Author Archive: Jeanine Joy

Burnout Prevention and Recovery, Resilience and Retention Evidence-based, experience-informed, root cause solutions

Burnout Prevention and Recovery

When we were asked to participate and be a resource to the NC Consortium on Physician Resilience and Retention ( a Committee of the NC Medical Society), we were moved to develop a white paper for an upcoming meeting. We began pulling research on burnout. Jeanine’s dissertation was on Employee Engagement so she was very familiar with the other end of the spectrum. Within two days, 300 journal articles had been identified. At that point we knew it would have to be a book; not just a white paper.

After reviewing over 500 articles, we elected to address, burnout prevention and recovery through two distinct lenses:

  1. What an individual can do to protect themselves and/or recover from burnout, and,
  2. What healthcare organizations can do, individually and collectively, to prevent burnout and help employees recover from burnout syndrome.

Designed to be easy

Recognizing that both physicians (read as “all providers of care”) and healthcare organization executives are busy and may not have time to read the entire book, we wrote the book so that a physician who just wants to know how to prevent or recover from burnout can get all the information needed without having to digest the full text of information for the healthcare organization. The information for the healthcare organization executive or manager who wants to know what the organization can do also stands alone.

Executives may want to review the section for individuals because training your staff to understand the knowledge and skills presented there will increase resilience, emotional intelligence, and create a more positively focused workforce. It will also help them deal with daily stressors in your role including workplace politics.

A brief overview of the problem with current statistics about burnout is provided at the beginning.

The Appendices have questionnaires for burnout, depression, coping, and anxiety.

Build Resilience by applying Science

The section for physicians provides actionable steps that increase resilience, self-compassion, and foster development of healthy habits of thought. The research consistently shows that this is the difference between those who are burned out and those who are not–not the amount of stress inherent in their role.

Healthcare Organizations Have Work To Do, Too

The need for resilience does not mean that there is not a great deal of work that can and should be done by healthcare organizations to make the work environment less stressful and more supportive of the physical and mental health of its employees. Some of that work could be done quickly in organizations that are motivated. Much of the organizational work will require concerted actions between organizations to change the environment including legal, regulatory, and payers.

Why the Authors are Qualified to Write This Book

Dr. Joy’s prior books on Employee Engagement, Suicide Prevention, and Resilience, her dissertation on empowering employees, and years of research on building resilience prepared her to write this book. She asked Phil Geissinger to join her to add his expertise on the leadership and management of healthcare organizations and the many burdens that have been added to the roles of healthcare clinicians over the last several decades because she knew his insights would focus on how to accomplish what has to be done in ways that reduce the likelihood of burnout.

It is clear that healthcare organizations and care providers must act to prevent and recover from burnout. Physicians experience stress from:

·         Lack of time ·         Financial Pressure ·         Lack of purpose and meaning
·         Malpractice costs ·         Long Hours ·         CME
·         Paperwork ·         Board Certification(s) ·         Erosions of Autonomy
·         Work-Life Conflicts ·         Inadequate sleep ·         Business of Medicine
·         Secondary Trauma

·         Collegial pressures

·         EMR/EHR

·         Practice economics

·         Insurance Companies

·         Human resource issues

 

People making their living off Physicians

One key aspect that enhances the ability of the approach to burnout applied is the change in the purpose of emotions that was validated in 2007. Understanding and applying the new guidance on the purpose and use of emotions make it much easier to develop resilience and to understand how to use cognitive restructuring to reduce stress. We expect healthcare providers will find it helps them help their patients.

Learning advanced and transformational coping skills means physicians and other healthcare providers experience less stress on a daily basis. Chronic stress leads to burnout and the adverse physical and mental health outcomes associated with burnout. 

Coping Skills Make a Difference

People will use the best coping mechanisms available to them but if they don’t know how to use healthy coping strategies they will use a coping strategy they can access–even if it is maladaptive or dysfunctional. Primary Prevention for maladaptive and dysfunctional coping strategies such as drugs and alcohol requires training in healthier stress management strategies.

