1. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 The Scientist: Balancing Health and Science Session 2 Stress & Stress Management Charlene M. Dewey, M.D., M.Ed., FACP Associate Professor of Medical Education and Administration Associate Professor of Medicine Co-Director, Center for Professional Health Chair, Faculty and Physician Wellness committee Assistant Dean for Educator Development Director, Educator Development Core

2. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Conflict of Interest Charlene Dewey ….has NO financial relationships to disclose.

3. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Goals The purpose of the session is to enhance self-awareness of stress triggers, stress responses and stress management using reflection, self-assessments, and awareness of energy with the purpose of managing energy and stress at work and home.

4. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Objectives Participants attending this session will be able to: 1.Identify stress triggers, stress responses and stress behaviors, and complete a flooding self-assessment. 2.Practice a stress management technique. 3.List and describe at least one way to manage each type of energy. 4.Optional: Write a B-A-SMARTER goal/objective for managing stress.

5. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Agenda 1.Introduction & recap 2.Stress 3.Stress management 4.Managing energy 5.Summary

6. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Ground Rules Portfolio: Some now and some on your own

7. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 I agree to keep things confidential. 1.True 2.False ARS

8. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Wellness Goals Clip Art found at Bing Images

9. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 After Session 1, I took time for myself to reflect on my wellness. 1.True 2.False ARS

10. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 I made progress on my wellness goal(s) from Session 1. 1.True 2.False ARS

11. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Stress

12. Stress What stresses you out? Measure your stress level (past 2-4 weeks) Anxious Engaged Enthusiastic Calm Relaxed Stress free Stressed out Exhausted Overwhelmed Drained Ready to cave Burnt out The Doctor Dewey Inst-O-Matic, Stress-O-Meter Run Down

13. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Stress List your stress triggers at home and work Stress Triggers at HomeStress Triggers at Work

14. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Stress

15. Stress

16. Stress Reactions

17. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Stress Reaction: Flooding Neurological and biochemical event Triggers Sudden onset: “Like an oncoming truck” Inability to self-soothe or self-regulate Tend to keep away or isolate Physiologic reactions* *Great Courses – Jason Satterfield

18. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Identifying Stress Reactions How do you feel when you are stressed? Determine your flooding score: Take the flooding assessment in your handout. (Appendix 1)

19. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 What is your flooding score? A.0 B.1-2 C.3-4 D.5-6 E.7-8 F.>8 ARS

20. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Identifying Stress Reactions What do others notice about you when you are stressed? How do you manage stress?

21. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Stress Management Self-awareness is the first step Things to do when acutely stressed or flooded: –Remove yourself and step away from the situation (restroom) –Self-regulate, breathe, relax – think CALM –Practice mindfulness techniques Attend to the conflict Processes - reflect on event triggers, symptoms, behaviors Seek coaching & mentoring

22. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Self-Regulation Exercise 1 minute Monitor and regulate breathing and heart rate Categories: –Foods in grocery store –Sports teams –Favorite book characters –Movie titles –Colors –Neurologic diseases –Other Things in a grocery store… 1.Milk 2.Eggs 3.Bread 4.Carrots 5.Apples 6.A restroom 7.Check out station 8.Ice cream…

23. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Relaxation Exercise Use when you need to relax Visualization or mindful body scan 1 min Clip Art found at Bing Images

24. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Managing Energy Physical Energy Emotional Energy Spiritual Energy Mental Energy Schwartz, T. & McCarthy, C. Manage Your Energy Not Your Time. HBR October 2007.

25. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Managing Energy “Longer days at the office don’t work because time is a limited resource. But personal energy is renewable…By fostering deceptively simple rituals that help employees regularly replenish their energy, organizations build worker’s physical, emotional, and mental resilience.” ~Schwartz & McCarthy Schwartz, T. & McCarthy, C. Manage Your Energy Not Your Time. HBR October 2007.

26. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 ARS 1.0-3 2.4-6 3.7-10 4.11-16 Are you heading for an energy crisis? What was your total point score?

27. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Physical Energy Eating and sleeping well Physical activity Take breaks Identify your stressors Manage and reduce stress –Home stressors –Work stressors Schwartz, T. & McCarthy, C. Manage Your Energy Not Your Time. HBR October 2007.

28. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Emotional Energy Fuel positive emotions & defuse negative emotions Express appreciation to others Tell a different story “Power of Positive Thinking” Use a different lens: reverse, long and wide Have mentors, coaches, confidants Self-identify which method works best for you Schwartz, T. & McCarthy, C. Manage Your Energy Not Your Time. HBR October 2007.

29. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Spiritual Energy Identify your “sweet spots” –What you enjoy the most? –What you do the best? –What is most important to you? Allocate time and energy to the positives Live your core values Engage in spiritual renewals Schwartz, T. & McCarthy, C. Manage Your Energy Not Your Time. HBR October 2007.

30. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Mental Energy Reduce interruptions “switching times” Designate “sprint zones” 90-120 m Plan, prioritize, and accomplish Self-identify how you plan best –Showers, car drive in/out, exercising, etc. –Check lists or to do lists –Others help provide directions Schwartz, T. & McCarthy, C. Manage Your Energy Not Your Time. HBR October 2007.

31. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Family Family – it is your crystal ball!! Every other ball bounces Family ball: –Delicate –Precious –Irreplaceable –Indispensible –Full of love

32. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Managing Energy Pair share Describe your ‘best practices’ for managing energy at work and home Switch

33. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 1.Physical 2.Mental 3.Emotional 4.Spiritual Which area needs work to manage your energy better? ARS

34. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Resources

35. Reflection Think of one activity you will do to: –Reduce your stress –Manage energy

36. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Do you plan to make a change based on this presentation? 1.Yes 2.No 3.Unsure ARS

37. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Summary As a result of participating you should be able to: 1.Identify stress triggers, stress responses and stress behaviors, and complete a flooding self- assessment. 2.List and describe at least one way to manage each type of energy. 3.Optional: Write a B-A-SMARTER goal/objective for managing stress. (homework)

38. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Next Session

39. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 Evaluations Please complete your evaluation form (two-sides) http://www.bing.com/images/search-evaluation

41. Created by: Charlene M. Dewey, M.D., M.Ed., FACP – Vanderbilt University School of Medicine, 2016 CALM CALM: Stress Management C Connect A Assess & address state of mind L Lead M Manage