Brain Fitness - White Paper

WHITE PAPER (Brain) Fitness First: Why self care matters - the business of wellness for busy health care professionals

Copyright Š Dr Jenny Brockis 2015 All Rights Reserved This publication may be reproduced without alterations at no cost in digital or print form, under the condition of full accreditation being given to the author. If there are any queries regarding the specifity of copyright, please contact jenny@drjennybrockis.com or via the contact details at the end of this publication.

Disclaimer: We care but you’re responsible.

This paper is general in nature and not meant to provide specific or medical advice.

Please take specialist advice prior to applying or taking on any of the ideas. Dr. Jenny Brockis and Associates at Brain Fit disclaim any and all liability with regard to any persons acting without said advice in respect to this White Paper, or any and all other publications produced by the author.

White Paper - (Brain) Fitness First Why self care matters - the business of wellness for busy health care professionals - Dr Jenny Brockis

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TABLE OF CONTENTS Copywrite and Disclaimer 2 Why successful health care includes self-care 4 The choice is yours 5 So what are some of the continuing practices and beliefs?

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Too much to do, too little time and too much b!**$y paperwork

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Too much stress is putting practitioners at risk of mental illness

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The risk of burnout an compassion fatigue

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A new paradigm of wellness in the caring professions

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Change is a framework 10 Creating a Healthy Health Workspace 11 Our Future and High Performance Thinking 12 References 12 About Jenny 13

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(BRAIN) FITNESS FIRST Wellness strategies for busy health care professionals "...if we are to prosper and thrive in our changing society and in an increasingly interconnected and competitive world, both our mental and material resources will be vital. Encouraging and enabling everyone to realise their potential throughout their lives will be crucial for our future prosperity and wellbeing."

Foresight Project on Mental Capital and Wellbeing

Why successful health care includes self-care.

The decision to choose to work with in the health care industry often comes from a desire to build a better world through the enhanced health and wellbeing of others.

Being passionate about wanting making a difference and being of service is a high calling. It demands a huge commitment of time and effort to the cause.

The quality of health care provided in Australia is the envy of many countries. The World Health Organisation (WHO) back in 2003 reported how "the Australian health system is world class in both effectiveness and efficiency. Australia has consistently ranked in the best performing group of countries for healthy life expectancy and health expenditure per person".

In order to provide our best, we have to be operating at our best.

So why is it that many health practitioners fail to take care of the one person necessary to make their vocation sustainable, long-lasting and rewarding?

The focus of this white paper is to examine some of the challenges currently facing busy health professionals and what can be put in place to ensure that carers are also caring for themselves.

White Paper - (Brain) Fitness First Why self care matters - the business of wellness for busy health care professionals - Dr Jenny Brockis

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The Choice is Yours Workplace wellness has been the focus of governments and employees for a number of years and the WHO has recognised the workplace as a key avenue for health promotion. Yet the uptake of wellness programs within the health-care sector remains low.

The first decision is to ask the hard questions:

Am I stopping myself from operating at my best because I put myself last?

How do I want to feel about my work and life each day?

Am I damaging my longterm health and working longevity by ignoring selfcare?

What do I need to do first?

What is the cost of choosing to do nothing?

The 2010 Pricewaterhouse Coopers (PWHC) report on workplace wellness in Australia states that this is an imperative because of the upward and rapidly increasing trajectory of chronic medical disease, accompanied by a rapidly ageing population.

The health workplace is no different from any other in that a healthy workplace is good for business. With spiralling costs of absenteeism sitting at over $7 billion each year and presenteeism costing four times as much, maintaining a healthy workforce makes good business sense.

Health coaching or mentoring is now seen as an important part of any results orientated wellness program. In the U.S the ROI is reported as being $3 for every $1 invested in wellness programs.

Wellness programs do far more than just maintain health and wellbeing - they boost engagement and productivity: Optus has reported a $1.6 million productivity gain through implementing a workplace wellness program.

The challenge to self-care in the caring professions There are a number of contributing factors. Much has to do with the culture and expectations that exists within the relevant health professions. The image of the dedicated doctor or other health professional being a person working incredibly long hours, with little rest at the expense of their own health, relationships and wellbeing is unsustainable and detrimental to the profession and those they care for.

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So what are some of the continuing practices and beliefs?

1. Many health professionals are drawn to their work by vocation, or calling. This is often combined with a strong work ethic and desire to work from a place of service to others. They place their own needs either last or way down the list of priorities.

2. A stigma remains that if you are not working full-time, or volunteering to do extra shifts you're not pulling your weight. Taking time off, choosing to work part-time or reducing hours is viewed in some quarters as a lack of devotion or commitment.

