LAWSON COACHING & CONSULTINGLAWSON COACHING & CONSULTING

Emotions Distress & Doctoring

uberlumen — Wed, 24 Apr 2013 15:30:44 +0000

Docs underutilize resources for emotional stress

With research showing that burnt-out hospital staff is more prone to unprofessional patient care, a new study in the Archives of Surgery finds that 79 percent of surveyed physicians experienced either a serious adverse patient event and/or a traumatic personal event during the previous year.

But despite the frequency of such stressful occurances–the common predecessor to burnout–physicians fail to use established support resources, according to the study conducted at a large tertiary care academic hospital.

Most physicians (89 percent) said a lack of time prevented them from seeking support, while 68 percent had concerns about confidentiality, and 68 percent thought it would negatively affect their career

With 88 percent of survey respondents choosing fellow physicians as their preferred source of support, the researchers suggest hospitals implement one-on-one peer physician support programs to help physicians effectively manage on-the-job stress.

Similarly, physicians in Ottawa found group counseling eased stress, FierceHealthcare previously reported. The physicians meet every two weeks to talk about stressful experiences at work, such as a difficult patient or a challenging diagnosis.

Hospitals also can use a physician health committee that offers support, emphasizing discussion as a committee, evaluation and treatment to professionals and the use of voluntary medical leave of absence, rather than the punitive culture that physicians worry about.

In addition to peers, support also can come from the top. According to a survey conducted by Physician Wellness Services (PWS) and Cejka Search last fall, healthcare administrators can offer flexible or reduced work hours to help physicians achieve better work/life balance, as well as address conflicts promptly to alleviate disruptive situations.

The post Emotions Distress & Doctoring appeared first on LAWSON COACHING & CONSULTING.

Integrity is Like a T.V. Dinner

uberlumen — Sat, 06 Apr 2013 10:49:28 +0000

Many see integrity as a description reserved for morally upstanding individuals. However, integrity is like a T.V. dinner. Remember T.V. dinners? The word integrity stems from integer which literally means whole. Now T.V. dinners have the peas, mystery meat, and potatoes each separated from one another by little boxed partitions. We do not show integrity when we put each part of us and how we behave in separate containers aka we act differently depending on whether we are at work or with our family etc. To have integrity is to behave the same no matter whether we are at work, at play, at home, etc. So integrity is when we behave like a T.V. dinner with the meat, potatoes, and peas all mixed together in one big pile.

The post Integrity is Like a T.V. Dinner appeared first on LAWSON COACHING & CONSULTING.

Why Emotions Matter: Nursing

uberlumen — Fri, 05 Apr 2013 22:31:12 +0000

Why Emotions Matter: Age, Agitation, and Burnout Among Registered Nurses

Rebecca J. Erickson, PhD
Wendy J. C. Grove, PhD

Abstract

Knowledge of the emotional demands facing today’s nurses is critical for explaining how work stressors translate into burnout and turnover. Following a brief discussion of how the experience of burnout relates to the nursing shortage, we examine the scope of nurses’ emotional experiences and demonstrate that these experiences may be particularly consequential for understanding the higher levels of burnout reported by younger nurses. Using survey data collected from 843 direct care hospital nurses, we show that, compared to their older counterparts, nurses under 30 years of age were more likely to experience feelings of agitation and less likely to engage in techniques to manage these feelings. Younger nurses also reported significantly higher rates of burnout and this was particularly true among those experiencing higher levels of agitation at work. We conclude by suggesting the need for increased awareness of the emotional demands facing today’s nursing workforce as well as the need for more experienced nurses to serve as emotional mentors to those just entering the profession.

Citation: Erickson, R., Grove, W., (October 29, 2007). “Why Emotions Matter: Age, Agitation, and Burnout Among Registered Nurses” Online Journal of Issues in Nursing. Vol. 13, No. 1.

The post Why Emotions Matter: Nursing appeared first on LAWSON COACHING & CONSULTING.

