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Rx forsanitytriagelovelaughterRAYMOND

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  • 1. Rx For Sanity:Triage, Love and LaughterPatricia L Raymond MD FACG Rx for Sanity, Norfolk VA www.RxForSanity.com
  • 2. www.RxForSanity.com
  • 3. “Does It Make Your Ears Wiggle?” -N.E. Raymond www.RxForSanity.com
  • 4. Traits which make a good HCP lead to ‘compassion fatigue’• Strive for perfection• Seek and accept responsibility• Willingness to defer gratification and to sacrifice• HCP isn’t what we do, it’s who we are www.RxForSanity.com
  • 5. Compassion Fatigue• Not related to: – Hours worked – Practice specialty – Managed care prevalence – Government interventions• Related to loss of perceived control, loss of personal-work balance www.RxForSanity.com
  • 6. www.RxForSanity.com
  • 7. Sometimes you have to take your brain and stomp on it a little. It just gets caked up. Mark Twain www.RxForSanity.com
  • 8. www.RxForSanity.com
  • 9. www.RxForSanity.com
  • 10. Your Prescription for Sanity• Triage: your professional life• Love: Family, finances, & mental health• Laughter: Personal health And we’ve only 75 minutes to change your life!Debbie Waiz www.RxForSanity.com
  • 11. Triage: Your Professional LifeDebbie Waiz www.RxForSanity.com
  • 12. Debbie Waiz www.RxForSanity.com
  • 13. Debbie Waiz www.RxForSanity.com
  • 14. “Please back in for prompter service.” Sign on our endoscopy suite doorDebbie Waiz www.RxForSanity.com
  • 15. No time for Information Overload • New techniques and equipment • Reading? Who has time to read?Debbie Waiz www.RxForSanity.com
  • 16. It’s not my job.Debbie Waiz www.RxForSanity.com
  • 17. Nursing Stress is Universal• Workload perceived as too great to give quality patient care• Unfairness in promotion opportunities, imbalance between jobs and responsibilities, conflict with colleagues, lack of appreciation of efforts by superiors, responsibilities of role, long and tiring work hours, inadequacy of equipment, and problems experienced with patients relatives www.RxForSanity.com
  • 18. DWA (doctors with attitude) www.RxForSanity.com
  • 19. www.RxForSanity.com
  • 20. Exercise: The Perfect Day• Get out your pen, and go to page two! www.RxForSanity.com
  • 21. Professional Rxs• Seek clinical satisfaction – Opportunity vs. Obligation • WHY not WHAT – Think creatively: challenges are opportunities – Raise the bar: Evidence based medicine – Be a partner: proactive and critical thinking…ask questions, ask questions, ask more questionsDebbie Waiz www.RxForSanity.com
  • 22. Critical Incident Stress• Create a healthy work environment – Humor – Take your breaks – Debrief/ dump toxins – In house stress management: Exercise, Tai Chi, yoga, meditation www.RxForSanity.com
  • 23. www.RxForSanity.com
  • 24. People treat you the way you teach them to treat you. ~Jack Canfield www.RxForSanity.com
  • 25. Rx for Information Overload• “Car College” » 15 min each way daily commute – 15 min each way x 10 trips weekly = 2.5 hours per week 46 weeks per year = 119 hours per year Needs card- Zazlove Regional and national society meetings www.RxForSanity.com
  • 26. “The great use of a life is tospend it on something that will outlast it.” William James www.RxForSanity.com
  • 27. Find your Windmill• Develop new tools: research, technology• Complimentary Alternative Medicine (CAM)• Mentoring of new nurses• Disease specific volunteerism• International, national, state or local Consider petitions, politics, publicity www.RxForSanity.com
  • 28. Your mission in life is where your deep joyand the world’s deep hunger meet. ~Richard Nelson Bolles www.RxForSanity.com