3. Patients have come to expect a 24/7 service with accessibility to their chosen health professional. This makes it harder for practitioners, especially those either self employed or in smaller practices to get sufficient time off. In addition, practitioners also see themselves in competition with others. So if one practice chooses to remain ‘open all hours’ then another provider may fear losing their patients to that practice unless they do the same.

4. Identified areas of need may have an insufficient health care workforce to cope with demand, leaving those practitioners unable to find cover for leave or others to share the burden.

5. One in five Australian adults are at risk of mental illness and that by definition includes health care practitioners. However the stigma attached to acknowledging problems of anxiety, depression or burnout can lead to self-medication issues or failure to seek appropriate help at an early stage. This is can be linked to feelings of guilt, embarrassment, or fear of being found out.

Busy people don't take much notice of health, especially their own unless it becomes a problem. What is required is a change in the mindset and culture around wellbeing.

Too much to do, too little time and too much b!**$y paperwork.

While the move to more paperless practices continues, the administrative and beaurocratic requirements required in the modern health care practice has been increasing exponentially. This leaves less time available for the clinical side of health care work at a time of burgeoning demand because of the ageing population and increasing incidence of chronic and complex medical conditions.

Trying to achieve more with less time is leading to the hamster wheel of life and work spinning ever faster leading to an increase in stress levels as we struggle to keep up.

In General Practice the statistics suggest that what stresses GPs out the most, remains unchanged since outlined

by Schattner and Coman in 1998!

Identified stressors in General Practice.

Time Pressure to see patients

Threat of litigation

Paperwork

Too much to do in a limited amount of time

Phone interruptions during consultations

Earning enough money

Patients who are difficult to manage

Intrusion of work on family and social life

Home visits (in hours)

Practice overheads costs

Negative media comments

Unrealistic community expectations

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Too much stress is putting practitioners at risk of mental illness The Beyond Blue National Mental Health survey of doctors and medical students in 2014 makes for sobering reading.

1. Doctors reported substantially higher rates of psychological distress and attempted suicide compared to both the Australian population and other Australian professionals.

2. Young doctors and female doctors appeared to have higher levels of general and specific mental health problems and reported greater work stress.

3. The general work experience for Australian doctors is stressful and demanding.

4. Stigmatising attitudes regarding the performance of doctors with mental health conditions persist.

5. Doctors appear to have a greater degree of resilience to the negative impacts of poor mental health.

6. The common barriers to seeking appropriate help include concerns about confidentiality, embarrassment and worries about future employability.

The risk of burnout and compassion fatigue Unless adequately addressed, the risk ultimately is that health care professionals will be lost to the system through burnout, compassion fatigue or early retirement. This loss of talented practitioners is a huge waste of expertise and is also a cost burden to the health industry and society.

In the U.S the level of reported burnout and compassion fatigue now runs at 46% of physicians.

Burnout has been defined as a loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. Those with the highest rates were working in the areas of critical care and emergency medicine.

A Cochrane review in 2014 reported that engaging in self-care, using a variety of techniques and practices was important in contributing to the health and wellbeing of health professionals. While this might appear to be a gross understatement of the obvious, it is at last an acknowledgment of the existence of the need for health professional self-care and wellness programs.

The three common challenges for health professionals 1. Time pressure 2. Managing energy levels 3. Managing frustrations, challenge and high levels of stress

Time pressure: In the health arena, time is always of the essence. Many health care professionals work in and get paid in units of time. Providing adequate care in a constant time squeeze scenario puts pressure on those delivering the service to always be working faster with less time available to think, consider and work through the more complex management cases. Processes and procedures are in place to minimize error, however the temptation to take short cuts is greater when saving time takes top priority.

White Paper - (Brain) Fitness First Why self care matters - the business of wellness for busy health care professionals - Dr Jenny Brockis

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Energy Management: We all have a finite amount of energy to devote to our endeavours. Many health care professionals work very hard and long hours. Many have a strong work ethic and enjoy being fully immersed doing the work they love.

But if our love affair with work becomes soured by fatigue, we risk losing our connection to our purpose of why we do our work and increasingly resentful of the demands and expectations of others in all areas of our lives.

Managing cognitive and physical energy across the workday is essential so as to have enough energy for family life, socializing and other interests.

Frustration management: There's no getting away from the fact that the world as we know it is changing and fast. Keeping up with the introduction of new technologies, best practice ideals, new medical discoveries and a heavy patient load is hard.

Feelings of uncertainty around our future, of anxiety around how to keep up, to stay relevant and competent can lead towards a sense of overwhelm manifesting as irritability, loss of empathy, poor interpersonal relationships and psychosomatic illness.

