How To Outsmart Your negative brain Dan Doherty RN, MSN, CEN Christiana Care Health Systems
The cost 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 ?
What’s Going to happen
Our 1st ineffective strategy Withdrawal/Detach Brain upset No one will listen Where do your stories go Sliming colleagues
Answer It’s not my journey
Our Confusion Compassion Empathy Seeing someone suffering and wanting to help Empathy Seeing someone suffering, taking on part of that suffering and wanting to help
Our 2nd favorite ineffective strategy What do you do in your free time? Idle brain/negative brain 12 minutes Missed opportunity
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) 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 Psychological Exhaustion (tired vs. depleted) Exhaustion Insomnia Distancing Headache Reduced sympathy & empathy Susceptibility to illness Cynicism & embitterment Resentment Anxiety/irrational fears Depersonalization Intrusive images Loss of hope Difficulty separating work from personal life Failure to nurture and develop non-work related aspects Behavioral Drugs & alcohol Absenteeism/presenteeism Anger/irritability Exaggerated sense of responsibility (I can’t let people down, I can’t leave, people are counting on me) Avoidance behaviors Impaired decision making Forgetfulness Interpersonal relationships Negative 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-Dopamine 50%/10%/40%
happy hormone-serotonin
Adrenaline and Cortisol The problem Adrenaline and Cortisol (Half-life)
Brain wants to know 2 things The problem I think here Brain wants to know 2 things Limbic System want to know 3 things I feel here I think here I feel here
Mindfulness Meditation 5 things see, hear & feel Breath in & out 30 seconds
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?