When you know good coping skills you don't use bad ones

You’ll find it interesting that most of the commonly recommended stress management strategies are dose-dependent palliative strategies. 

Stress Coping Strategies

Our book, Burnout: Prevention and Recovery, Resilience and Retention, is available on Amazon. Both Phil and Jeanine are available for keynote presentations and training to reduce burnout and provide the other benefits described in their book.Please let us know if you are interested in discussing training or speaking needs that we provide.

Burnout prevention and recovery can be easy, permanent, and relatively quick when the plan is based on research.

Together, we will make working in healthcare better for everyone which improves patient care and outcomes. 

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Academic Burnout Solutions

study life goals advice

Dear Dr. Joy: How can I study for 10+ hours a day without getting depressed and how can I make myself get used to it?

How can I study for 10+ hours a day without getting depressed and how can I make myself get used to it?

Q: I must study continually for 10 months non-stop, then I have exams in 7 subjects (only one exam for each in those 10 months) and the results will determine my future. I’m supposed to study +10 hours a day and I’m not used to such hours.

Alright, yes, I’ll admit it. I’d love to have an advice column. I’m receiving requests on Quora to answer more questions than I have time to answer. I’ve decided to start publishing my answers here. 

Dr. Joy’s advice:

If you find a way to relate to what you are studying and see it as an opportunity for rapid personal growth instead of a test that determines who you will become, it will be interesting.

Over the past six years, I’ve spent many months where I studied far more than 10 hours a day doing research for my books but I connected the reading/studying I was doing to my ultimate goal of helping people thrive more which gave it meaning that energized me to do more. Poke at the way you’re thinking about this and try to find different ways to look at the situation.

Find thoughts that feel better and then reinforce those thoughts so they become your main way of perceiving this situation. 

10 Hours is not as long as it sounds

Also, 10 hours sounds like a lot but it isn’t. Most workers have a commute to the job, work 8 hours and then have a commute home. After they do all of that many of them still find time to raise a family, fall in love, volunteer in their community, read for pleasure, and more. #1 is giving up the television and you’ll be amazed at how much time you have. Also, do take breaks to stand up, stretch, breathe deeply. The refreshment of that will more than make-up for the time it takes.

In good weather take the time to study outside.

Also, lessen the “determine your future” bit of this. It may determine your immediate opportunities but YOU determine your future. You aren’t creating a finished product through your studying efforts. You will never be a finished product. Humans continually evolve and grow. Some humans who became wildly successful didn’t even begin the activity that made them household names until they were past the age when most people retire. So let go of the “will determine my future” belief and make this a time of developing you into someone who knows more than you know today.

I wish you all the best.

What common mistakes do people make when choosing a life partner?

advice column choosing a partner

Dear Dr. Joy,

“The heart wants what the heart wants,” or do we go for a cold judgment approach.

What should be some good guidelines and misconceptions to be careful about

Dr. Joy’s Advice:

Settling.

They settle for someone who isn’t exactly what they want in a partner and:

  • Think they can live with the absence of the missing qualities, or
  • Think they can change the person (The only person who can change anyone is the person who is changing and that doesn’t happen unless/until they want to change.)

Many people make these mistakes without conscious thought. They want the fantasy they build around the person they are dating and don’t think thoughtfully about whether traits that they’ve overlooked will always be acceptable. For example, Terri loved Ron’s adventurous and spontaneous nature. He made her life more fun and she envisioned a future that was better than she’d ever dreamed of with Ron at her side. But she had also always dreamed of being a mother and when the first baby arrived her outlook about Ron’s adventurousness changed.