Practice, Practice, Practice

uberlumen — Wed, 13 Mar 2013 23:41:19 +0000

In today’s encore excerpt – practice. Rather than being the result of genetics or inherent genius, truly outstanding skill in any domain is rarely achieved with less than ten thousand hours of practice over ten years’ time. “For those on their way to greatness [in intellectual or physical endeavors], several themes regarding practice consistently come to light: 1. Practice changes your body. Researchers have recorded a constellation of physical changes (occurring in direct response to practice) in the muscles, nerves, hearts, lungs, and brains of those showing profound increases in skill level in any domain. 2. Skills are specific. Individuals becoming great at one particular skill do not serendipitously become great at other skills. Chess champions can remember hundreds of intricate chess positions in sequence but can have a perfectly ordinary memory for everything else. Physical and intellectual changes are ultraspecific responses to particular skill requirements. 3. The brain drives the brawn. Even among athletes, changes in the brain are arguably the most profound, with a vast increase in precise task knowledge, a shift from conscious analysis to intuitive thinking (saving time and energy), and elaborate self-monitoring mechanisms that allow for constant adjustments in real time. 4. Practice style is crucial. Ordinary practice, where your current skill level is simply being reinforced, is not enough to get better. It takes a special kind of practice to force your mind and body into the kind of change necessary to improve. 5. Short-term intensity cannot replace long-term commitment. Many crucial changes take place over long periods of time. Physiologically, it’s impossible to become great overnight. “Across the board, these last two variables — practice style and practice time — emerged as universal and critical. From Scrabble players to dart players to soccer players to violin players, it was observed that the uppermost achievers not only spent significantly more time in solitary study and drills, but also exhibited a consistent (and persistent) style of preparation that K. Anders Ericsson came to call ‘deliberate practice.’ First introduced in a 1993 Psychological Review article, the notion of deliberate practice went far beyond the simple idea of hard work. It conveyed a method of continual skill improvement. ‘Deliberate practice is a very special form of activity that differs from mere experience and mindless drill,’ explains Ericsson. ‘Unlike playful engagement with peers, deliberate practice is not inherently enjoyable. It … does not involve a mere execution or repetition of already attained skills but repeated attempts to reach beyond one’s current level which is associated with frequent failures.’ … “In other words, it is practice that doesn’t take no for an answer; practice that perseveres; the type of practice where the individual keeps raising the bar of what he or she considers success. … “[Take] Eleanor Maguire’s 1999 brain scans of London cabbies, which revealed greatly enlarged representation in the brain region that controls spatial awareness. The same holds for any specific task being honed; the relevant brain regions adapt accordingly. … “[This type of practice] requires a constant self-critique, a pathological restlessness, a passion to aim consistently just beyond one’s capability so that daily disappointment and failure is actually desired, and a never-ending resolve to dust oneself off and try again and again and again. … “The physiology of this process also requires extraordinary amounts of elapsed time — not just hours and hours of deliberate practice each day, Ericsson found, but also thousands of hours over the course of many years. Interestingly, a number of separate studies have turned up the same common number, concluding that truly outstanding skill in any domain is rarely achieved in less than ten thousand hours of practice over ten years’ time (which comes to an average of three hours per day). From sublime pianists to unusually profound physicists, researchers have been very hard-pressed to find any examples of truly extraordinary performers in any field who reached the top of their game before that ten-thousand-hour mark.” Author: David Shenk Title: The Genius in All of Us Publisher: Anchor Date: Copyright 2010 by David Shenk Pages: 53-57

The post Practice, Practice, Practice appeared first on LAWSON COACHING & CONSULTING.

Physician Mindfulness

uberlumen — Sat, 02 Mar 2013 21:21:31 +0000

Physician meditation, communication improve care

May 1, 2012 | By Debra Beaulieu

Learning “mindful meditation and communication” skills may sound to some doctors like a luxury for which they don’t have time, but new research from the University of Rochester confirms it may be well worth the investment for physicians and their patients.

The study, published in Academic Medicine, is a follow-up to a paper the researchers published in the Journal of the American Medical Association in 2009. For the initial study, Howard Beckman, M.D., clinical professor of Medicine and Family Medicine at the University of Rochester Medical Center, and colleagues enrolled 70 physicians in a mindfulness training program that involved eight weekly sessions, followed by 10 monthly sessions. They found that participants were better equipped to handle psychological distress, fend off burnout and improve their well-being. For the follow-up, the team interviewed 20 of the physicians about their experience with the training.