  • 29. Love: Family, Finances & Mental HealthDebbie Waiz www.RxForSanity.com
  • 30. The Art of Healing W.H. Auden Most patients believe Dying is something they do, Not their physician, That white-coated sage, Never to be imagined Naked or married.Debbie Waiz www.RxForSanity.com
  • 31. Family and Medicine• Divorce rates 10-20% higher than general population• Do we leave our communication skills at the office? Ann Int Med 2001 Sou Med Jou 2000Debbie Waiz www.RxForSanity.com
  • 32. Financial stresses• 35 to 45 y/o average personal debt equals 95% of annual income• Most spend less than 1 hour per month on retirement planning• 2 of 3 HCPs does not have a willDebbie Waiz www.RxForSanity.com
  • 33. Substance Abuse• One in seven nurses during their career – Similar frequency to general population – Through legitimate Rx or diversion – Demerol is drug of choice – More common among nurses with access to substance (ED, ICU, Endo) West J Med 2001Debbie Waiz www.RxForSanity.com
  • 34. Substance Abuse: Your Choices• No action• Enable• Report• 50% report blackouts during patient care while using West J Med 2001Debbie Waiz www.RxForSanity.com
  • 35. Nurse suicide• One of the top five causes of death in nurses• Six times higher rate than general public• Felt to be related to CI stress – Unrelated to incidence of substance abuse – MD suicide (2 x male MD, 4 x female MDs) IS related to substance abuse as predictorDebbie Waiz www.RxForSanity.com
  • 36. Debbie Waiz www.RxForSanity.com
  • 37. Exercise: Focus Points Go to page 3! • People • Shelter • Work • Money • Food • Fun • Clothing Repeat q 3 monthsDebbie Waiz www.RxForSanity.com
  • 38. Personal & Family Rxs• Take control – Make time for family • Become a ‘Multi-Shirker’ (Scott Adams) • Hire a wife!• Fee only financial advisor, or self-educate about financial health• Seek NHP (nursing health programs) for yourself or othersDebbie Waiz www.RxForSanity.com
  • 39. Laughter: Personal Health & WellnessDebbie Waiz www.RxForSanity.com
  • 40. The Science of WellnessDebbie Waiz www.RxForSanity.com
  • 41. The Science of Wellness • Stop smoking TobaccoFreeNurses.orgDebbie Waiz www.RxForSanity.com
  • 42. The Science of Wellness• Stop smoking• Eating habitsDebbie Waiz www.RxForSanity.com
  • 43. Debbie Waiz www.RxForSanity.com
  • 44. Debbie Waiz www.RxForSanity.com
  • 45. Debbie Waiz www.RxForSanity.com
  • 46. AmIHungry.comDebbie Waiz www.RxForSanity.com
  • 47. The Science of Wellness• Stop smoking• Eating habits• Exercise 30 minutes dailyDebbie Waiz www.RxForSanity.com
  • 48. Exercise as MedicineCardiovascular disease, CHF, CVA, PVD, Type II Diabetes, Obesity, Dyslipidemia, Cancer (breast, colon, prostate, pancreas, melanoma), Asthma, COPD, Osteoarthritis, Rheumatoid Arthritis, Cognitive Dysfunction Booth, J Applied Physiology 2002;93:3-30Debbie Waiz www.RxForSanity.com
  • 49. Debbie Waiz www.RxForSanity.com
  • 50. Hi,This is a hassle to remind you to Have you exercised today? Remember that your health is more important than what you do. Meditate and journal today too. Be in balance. Breathe. So get to it!Youll be sent one of these hassles roughly every 2 days.Thanks, -- The HassleMe Team http://hassleme.co.uk/Debbie Waiz www.RxForSanity.com
  • 51. HassleMe http://hassleme.co.uk Because sometimes in life, you just need to be nagged...Debbie Waiz www.RxForSanity.com
  • 52. The Science of Wellness • Stop smoking • Eating habits • Exercise 30 minutes daily • Sleep 8 hours a nightDebbie Waiz www.RxForSanity.com