It was no longer a good thing that he often did things that were somewhat dangerous and always seemed to be learning a new sport that put his life at risk (sky-diving, deep sea diving, motocross, etc.) Then her best friend’s husband was killed in a motorcycle accident on his way to work when her friend was expecting their first child and Terri began worrying even more about ending up raising their child on her own if Ron had an accident during one of his adventures. She attempted to convince Ron to stop risking his life but that only drove a wedge between them. Ron felt that he hadn’t changed and he shouldn’t have to change. Even if Terri had thought far enough into the future to consider how she would feel once they were parents, she probably would have assumed Ron would change the way she planned to change. Most people make such assumptions and don’t have the conversation.

They don’t wan to rock the boat now that they think they’ve found the perfect partner.

The time to rock the boat is before you get married.

Do you really want to marry someone who frequently becomes intoxicated or high?

Consider how that could impact your ability to accumulate assets. If your spouse is busted with illegal drugs in your home or car the assets can be seized. If your spouse gets a DUI, the legal bills and increased auto insurance costs will be a significant financial burden and if an accident that harms someone occurs it could wipe you out.

Consider who will take care of the children if your spouse is frequently intoxicated or high.

Someone needs to be sober to save the children in case the house catches on fire. That sounds a bit worrisome, but how would you feel if a fire occurred and your child died because both parents were intoxicated? While it may be a lot of fun to get a good buzz by sharing a bottle or two of wine when you’re dating, it is not nearly as much fun when one of you needs to remain sober to take care of the children or when you can’t drink because you’re pregnant.

Many people marry for looks. When one of my daughters was about 11 she was very into how guys looked and went gaga over ones she thought were hot. I told her that looks weren’t everything and that when she considered a relationship with a guy she should ask herself if she’d still like him if she lost her sight or his appearance was changed in an accident. Surprisingly, she listened to me and I’m glad. But many men and women focus their partner’s physical appearance. While you want to find your partner attractive, looks should not be one of the top 5 criteria.

One way to avoid making a mistake is to decide what you want in a partner before you are in a relationship. Don’t set the bar too low. I spoke to a woman one time who said, “My next boyfriend is going to have a job and a car.” She didn’t say “a safe car” or a “reliable car.” Just a car. She also didn’t say “a steady job” or a “good job.” Apparently, any car and job would make a man good enough for her.

Don’t set your sights too low.

Go for an equal and if you have low self-esteem, aim high and work on your self-esteem.

Talk about your long range plans and desires. My husband has never lived in the country and I long to return to country living when we retire. He is okay with country living as long as we are close to a college because he wants to teach during retirement. I decided I was okay with that limitation to the location of our retirement home. There are many rural areas with great Universities in the area. But what if he hadn’t been willing to leave the city and we hadn’t talked about it?

We didn’t talk about my husband’s desire to go back to school to earn his Doctorate but fortunately, I believe in lifelong learning and am supportive. But many spouses would resist this undisclosed goal because of the cost involved.

Deep conversations and a willingness to let the relationship go if you discover things you don’t want to spend the rest of your life living with. The willingness to let go is what is most often lacking. It is easier when you realize that you can love someone and let them go and not feel heartache if you continue loving them in a fond way. It is when we attempt to stop loving someone we love that our heart aches. Our hearts know how to fall in love. They don’t know how to stop loving. But loving does not mean we have to stay together.

Letting go also requires trust that this isn’t our last chance or our best chance. I went through a lot of shenanigans (blind dates, internet dating, going to mixers, etc.) looking for love after my divorce. Where did I meet my husband? He was in my backyard golfing with a friend of mine’s husband. He lived 1/2 mile away. We’d both been invited to their Christmas party but he didn’t go one year and I didn’t go the next.

Opportunities for love are all around us. We will not find the right one when we are clinging to the wrong one.

I wish everyone as much love as they can handle in their life.

All the best to you.

How can I know what I want from life or why am I alive?

Advice about life and goals

I’m 23 yo guy. I just graduated with a major I don’t like (architecture), I got refused in an interview yesterday for a teaching job. even my love for my family is fading, they’re great, I am just not capable of loving. I have no life goal, I don’t know what I love in life. I feel like a dead man!