Highlights from their feedback are as follows:

60 percent said the training helped them become more attentive listeners
50 percent said they were more self-aware and less judgmental in conversations at work and home
75 percent found strong benefits in being able to discuss their personal medical experiences with other doctors in the training program in a setting they felt was safe and free of judgment
70 percent placed a high value on the mindfulness course having a well-defined curriculum that designated time and space to pause and reflect

But to truly improve primary care, the researchers suggested training individual physicians in mindfulness doesn’t go far enough.

“Programs focused on personal awareness and self-development are only part of the solution,” the researchers stated. “Our healthcare delivery systems must implement systematic change at the practice level to create an environment that supports mindful practice, encourages transparent and clear communication among clinicians, staff, patients and families, and reduces professional isolation.”

The post Physician Mindfulness appeared first on LAWSON COACHING & CONSULTING.

Expert advice will give you a brain freeze

uberlumen — Wed, 08 Aug 2012 21:56:47 +0000

It turns out that getting expert advice literally shuts out brain down, and it can prevent us from making a truly informed decision. This fact is important to know when you seek expert advice.

1. Don’t rely on a single expert’s advice, get a second or even a third opinion.

2. Do your own research and determine your potential decision options BEFORE you meet with an expert.

I would have loved to not only know of this research but to also really absorb and embrace its truth before some key experiences in my life with “experts” in fields outside of my expertise. Yes even doctors can fall into this trap of trusting advice from other “experts”, and I can vividly remember several incidences in which my brain shut down/shut off because I was with an “expert”

Expert Advice Shuts Your Brain Down Article

The post Expert advice will give you a brain freeze appeared first on LAWSON COACHING & CONSULTING.

Doctors experience trauma to their hearts and stress to their souls by Edwin Leap, MD

uberlumen — Fri, 27 Jul 2012 18:12:55 +0000

I was talking to some new friends over lunch recently, at the nationally renowned Hominy Cafe, in Charleston, SC. Any place with a Fried Green Tomato BLT, and Shrimp and Grits for breakfast, has my vote!

To the point: my question to these esteemed emergency medicine educators was this: “Do you ever have irrational fears about the people you love, because of what you do?”

The answer was a resounding “absolutely!”

Like me, they worried when ambulances were dispatched while their children were out with friends. They worried when their spouses drove in heavy traffic. The list went on. And I shook my head in agreement.

I had been contemplating this question for quite a long time. What are the consequences of years in the emergency department? Sure, I know: the consequences are anger, bitterness, frustration, distrust, cynicism. Balanced, fortunately, by compassion, perspective, appreciation for life’s gifts, love of common people and the ability to hang out with heavily tattooed bikers, drunks and former felons without feeling the least bit uncomfortable.

But what I mean is this: what emotional, psychiatric consequences are there? What scars do we carry deep inside? I don’t think we acknowledge this; we certainly don’t address it. But the truth is, our specialty takes us into the heart of terror, into the midst of the worst situations humans can experience. All roads, as we know, lead to the emergency room.

The abused child, the raped woman, the burnt workman, the assaulted senior citizen, the addicted teen, the mother dead by suicide. The new diagnosis of cancer the new diagnosis of HIV or Hepatitis. We see the schizophrenic young man who wanders away, we see the demented husband of 50 years who cannot recognize the love of his life.

We tell loved ones that their dearest is dead. We listen as families wail, and collapse onto the ground in the emotional equivalent of a hurricane, suddenly thrust from normalcy and hope to terrible brokenness and stunning loss.

It’s a common fact of the job. We talk about it a little. We teach students and residents how to break bad news. And we tell them the primacy of their own relationships, and explain the perils of using drugs or alcohol to cope. And then we send them off the way we were sent off; like lambs before lions, to face a life of emotional maelstroms.

