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CLMA Laboratory Managers version, Rx For Sanity


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A customised version of my Rx For Sanity: Triage, Love, and Laughter keynote for the Clinical Lab Management Association

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CLMA Laboratory Managers version, Rx For Sanity

  1. 1. April 22-28, 2012
  2. 2. Rx For Sanity: Triage, Love, & Laughter! Patricia L Raymond MD FACG Rx for Sanity, Norfolk VA
  3. 3. “ Does It Make Your Ears Wiggle?” -N.E. Raymond
  4. 4. Traits which make a good HCP lead to ‘compassion fatigue’ <ul><li>Strive for perfection </li></ul><ul><li>Seek and accept responsibility </li></ul><ul><li>Willingness to defer gratification and to sacrifice </li></ul><ul><li>HCP isn’t what we do, it’s who we are </li></ul>
  5. 5. Compassion Fatigue <ul><li>Not related to: </li></ul><ul><ul><li>Hours worked </li></ul></ul><ul><ul><li>Practice specialty </li></ul></ul><ul><ul><li>Managed care prevalence </li></ul></ul><ul><ul><li>Government interventions </li></ul></ul><ul><li>Related to loss of perceived control, loss of personal-work balance </li></ul>
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  7. 7. Sometimes you have to take your brain and stomp on it a little. It just gets caked up. Mark Twain
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  10. 10. Your Prescription for Sanity <ul><li>Triage & Love: Your professional life </li></ul><ul><li>Laughter: Personal health and wellness </li></ul> And we’ve only 60 minutes to change your life!
  11. 11. Triage: Your Professional Life
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  14. 14. “ Please back in for prompter service.” Sign on our endoscopy suite door
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  16. 16. No time for Information Overload <ul><li>New techniques and equipment </li></ul><ul><li>Reading? Who has time to read? </li></ul>Debbie Waiz 15 th Annual Endoscopy Symposium
  17. 17. It’s not my job. RIP
  18. 18. You know you've been in the laboratory too long when... You can't watch CSI without cursing at least one scientific inaccuracy
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  20. 20. Phabulous Phlebotomists
  21. 21. DWA (doctors with attitude) apple
  22. 22. Beyond the lab walls <ul><li>Red tape! </li></ul><ul><ul><li>Physician signature requirement for CMS </li></ul></ul><ul><ul><li>ICD-9 CM codes like prothrombin time for chest pain </li></ul></ul><ul><li>Medicare billing/uniform medicare copayment </li></ul><ul><li>Patient safety </li></ul><ul><li>Professional development of staff </li></ul>
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  24. 24. Create a healthy work environment <ul><li>Humor </li></ul><ul><li>Take your breaks </li></ul><ul><li>In house stress management: Exercise, Tai Chi, yoga, meditation </li></ul><ul><li>Encourage creativity </li></ul>
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  31. 31. April 22-28, 2012
  32. 32. Shuffle Doc <ul><li>Four clear petri dishes (sets) filled with various weighted things (Marbles, sand, river rocks and coins) sealed with tape. </li></ul><ul><li>For the target zone, I had large photos of our Pathologists and Lab Manager arranged in a triangle pattern. I covered this with clear plastic and taped it all down on the floor. A small broom was used for the &quot;pusher&quot;, and techs stood about 12 ft away, </li></ul><ul><li>Each got two chances using all four discs. A point value was assigned to each picture, and an area off the target was a penalty zone (minus points). </li></ul><ul><li>The chief Pathologist was worth the most points. </li></ul>
  33. 33. Purple people eater relay <ul><li>Personal protective equipment (PPE) </li></ul><ul><ul><li>The purple people eater who preys on laboratorians who don't wear protective equipment. </li></ul></ul><ul><li>Relay race that required racers to transport &quot;acid&quot; (represented by an egg) in an approved &quot;hazardous materials carrier&quot; (a spoon). </li></ul>