  • 53. Aging and sleep• Lancet 1999• 8 hours verses 4 hours in normal college students• glucose intolerance identical to early adult type diabetes• TSH & cortisol levels like elderly Mall study: 13 % less max happy with each hour < 8 7 = 87% 6 = 74% 5 = 61%Debbie Waiz www.RxForSanity.com
  • 54. The Science of Wellness • Stop smoking • Eating habits • Exercise 30 minutes daily • Sleep 8 hours a night • See a physicianDebbie Waiz www.RxForSanity.com
  • 55. 1998- 2 polyps 1999- 2 polyps 2002- no polyps 2007- 5 polyps (and a poor prep, it is rumored) Scott Adams/Dilbert: W.A.D. foundDebbie Waiz www.RxForSanity.com
  • 56. The Science of Wellness • Meditate/ breathe/ journal/ spiritualDebbie Waiz www.RxForSanity.com
  • 57. Spirituality & medicine• Meditation – Psoriasis, heart disease, chronic pain – UCLA meditation tapes to BP patients 73% reduction in medication, 50% stop meds altogether• Journaling – Smith Annals Internal Medicine COPD RADebbie Waiz www.RxForSanity.com
  • 58. Spirituality & medicine• Optimism – Mayo clinic: pessimists risk factor for premature death, overall lower level of health, more use of medical resources and higher medical costs – Internal Medicine News: pessimism worsens lung function; pessimism equivalent to 20 pack- year smokingDebbie Waiz www.RxForSanity.com
  • 59. Debbie Waiz www.RxForSanity.com
  • 60. The Science of Wellness• Meditate/ breathe/ journal/ spiritual• Happiness listDebbie Waiz www.RxForSanity.com
  • 61. may my mind stroll about hungry,and fearless, and thirsty, and supple. ee cummings may my heart always be openDebbie Waiz www.RxForSanity.com
  • 62. Debbie Waiz www.RxForSanity.com
  • 63. ColonoscopyJoke.com RxForSanity.comDebbie Waiz www.RxForSanity.com
  • 64. Debbie Waiz www.RxForSanity.com
  • 65. The Science of Wellness • Meditate/ breathe/ journal/ spiritual • Happiness list • Have Sex • Reassess quarterlyDebbie Waiz www.RxForSanity.com
  • 66. The Caerphilly Study: Smith, Frankel, Yarnell, BMJ 1997• N=918 males(45-59 y/o), 10 year f/u• Stratified to self-reported frequency of intercourse – Low: Less than q month – Intermediate – High: BIW or more frequent• Data adjusted for variables of age, social class, systolic blood pressure, smoking, baseline CAD, cholesterolDebbie Waiz www.RxForSanity.com
  • 67. The Caerphilly Study: Results Low Intermediate High Frequency Frequency Frequency All Cause Mortality 1.9 1.6 (CI 1.0-2.8) 1.0 CI 1.0-3.4 P<0.04 Coronary Heart Disease 2.1 CI 0.9 -5.1 1.8 (CI 0.8-4.0) 1.0 P<0.10Debbie Waiz www.RxForSanity.com
  • 68. Women vs. MenQuality vs. Quantity • Sexual dissatisfaction for women is an independent risk factor for MI – Abramov, Psychosom Med 1976 • Lack of sex associated with death in men • Lack of enjoyment associated with death in women • Duke Study on Ageing – Palrnore, Gerontologist 1982Debbie Waiz www.RxForSanity.com
  • 69. Rx Yourself Now: If you really want to do something you’ll find a way. If you don’t, you’ll find an excuse.Debbie Waiz www.RxForSanity.com
  • 70. The Science of Wellness • Stop smoking • Moderate your eating habits • Exercise 30 minutes daily • Sleep 8 hours a night • See a physician • Seek the spiritual • Make a “Happiness List” • Have more/better sex • Reassess quarterlyDebbie Waiz www.RxForSanity.com
  • 71. SSDT: Not sex!Debbie Waiz www.RxForSanity.com
  • 72. This is your prescription for sanity: • Medicine is an opportunity, not an obligation • The Perfect Day • Focus Points • Happiness List • Have more (or better) sexDebbie Waiz www.RxForSanity.com
  • 73. “Does It Make Your Ears Wiggle?” -N.E. RaymondDebbie Waiz www.RxForSanity.com
  • 74. Don’t wait for a second opinion!Debbie Waiz www.RxForSanity.com
  • 75. Debbie Waiz www.RxForSanity.com