1. Wellbeing for the Healthcare Professional
South Dakota Perinatal Association Annual Conference
September 21, 2017
Ranae Aukerman, DNP, APRN, NNP-BC

2. Breathe…

3. Why is this important?
Burnout in the healthcare industry is increasingly problematic.
to Self: decreased physical and mental health
to Organizations:
decreased staff engagement
decreased patient satisfaction
increased turnover (intent to leave job/profession)
increased medical errors
But we need to remember that Burnout is a compensatory mechanism.

4. Who’s burned-out? Not profession specific
Study by Moss et al: Critical Care nurses -33% exhibited three classic signs of burnout – 85% exhibit at least one.
Exhaustion – Cynicism – Inefficacy
Average turnover rate of nurses nationally (2016) 13–20%
40 bed unit at 17% RN turnover = > $1,000,000
Estimated cost $65,000 per RN in this study, variable

5. Physician Burnout
Dependent on specialty burnout rates range 42% (psych/mental health)
to 59% (Emergency Medicine) OB/FM/Pediatrics 51 – 55%
Source: Medscape Lifestyle Report 2017 – Race and Ethnicity Bias, Burnout
Turnover costs significant

6. Let’s talk about what we can do
Wellbeing:
Do you feel:
Content?
Energized?
Connected?
Balanced?
Are you able to put the bad days in perspective and live with a sense of purpose?
Resilience:
“the ability to bend, but not break, and even to grow from adversity in one’s life.”
- Steven Southwick

7. Wellbeing begins with the simple question—what can I do to feel content and balanced? Asking this shifts our whole perspective—we are no longer looking to someone else to tell us what we need to do. We are empowering ourselves to explore what we really need and to evaluate for ourselves what makes sense.

8. Wellbeing model:
MaryJo Kreitzer PhD, RN, Founder Earl E Bakken Center for Spirituality and Healing,
University of Minnesota

9. Evidence leads us to: Mindfulness Positivity
Mindfulness means paying attention in a particular way: on purpose, in the present moment, and non-judgmentally. - Jon Kabat-Zinn,
Positive emotions make us more creative, more capable of seeing what is actually happening, and more able to find solutions. -Barbara Fredrickson
Leads us back to self-care, but we’ve known that forever – at least the 1970’s. We preach without impact, I can tell you to…..
But at the end of the day the organizations need to be part of the process, and we find that as social animals it takes more than a massage and lots of kale
So studies are occuring......
Mindfulness MBSR rises to the top the evidence pile. Mindfulness training has been shown to impact compassion and empathy, increasing patient interaction and patient satisfaction
Positivity rises to the top Happiness is important, but a double-edged sword...

10. Mindfulness
It allows us to “watch” our lives, pay attention to our experience. Mindfulness decreases sympathetic reactivity and decreasing stress hormones putting us in a more balanced physiologic place.
Research is verifying it’s contribution to personal health, happiness and resilience
MBSR is gold standard
Headspace app
Major organizations have implemented initiatives on MF – US Army, Google. School systems are using the concepts to deal with teacher burnout as well as using to increase empathy in school-aged children.

11. Self-Compassion What would you say to a friend?
Do you give yourself the same compassion and encouragement?
Evidence: Self-Compassion has been shown to decrease depression, anxiety and stress, positively impacting traits of empathic concern, altruism perspective-taking and forgiveness of others.
Could be considered the foundation on which self-care is based.
The evidence (Neff & Pommier, 2013, Raab etc) cited on benefits of MSC is found to have large effect size across 20 studies

12. Positivity
“We’re finding it’s not necessarily the reality that shapes us, but the lens through which our brain views the world that shapes our reality. If we can change the lens we can change our happiness.”
-Shawn Achor

13. What’s the evidence?
The brain functions better when functioning more positive than negative.
Sometimes called the Happiness Advantage
When positive emotions/outlook > negative there is improved cognitive function, creativity, energy and more resilience.
Workplace study: 31% more productive, physicians 19% more accurate in diagnosis.
Positivity increases dopamine production = happier, turns on learning centers

14. Habits to improve positivity:
3 Gratitudes (3 roses and a thorn)
Journaling
Exercise
Meditation
Random Acts of Kindness
Doing 3 gratitudes for 21 days creates a habit – rewires us to look for the positive
Journaling a positive event allows us to relive it – creates memory, changes wiring
Exercise improves blood flow and positive physical and emotional experience
Meditation – mindful connection to positive outlook, experience fully
Random acts of kindness…....

15. Wellbeing is personal
Mindful/Positive

16. In a supportive social context

17. Breathe and notice your life
Every day we are engaged in a miracle we don’t even recognize.
-Thich Nhat Hanh