  34. 34. Purple people eater relay <ul><li>Each leg of the race required a runner to put on another piece of protective equipment carry the &quot;acid,&quot; find the material safety data sheet (MSDS) for acid and, finally, dispose of both &quot;hazardous material&quot; and PPE in approved containers </li></ul><ul><li>Reinforced training about the importance of wearing PPE. </li></ul>
  35. 35. The “Clottery” <ul><li>Tickets, given daily to each employee, for a chance to win the prize of a paid day off. </li></ul><ul><li>Tickets were placed in a sharps container from which the winner was drawn. </li></ul><ul><li>Lab management also drew for canvas tote bags and grab bags filled with goodies.. </li></ul>
  36. 36. Pick your friends’ nose <ul><li>“ Know-the-nose contest&quot; consisted of 35 up-close and photographs of laboratorians' noses. </li></ul><ul><li>Participants had to connect the proboscis with the person. </li></ul>
  37. 37. Toxins R Us <ul><li>“ Know-your-toxic-waste contest.&quot; </li></ul><ul><li>Scavenger hunt; participants were required to find the MSDS and locate specific pertinent equipment for an assigned chemical. </li></ul><ul><li>Participants were given movie tickets. </li></ul>
  38. 38. National Medical Lab Week to help solve a common problem--lack of recognition for laboratorians <ul><li>Special event for every day of the week that focused on one of the five different specialty labs at the Blood Center </li></ul><ul><ul><li>(1) processing, (2) components, (3) special components, (4) clinical trials, and (5) consultation. </li></ul></ul><ul><li>Invited the entire staff to come and learn. (open house, a little carnival with games) </li></ul>
  39. 39. Stick the vein <ul><li>Players were blindfolded and had to stick adhesive dots within target areas on a phlebotomy training arm. </li></ul>
  40. 40. Are you joyous at work? <ul><li>Did I bring joy? </li></ul><ul><li>Did I find joy? </li></ul> Egypt afterlife
  41. 41. Other ways to find joy in the medical workplace <ul><li>Disease of the month </li></ul><ul><li>Body art- sharpies, bottom décor </li></ul><ul><li>Ownership of their health- Nona’s book </li></ul><ul><li>Cartoon book </li></ul><ul><li>Butt Meddler, butt-ons, joke books </li></ul>
  42. 42. “ The great use of a life is to spend it on something that will outlast it.” William James
  43. 43. Find your Windmill <ul><li>The lab experience </li></ul><ul><li>Own your results </li></ul><ul><ul><li>Text to phones </li></ul></ul><ul><ul><li>Copies mailed/emailed to patients </li></ul></ul><ul><ul><ul><li>Explanation of results and suggestions </li></ul></ul></ul>
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  45. 45. Your mission in life is where your deep joy and the world’s deep hunger meet. ~Richard Nelson Bolles
  46. 46. Laughter: Personal Health & Wellness
  47. 47. The Science of Wellness
  48. 48. The Science of Wellness <ul><li>Stop smoking </li></ul><ul><ul><li> </li></ul></ul>
  49. 49. The Science of Wellness <ul><li>Stop smoking </li></ul><ul><li>Eating habits </li></ul>
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  56. 56. Thoughtful, Smart Weight Management <ul><li> </li></ul><ul><li>Walsh- Does This Clutter Make My Butt Look Fat? </li></ul><ul><li>Wansink- Mindless Eating </li></ul><ul><li>Bailor – The Smarter Science of Slim </li></ul>
  57. 57. The Science of Wellness <ul><li>Stop smoking </li></ul><ul><li>Eating habits </li></ul><ul><li>Exercise 30 minutes daily </li></ul>
  58. 58. Exercise as Medicine <ul><li>Cardiovascular disease, CHF, CVA, PVD, Type II Diabetes, Obesity, Dyslipidemia, Cancer (breast, colon, prostate, pancreas, melanoma), Asthma, COPD, Osteoarthritis, Rheumatoid Arthritis, Cognitive Dysfunction </li></ul> Booth, J Applied Physiology 2002;93:3-30
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  60. 60. <ul><li>Hi, </li></ul><ul><li>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! </li></ul><ul><li>You'll be sent one of these hassles roughly every 2 days. </li></ul><ul><li>Thanks, -- The HassleMe Team </li></ul>
  61. 61. HassleMe Because sometimes in life, you just need to be nagged...
