1. How To Outsmart Your negative brain
Dan Doherty RN, MSN, CEN
Christiana Care Health Systems

2. The cost
Burnout
Compassion fatigue
Vicarious trauma

3. Burnout

4. Compassion Fatigue

5. Vicarious trauma
Not PTSD
Affects not just us

6. The Big issue Lack of control and uncertainty
Do not know the beginning or often do not see the end (fragmented care)

7. What Happened here ?

9. What’s Going to happen

10. Our 1st ineffective strategy
Withdrawal/Detach
Brain upset
No one will listen
Where do your stories go
Sliming colleagues

11. Answer
It’s not my journey

12. 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

13. Our 2nd favorite ineffective strategy
What do you do in your free time?
Idle brain/negative brain
12 minutes
Missed opportunity

14. 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

15. 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)

16. Feeling depleted
Negative self image
Intrusive images/thoughts
Difficulty separating work from personal life

17. How good Was You day?

18. Lazy Brain
Over generalizes
Can’t multi-task (which is good news)

19. Nosey brain

20. 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

21. happy hormone-Dopamine 50%/10%/40%

22. happy hormone-serotonin

23. Adrenaline and Cortisol
The problem
Adrenaline and Cortisol
(Half-life)

24. 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

25. Mindfulness Meditation 5 things see, hear & feel
Breath in & out 30 seconds

26. 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,

27. QUESTIONS?