How To Outsmart Your Negative Brain Daniel Doherty RN, MSN, CEN - - PowerPoint PPT Presentation

How To Outsmart Your Negative Brain

Daniel Doherty RN, MSN, CEN

Staff Development Specialist Emergency Department , CCHS

Disclosure Statement Presenter discloses no conflict of interest relative to this educational activity

Learning objectives

• Identify how stress can cause the brain’s

negative bias

• Discover the negative outcomes of utilizing

“reactive” coping strategies

• Develop initial strategies to overcome the

stressful effects of working in nursing

• Apply strategies to separate work from home
• Modify their thoughts process to outsmart their

negative brain

• 150+ Patient and Family Advisers
• Primary Care Office Visits: 227,295
• Home Health Care Visits: 308,096
• 21st in U.S. Admissions: 53,072
• 29th in U.S. Surgeries: 38,712
• 21st in U.S. ED Visits: 187,317
• 32nd in U.S. Births: 6,469

.

Christiana Health Care Systems

The Catalyst

Cost to The Brain

• Burnout
• Compassion fatigue
• Vicarious trauma

Burnout

Compassion Fatigue

Vicarious Trauma

• Not PTSD

Affects not just us

The Big Issue

• Lack of control and uncertainty
• Do not know the beginning or
• ften do not see the end

(fragmented care)

What Happened Here?

Our 1st Ineffective Strategy Withdrawal/Detach

– Brain upset – No one will listen

• Where do your stories go
• Sliming colleagues

Answer: It’s not my journey

Our Confusion

• Compassion
• Seeing someone suffering and wanting to

help

• Empathy
• Seeing someone suffering, taking on part
• f that suffering and wanting to help

Our 2nd Favorite Ineffective Strategy

What do you do in your free time? Idle brain/negative brain 12 minutes Missed

• pportunity

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)

• Trick the brain into having fun
• 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

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)

• Feeling depleted
• Negative self image
• Intrusive images/thoughts
• Difficulty separating work from personal

life

How Was Your day?

147 83 49 20 60 17 19 24 19 14 0

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
• 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

Happy Hormone-Dopamine

50%/10%/40%

Happy Hormone-Serotonin

The Problem Adrenaline and Cortisol (Half-life)

The Brain

I think here I think here I feel here

Brain wants to know 2 things

Limbic System want to know 3 things

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

Mindfulness

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

• Be like Mandy---play a lot!
• Dopamine (something to look forward to every 8 weeks, accomplish a

goal), oxytocin (connect with people, touch someone) and give someone some serotonin

Questions?

ddoherty@christianacare.org

Bakker, A. B., Killmer, C. H., Siegrist, J., & Schaufeli, W. B. (2000). Effort-reward imbalance and burnout among nurses. Journal of Advanced Nursing, 31(4), 884–891. Retrieved from https://www.researchgate.net/publication/12556406_Effort- reward_imbalance_and_burnout_among_nurses Beck, C. T. (2011). Secondary traumatic stress in nurses: A systematic review. Archives of Psychiatric Nursing, 25(1). doi:10.1016/j.apnu.2010.05.005 Benoit, L. G, Veach, P. M., & LeRoy, B. S. (2007). When you care enough to do your very best: Genetic counselor experiences of compassion fatigue. Journal of Genetic Counseling, 16(3), 299–312. doi:10.1007/s10897-006-9072-1 Bergman, C. L. (2012). Emergency nurses’ perceived barriers to demonstrating caring when managing adult patients’ pain. Journal of Emergency Nursing, 38(3), 218–225. doi:10.1016/j.jen.2010.09.017 Bober, T., & Regehr, C. (2005). Strategies for reducing secondary or vicarious trauma: Do they work? Brief Treatment and Crisis Intervention, 6(1), 1–9. doi:10.1093/brief-treatment/mhj001 Bradbury-Jones, C., & Tranter, S. (2008). Inconsistent use of the critical incident technique in nursing research. Journal of Advanced Nursing, 64(4), 399–407. doi:10.1111/j.1365- 2648.2008.04811.x

Reference

Bradbury-Jones, C., & Tranter, S. (2008). Inconsistent use of the critical incident technique in nursing research. Journal of Advanced Nursing, 64(4), 399–407. doi:10.1111/j.1365- 2648.2008.04811.x Epstein, R. (2011). Fight the frazzled mind. Scientific American Mind,22(4), 29-35. Retrieved from http://drrobertepstein.com/downloads/Epstein-Fight_the_Frazzled_Mind- SCIENTIFIC_AMERICAN_MIND-Sept_Oct_2011-pp30-35.pdf?lbisphpreq=1 Hooper, C., Craig, J., Janvrin, D. R., Wetsel, M. A., & Reimels, E. (2010). Compassion satisfaction, burnout, and compassion fatigue among emergency nurses compared with nurses in other selected inpatient specialties. Journal of Emergency Nursing, 36(5), 420–427. doi:10.1016/j.jen.2009.11.027 Kerasiotis, B., & Motta, R. W. (2004). Assessment of PSTD symptoms in emergency room, intensive care unit, and general floor nurses. International Journal of Emergency Mental Health, 6(3), 121–133. Mathieu, F. (2012). The compassion fatigue workbook: Creative tools for transforming compassion fatigue and vicarious traumatization. New York, NY: Routledge. http://www. ProQOL.com

Reference