  62. 62. The Science of Wellness <ul><li>Stop smoking </li></ul><ul><li>Eating habits </li></ul><ul><li>Exercise 30 minutes daily </li></ul><ul><li>Sleep 8 hours a night </li></ul>
  63. 63. Aging and sleep <ul><li>Lancet 1999 </li></ul><ul><li>8 hours verses 4 hours in normal college students </li></ul><ul><li>glucose intolerance identical to early adult type diabetes </li></ul><ul><li>TSH & cortisol levels like elderly </li></ul><ul><ul><li>Mall study: </li></ul></ul><ul><ul><li>13 % less max happy with each hour < 8 </li></ul></ul><ul><ul><li>7 = 87% 6 = 74% 5 = 61% </li></ul></ul>
  64. 64. The Science of Wellness <ul><li>Stop smoking </li></ul><ul><li>Eating habits </li></ul><ul><li>Exercise 30 minutes daily </li></ul><ul><li>Sleep 8 hours a night </li></ul><ul><li>See a physician </li></ul>
  65. 65. Scott Adams/Dilbert: W.A.D. found 1998- 2 polyps 1999- 2 polyps 2002- no polyps 2007- 5 polyps (and a poor prep, it is rumored)
  66. 66. The Science of Wellness <ul><li>Meditate/ breathe/ journal/ spiritual </li></ul>
  67. 67. Spirituality & medicine <ul><li>Meditation </li></ul><ul><ul><li>Psoriasis, heart disease, chronic pain </li></ul></ul><ul><ul><li>UCLA meditation tapes to BP patients 73% reduction in medication, 50% stop meds altogether </li></ul></ul><ul><li>Journaling </li></ul><ul><ul><li>Smith Annals Internal Medicine COPD RA </li></ul></ul>
  68. 68. Spirituality & medicine <ul><li>Optimism </li></ul><ul><ul><li>Mayo clinic: pessimists risk factor for premature death, overall lower level of health, more use of medical resources and higher medical costs </li></ul></ul><ul><ul><li>Internal Medicine News: pessimism worsens lung function; pessimism equivalent to 20 pack- year smoking </li></ul></ul>
  69. 69. Debbie Waiz 15 th Annual Endoscopy Symposium
  70. 70. The Science of Wellness <ul><li>Meditate/ breathe/ journal/ spiritual </li></ul><ul><li>Happiness list </li></ul>
  71. 71. may my mind stroll about hungry, and fearless, and thirsty, and supple. ee cummings may my heart always be open
  72. 72. Debbie Waiz 15 th Annual Endoscopy Symposium
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  75. 75. The Science of Wellness <ul><li>Meditate/ breathe/ journal/ spiritual </li></ul><ul><li>Happiness list </li></ul><ul><li>Have Sex </li></ul><ul><li>Reassess quarterly </li></ul>
  76. 76. The Caerphilly Study: Smith, Frankel, Yarnell, BMJ 1997 <ul><li>N=918 males(45-59 y/o), 10 year f/u </li></ul><ul><li>Stratified to self-reported frequency of intercourse </li></ul><ul><ul><li>Low: Less than q month </li></ul></ul><ul><ul><li>Intermediate </li></ul></ul><ul><ul><li>High: BIW or more frequent </li></ul></ul><ul><li>Data adjusted for variables of age, social class, systolic blood pressure, smoking, baseline CAD, cholesterol </li></ul>
  77. 77. The Caerphilly Study: Results Low Frequency Intermediate Frequency High Frequency All Cause Mortality 1.9 CI 1.0-3.4 P<0.04 1.6 (CI 1.0-2.8) 1.0 Coronary Heart Disease 2.1 CI 0.9 -5.1 P<0.10 1.8 (CI 0.8-4.0) 1.0
  78. 78. Women vs. Men Quality vs. Quantity <ul><li>Sexual dissatisfaction for women is an independent risk factor for MI </li></ul><ul><ul><li>Abramov, Psychosom Med 1976 </li></ul></ul><ul><li>Lack of sex associated with death in men </li></ul><ul><li>Lack of enjoyment associated with death in women </li></ul><ul><ul><ul><li>Duke Study on Ageing </li></ul></ul></ul><ul><ul><ul><ul><li>Palrnore, Gerontologist 1982 </li></ul></ul></ul></ul>
  79. 79. Rx Yourself Now: <ul><li>If you really want to do something you’ll find a way. </li></ul><ul><li>If you don’t, </li></ul><ul><li>you’ll find an excuse. </li></ul>
  80. 80. The Science of Wellness <ul><li>Stop smoking </li></ul><ul><li>Moderate your eating habits </li></ul><ul><li>Exercise 30 minutes daily </li></ul><ul><li>Sleep 8 hours a night </li></ul><ul><li>See a physician </li></ul><ul><li>Seek the spiritual </li></ul><ul><li>Make a “Happiness List” </li></ul><ul><li>Have more/better sex </li></ul><ul><li>Reassess quarterly </li></ul>
  81. 81. SSDT: Not sex!
  82. 82. This is your prescription for sanity: <ul><li>Regain your passion and joy in medicine </li></ul><ul><li>Self care is your right </li></ul><ul><li>Have more (or better) sex </li></ul>
  83. 83. “ Does It Make Your Ears Wiggle?” -N.E. Raymond
  84. 84. Don’t wait for a second opinion!
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