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Wash, Dry, Resilience, Repeat..

by Ellen Fink-Samnick MSW, ACSW, LCSW, CCM, CRP on 06/03/18

Performance excellence is the latest casualty of workplace stress, negatively impacting both patient outcomes and workforce retention. This dynamic is one of many factors to put resiliency front and center in the health care industry. The theme has emerged in response to critical data:

·       One completed physician suicide daily

·       Nurses are 23% more likely to commit suicide than women in general 

·       Social workers have long been associated at higher risk for suicide than other professions, and have turnover rates at 215%. 

·       Health and human service professionals are among the top jobs at risk for suicide, and have among the highest rates of Depression.

 

Professional Resilience 1.0

My profound concern for the workforce is longstanding. For over a decade I’ve focused intentionally on the topic of resiliency, specifically Professional Resilience. The definition I developed is:

 “a health and human service professional's commitment to achieve balance between occupational stressors and life challenges, while fostering professional values and career sustainability. This is accomplished through a set of defined building blocks and individualized strategies.”.

Recognizing that everyone’s magic wand remains at the repair shop awaiting backordered parts, I designed a comprehensive paradigm inclusive of the definition above, plus six building blocksand fourteen strategies:

The building blocks:

·       Promote physical and psychological self-care;

·       Maintain a foundation of inner strength;

·       Define personal and professional values;

·       Be motivated to identify, then achieve, personal and professional goals and aspirations;

·       Believe in self-advocacy; and

·       Know that the energy of these concepts enhances career satisfaction and longevity

The strategies:

1.      Value, do not devalue, your “professional self”

2.      Present with a presence. 

3.      Have positive contacts with colleagues and peers. 

4.      Achieve validation

5.      Use the power of professional networking.

6.      Stop saying you cannot take a break. 

7.      Use creative visualization. 

8.      Take control and shift activities. 

9.      Laugh at least once a day! 

10.   Stop to take that long deep breath

11.   Develop a grounding list. .

12.   Exercise. 

13.   Release frustration with a silent meow. 

14.   Revision honestly and regularly usingthe revisioning tool, a template to:

·       revise previously defined life's goals and priorities,

·       define an individualized schedule,

·       identify realistic obstacles to the schedule's implementation, and

·       progress with a plan to reflect your current perspective.

 

Professional Resilience 2.0

While the Professional Resilience Paradigm has stood the test of time these past ten years, issues continue to emerge for the workforce to reconcile. After all, it is a fluid industry. The stakes for patients are inordinately high when practitioners are unable to effectively manage the workplace pressures.Concerning data around the relationship between workplace stress, medical errors, and the quality of care have contributed to adding a fourth Aim to the Triple Aim; the quality compass for healthcare professionals. Integration of a goal, to improve the work life of health care providersjoins the other elements of the Triple Aim; enhancing the patient experience, improving population health, and reducing costs.

 

Burnout and compassion fatigue are occupational hazards for health and human service professionals across every practice setting. Addressing them is a necessity. A recent report by Press Ganey details a four point strategy to curb clinician burnout:

1.      Deconstruct burnout into actionable components

2.      Understand the interrelationships between burnout components

3.      Measure the clinician experience as it relates to components of burnout

4.      Design interventions that boost resilience and hamper burnout

These are well intended points that address the stressors and rewards faced by individual clinicians and teams across the industry. The clear delineation of the inherent components of burnout and resilience are especially noteworthy:

·       Inherent components: 

o  The emotional drain linked to providing care to the ill

o  Witnessing suffering

o  The daily pressure of making clinical judgments that affect patients' lives

o  Rewards include the joy of helping people, doing meaningful work, and respect from

o  patients, staff, and the community

·       External components:

o  Working with electronic health records

o  Low staffing levels

o  Pressure for increased productivity

o  Diminished autonomy

o  External rewards include compensation, prestige, and recognition from patients

The list of external components is part of an ever evolving list of workforce disrupters, which have been tackled in the literature, including:

·       Workplace bullying

·       Workplace violence

·       Providing immigrants unequal care

·       Exposure to mass violence incidents

·       Regulatory and reimbursement requirements

·       Complex client and caregiver dynamics

 

Professional Resilience 3.0 and Beyond

Emphasis on resiliency and workforce sustainability is mandated. Attention to professional self-protection and worth are too often minimized by diverted attention to other organizational priorities, from length of stay to the fiscal imperative to balance costs of care. Value-based programming has only amped up the industry’s impetus to allow costs, at times to supersede quality of care. 

 

Despite the prevailing industry trials and tribulations, practitioners can commit to effectively promote their own Professional Resilience.  

Here are five fresh action-oriented strategies to put in place immediately:

1.     Define a ‘safe’ space-Identify a physical place to seek refuge where you work (e.g. your office, that of a colleague, a stairwell, bathroom)

2.      Assure ‘unconditional support’ in your corner-Have someone you can trust to support you as well as call you out.

3.      Tag a mentor-Have someone objective to inspire you to soar and catch you when you fall.

4.      Take 10-Take time to refocus if not recharge; whether 10 seconds, minutes, hours, or days. If you need 10 weeks, you need a new job!

5.      Take stock:Insight and self-reflection are indisputable strengths and not weaknesses.

 

The struggle continues for all health and behavioral health professionals to self-protect from workforce trauma. Assuring our sustainability is vital as compelling numbers validate the vulnerability of every practitioner providing care today. Can you afford to wait to garner all the Professional Resilience you can muster?


Until next time...Stay Resilient  

Ellen

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