 high risk of developing cardiac illness and other stress-related illnesses

80-109 Type A2 also a cardiac-prone personality but your risk of heart disease is not quite as high as a Type A1

Type A personalities generally have "A STRESS PROBLEM" although most do not recognise this until extreme symptoms or serious illnesses develop. Type A behaviour is a learned personality complex which is well-rewarded in our culture.

60-79 Type AB

You are a mixture of Type A and Type B patterns. This is a healthier pattern than either A1 or A2, but you have the potential for slipping into Type A behaviour and you should recognise this.

<59 Type B This personality complex is characterised by general relaxation and coping adequately with stress.

Maturity is achieved when a person accepts life as full of tension.

– Joshua L. Liebman

Three core burnout symptoms 1) Exhaustion

You are empty, drained, tapped out and unable to recover

2) Depersonalization This usually shows up as “compassion fatigue,”

sarcasm, cynicism and blaming your patients 3) Lack of Efficacy

This presents as thoughts of “what’s the use?”. You may doubt that your work makes any difference

Physical signs and symptoms of burnout

Feeling tired and drained most of the time Lowered immunity, feeling sick a lot Frequent headaches, back pain, muscle aches Change in appetite or sleep habits

Emotional signs and symptoms of burnout

Sense of failure and self-doubt Feeling helpless, trapped, and defeated Detachment, feeling alone in the world Loss of motivation Increasingly cynical and negative outlook Decreased satisfaction and sense of

accomplishment

Behavioural signs and symptoms of burnout

Withdrawing from responsibilities Isolating yourself from others Procrastinating Using food, smoking or alcohol to cope Taking out your frustrations on others Skipping work

Preventing burnout Physician, Heal Thyself.. Your wellness prescription – 3 remedies

Physical Self Social Self Coping Self

Physical self Nutrition Exercise Sleep

Social Self Plan or structure time to maintain friendships

with those far away “Real” v/s “Virtual” relationships Make friends across the departments Take regular “breaks”

90/10 Principle

10% of life is made up of what happens to you. 90% of life is decided by how you react.

Coping Self Relaxation exercises

Freeze Frame Technique

Freeze Frame Technique

Freeze frame technique To stop the physiological chain reaction, you

need to find a way to manage your stress from moment to moment and day by day using a technique called the “Freeze frame technique’

When a scene becomes stressful, the technique allows you to freeze that perceptual frame and isolate it in time so you can observe it from a more detached and objective viewpoint— similar to pausing the VCR for a moment.

Harvard Business Review • July 2003

Freeze frame technique – 5 steps Recognize and disengage.

Take a time-out so that you can temporarily disengage from your thoughts and feelings—especially stressful ones.

Breathe through your heart. Shift your focus to the area around your heart. Now

feel your breath coming in through that area and out your solar plexus.

Invoke a positive feeling. Make a sincere effort to activate a positive feeling.

Harvard Business Review • July 2003

Freeze frame technique – 5 steps Ask yourself, “Is there a better

alternative?” Ask yourself what would be an efficient, effective

attitude or action that would de-stress your system. Note the change in perspective.

Quietly sense any change in perception or feeling and sustain it as long as you can.

Harvard Business Review • July 2003

Overcoming Burnout Slow down Get Help Reconsider your goals and priorities

Acknowledge your losses

Calmness is the cradle of power.– J. G. Holland

Thank you for your attention