I wonder, often, how common PTSD is among our population. Post Traumatic Stress Disorder is in the news a lot. We associated with terrible trauma, with death and the threat of death, with disaster, with terrorism and combat. We shake our heads in sympathy with the young man or woman, shaken by tours of duty in Iraq or Afghanistan, whether or not they actually pulled triggers or even saw death. Their very proximity to those things is sufficient to win our appropriate concern.

And yet. And yet … Day after day, night after night we go into a workplace where we have no control over who or what comes through the door. And we have no way to predict what we might see. Certainly, we might spend a shift in utter boredom (hey, it could happen!). Or we may see something so horrible that it changes us forever. We may leave having been stained with the blood of a police-officer, coughed on by a patient with tuberculosis, or tearful from giving terrible news to someone we knew.

Furthermore, we go back to the same rooms where we saw death, the same floors that were littered with dressings and body fluids, the same conference rooms where we delivered the terrible news.

And we do it for years. Decade after decade we accumulate stories and experiences which, taken singly, would send the average citizen screaming to their counselor or psychiatrist…and not without reason.

But we? We are rich doctors. We are the educated. We are expected to do it, to show up the next day after the horror of the day before. We are not excused because of the terrible things we endure, but instead wear them as a tragic badge of honor, even as we die a little inside from fear, from worry, from taking all of those things and imagining how they might appear in our own lives, or in the lives of our families. From the fear that we will make a mistake in the midst of chaos, and add to the sum-total of pain in the world.

I don’t know how many of us meet the strict criteria of PTSD. But we experience trauma to to our hearts and stress to our souls. If you have ever wondered about this, on the drive home, or in the hours before work. If you have ever contemplated it in the night between patients, in the fog of exhaustion, or decompressed from it on the beach with your family, then you aren’t alone.

I’m writing to say that your fears, your terrors, are common to all of us who serve our tours in the emergency department. And you are allowed to be shaken by them, to be wounded by them.

I hope you will not let them shape you, or break you. But I fear that much of what we call burnout, much of our “bitterness” or “anger,” or “bad attitudes” are simply our attempt to express acceptable emotions over the hard things we see, do and remember ever after. Because for some reason, we are not supposed to be affected no matter how much misery crashes on our lives like tsunamis.

It’s high time our colleagues, our employers, our friends and educators and even our politicians recognized that money, education and title don’t ease the pain, and the fear, that is inherent in our work.

Perhaps, however, the most important step in healing would be for us all to admit to ourselves that it’s a hard job, and that the consequences to our lives run deeper than circadian problems and contract negotiations.

And that even healers, like us, have wounds too deep to fully understand.

The post Doctors experience trauma to their hearts and stress to their souls by Edwin Leap, MD appeared first on LAWSON COACHING & CONSULTING.

What is the question that will change your day?

uberlumen — Wed, 25 Jul 2012 19:14:33 +0000

The other night working in the Emergency Department I was dog tired as I picked up a chart of a patient to see. After I obtained the pertinent medical information from this patient, I then asked my 94 year old patient, “Where were you during world war 2?”

He proceeded to share a little known story about his time working with General Patton. The patient told me that even his own grandkids don’t ask nor seem interested in his life experiences. It was an interesting and amazing patient interaction. I left that conversation so energized that the last 2 hours of my shift flew by.

Reflecting on this event, reminds me of the power of our ability to choose what perspective we will be in and what powerful question we can ask of ourselves and others. Perspective: It is amazing to me how quickly I can shift from ‘dog tired’ perspective to ‘wow what an incredible patient and story’ perspective–shifting from falling asleep to being fully awake–better than any cup of caffeine! Question: It is fun and shocking the power of a question to shift our thoughts and energy levels. I recently asked at a dinner party: What do you crave? This one question made for a deep and meaningful and laughter filled discussion.

What is the question that you could ask at work and at home that would energize or change your day for the better?

The post What is the question that will change your day? appeared first on LAWSON COACHING & CONSULTING.