Dr. Joy’s Advice:

 

Please consult your doctor to check for depression.

Most people don’t have a life goal, especially not at 23. If they do, it usually changes many times over the course of their life. You’re holding yourself to a high standard and no one else is doing that (unless you have a parent who likes to find problems with you and fix them). If that is the problem being found, you’ve got a lot more going right than many 23-year-olds.

You’ve got a degree under your best. Okay, so you’ve decided you don’t like what you studied but the thing is many jobs require a degree but not a specific one.

What don’t you like about what you studied? You know what to avoid when you’re looking for jobs.

Were you really refused for a job, or was another candidate simply viewed as a better choice for that particular job? Some jobs have hundreds of applicants and to feel refused because they selected another candidate is being very harsh on yourself. Try seeing it as one step closer to getting a job. Also, even if you did crash and burn during the interview, you got some experience and you now know that you need to practice. Ask a family member or friend to give you mock interviews so you can practice and ask them to be hard on you so you’re ready for anything that comes up.

Many people don’t interview well and the cure is practice to gain confidence and seeing an interview as one out of many opportunities and trusting that the right opportunity will feel easy, not terribly difficult.

Many young adults your age are pulling further away from their birth family. It is not an unusual feeling. Non-human animals often leave their parents upon maturity and never return. I’m not saying you should do that, just that pulling away isn’t all that unusual.

Everyone, even you, is capable of loving. Your early life experience may have taught you to suppress emotions so they may be buried, but you are capable of love. Pay attention to how you feel. Tell yourself that you will notice your emotions. Emotions are not your enemy. They are actually designed to guide us toward self-actualization by feeling good when we’re moving in that direction and tell us we’re heading the wrong way with negative emotion.

Your post was brief but in many ways, it had elements that sound like catastrophizing or awfulizing, which is making a single incident (job interview) into a permanent and pervasive problem. Learning to see things as temporary situations will help you feel good. Nothing in life is permanent.

The “feeling like a dead man” comment makes me think that you’ve either been taught to suppress your emotions so you can’t feel their guidance (this is reversible) or that you’re depressed. In either case, I do encourage you to seek help. You’ll be surprised how easy it is to feel better.

I wish you all the best.

Teach Children the Right Skills Once. They will Benefit for Life

Teach Children the right skills once and they will benefit for life.

Research shows that teaching children stress reduction (resilience building) skills has a significant positive effect on outcomes longitudinally. Even children who are not expected to do well because of early hardships do better than expected if they learn these skills. Improvements seen include:

  • More likely to graduate from high school
  • More likely to go to college
  • More likely to graduate from college
  • Less likely to abuse drugs
  • Less likely to abuse alcohol
  • Less likely to commit crimes
  • Less likely to smoke cigarettes
  • Less likely to have a baby during teens
  • Less likely to die from street violence
  • Less likely to become depressed
  • Less likely to commit suicide

What do parents want that isn’t on that list? Why aren’t we teaching this to all children?

These skills create beneficial habits of thinking that reduce stress throughout the lifespan, regardless of the source of the stress.

For the citations, see Our Children Live in a War Zone.

Give your children a better chance at success. Learn the skills that matter and share them with your children.

I am very excited about the release of Our Children Live in a War Zone,  A Plan to Bring Peace to our Homes, Streets, and World on November 24, 2015. Now parents and teachers don’t have to wait for the government to implement programs that will improve the lives of children. They can learn the skills and teach the children they nurture how to be more resilient and less stressed today.

Jeanine Joy teaches, speaks and writes about human thriving. She is an expert in teaching people how to adjust their mindsets in any way they deem helpful in reaching their dreams and goals.  Her books are available here.

If this helped you, please share so that others may be helped. Thank you.
For more of my articles on LinkedIn and at Happiness 1st Institute.