The Sage & The Saboteur: How to Overcome Your Limiting Beliefs

uberlumen — Wed, 25 Jul 2012 19:03:41 +0000

Do you remember the old cartoons that depicted an angel and a devil on each of your shoulders? Well it turns out that we have a Sage and the Saboteur in our brains. The Saboteur is a ‘voice’ or thoughts and feelings that was adaptive in our early development and when we were being chased by Saber Tooth Tigers. It is an early warning ‘voice’ that may say early on in our lives, “Don’t even try to jump that fence because if you do, you will break your leg.” However, this ‘voice’ grows up with us and becomes our limiting beliefs voice. It begins to tell us, “You are not enough.” and “You are a failure.” and “You will never amount to anything.” Ever heard that voice? I certainly have, and I continue to hear it AND listen to it.

The other ‘voice’ is that of the Sage. It tells us things like, “You are enough.” and “It is possible.” and “You can do it.” It turns out that if we train ourselves to listen to this ‘voice’, our brain runs/functions much better in fact studies have shown over 30-40% better! When we listen to this positive Sage ‘voice’, our brains are flooded with dopamine and serotonin–chemicals that immediately enhance our brains learning centers allowing us to think more quickly and creatively, solve problems better and see and create new ways of doing things.

If you are like me, you hear the ‘voice’ of the saboteur more than the Sage. And if you are not hearing the saboteur, it means that you have not become aware of it or it is doing a great job of tricking you into believing that it is speaking the truth
or at least speaking things that are helping you. The saboteur may have convinced you that without it’s advice you would make stupid choices or become lazy, but nothing is further from the truth. The saboteur ‘voice’ that says, “Now, that was a stupid thing to do.” often will continue that mantra over and over again creating more sleeplessness and more anxiety whereas the Sage’s approach might be to say, “So you made a mistake, to err is human, and this mistake could be made into an opportunity depending on how you react to it.”

Ok. Interesting. Now what. The key to weakening The saboteur ‘voice’ (note: most of us have multiple Saboteur ‘voices’ such as a judger and a pleaser and a controller etc.) is:
1. Don’t fight them/it
2. Simply observe and notice the saboteur thoughts and feelings when they arise
3. Tag or label these thoughts or feelings every time you notice them (some who are in training against the saboteur will keep a journal or jot down a quick note when they notice the saboteur thoughts and feelings aka ‘voice’)

The post The Sage & The Saboteur: How to Overcome Your Limiting Beliefs appeared first on LAWSON COACHING & CONSULTING.

50 No’s & 5 Yes’s: How to Treat Overwhelm?

uberlumen — Sat, 30 Jun 2012 23:00:14 +0000

Overwhelm is a HOT topic. We all feel overwhelmed at some time in our lives. Our To-Do lists are stuffed to the gills, and we walk around in a To-Do list haze so overwhelmed that we are so busy listening to the tape playing in our heads of what we need To-Do instead of capturing all the amazing things happening all around us.

Solutions? Burn the To-Do list? Maybe.

1. Practice Present Perfect: Our brains are designed to be in the present moment, but our To-Do lists and overwhelm feelings and thoughts are predominantly in the future. The studies show that by not being focused in the present our brainsare much less efficient so the overwhelm and To-Do lists are actually making us less productive. How do we practice being more present? Keep a 3×5 card in your pocket or jot down notes in your smartphone when you are in a moment that you have lost track of time in. These moments of flow are the present moments that bathe our brain in the chemicals that make us more efficient, more productive, and are the antidote for overwhelm.

2. Purpose: It is easy to live in the land of overwhelm when we lose site of our purpose. When was the last time you were truly thrilled? What was your most recent peak experience? Tapping into these moments will help you focus on doing the things that you were made to do. The things that you were made to do are those things that thrill you. Get in touch with your thrilling moments and you will begin to get in touch with your Yes’s. Now list the 1-5 things that you most love to do at work, at home, etc. This is your YES list. These are the To-Do items that you were designed to Do and Be with.

3. Prioritize: Starting with No’s leads to less overwhelm and more YES. I recently challenged one of my clients to put together a list of 50 No’s. 50 items that he is going to say no to. What is on our list of No’s? Which of these No’s are you going to commit to? I would love to say No to checking my email on my smartphone when out to dinner…..The NO list is the list that frees us up to say YES.

The post 50 No’s & 5 Yes’s: How to Treat Overwhelm? appeared first on LAWSON COACHING & CONSULTING.