Adopting a new framework for the development and delivery of a self-care can lead to individuals: • • • • •

Retaining a sense of purpose for their work Having sufficient energy to effectively manage workloads Enjoying a higher level of health and fitness Leading by example by being the change they wish to see in others Seeing a reduction in the incidence of stress related illness, mental illness or burnout.

Wellness is far more than physical fitness. It's about being brain fit as well. Brain fitness looks to optimise brain health and function so we think better, manage our emotions more effectively and stay healthier overall.

It is perhaps ironic that the common human response to increased stress is to stop engaging in those activities that would assist in stress management and indulge in other activities that aggravate the problem.

The question of where to start is best served with self-reflection on where we sit on the brain fitness scale.

Model 1: The Brain Fitness Scale

Increase in happiness Higher level of achievement Improved Wellbeing

White Paper - (Brain) Fitness First Why self care matters - the business of wellness for busy health care professionals - Dr Jenny Brockis

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Eyes wide shut

The polar opposite of being fully brain fit is being unconscious. Clearly this is not a state conducive to high performance thinking.

Responds to pain

At least there is sign of life here, which provides hope for further improvement. However reacting only when prodded to severe pain is not a sustainable way to be operating in practice.

Autopilot

The human brain is highly adept at energy saving through the creation of automatic behaviours and habits. This works well to free up the prefrontal cortex to pay attention to more immediate and important matters. However, under stress the reliance on our automatic behaviours restricts thinking capacity to come up with the best solution for a given situation. Going through the motions to get through a day, is at best survival, at worst a loss of competence, efficiency and motivation.

Cooperative and Change Able

The tipping point comes from the awareness that things can be different and choosing to implement the necessary changes. Possibility thinking and taking time out to consider different options or ways or doing is the first step towards greater mental flexibility and optimism.

Fully conscious

This is where being fully alert and sensitive to what is required keeps thinking skills in the high performance bracket. This is where the conscious choice to implement new ways of operating, lifestyle habits results in the experience of feeling back in control.

Brain Fit

A high level of brain fitness builds empathy, compassion and broadens perspective. This is self -directed leadership guiding change in ourselves and influencing others.

Where ever your current position is on the brain fitness ladder, choosing to focus on and undertaking those activities most relevant to you and your circumstances is what leads to change.

In the 2013 Position Statement that addressed the health of physicians, reference was made to the need for the integration for health professional health and wellbeing to be seen as a workplace issue, not just something those individuals have to address on their own.

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A new paradigm of wellness in the caring professions A major stumbling block for self-care and wellness commonly revolves around how time is prioritised and the value an individual places on their own health and well-being.

Self-sacrifice while a noble gesture is not particularly helpful to the needs for better health care services.

There are three key factors helpful to assist in changing the culture in the health profession towards good selfcare. These include staying focused towards the desired end goal, keeping a sense of perspective, and are underpinned by a strong sense of purpose.

Model 2: Culture change for good self-care

Change is a framework Health professionals are taught a lot of facts. They think in facts and apply their knowledge of those facts to the care of their patients. But facts and figures alone don't produce change, it is the framework we apply to our thinking that makes the difference It also requires support. Having a buddy system, some form of accountability, a coach or a mentor makes change easier to achieve. It is the practice of new behaviours that reinforces new neural networks. These then ultimately become the default network of choice for a particular activity.

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Creating A Healthy Health Workplace 1. RE-ENERGISE As with any diagnostic problem the first step is to identify what the problems are and the contributing causes.

Sometimes we are too close to see what the real issue is, so getting a third person perspective can be really helpful to identify what’s really going on.

Having made a diagnosis, the temptation is often to dive straight in with a prescription.

Stepping back first to ensure that the basic requirements or our physiology are being met first ensures that when we do start adopting new habits and ways of doing things, you are already in a more optimised state of readiness to achieve success.

Regaining energy starts to happen when we checking in with what we know is helpful to our health and wellbeing vs. what we are actually doing.

Table 1: Better Brain Health

CREATE Mental Stretch Sleep Move Refuel Smart

OPERATE Mental Energy Mindful Focus Mind State

INTEGRATE Lead Collaborate Change Able Innovate

2. RE-CALIBRATE The second stage is looking at how we expend our energy and recalibrate how we are currently operating.

Smartening down allows us to work more efficiently and reduce stress loads.

How we think, speak and behave in a relaxed state can be very different from how we are when stressed and under the pump.

Our choice of state of mind and focus drives not just how well we work, but how we perceive our world.

3. RE-IMAGINE Keeping abreast of the massive amount of change and increased complexity required of us today demands a high level of mental agility and flexibility. Achieving this comes from developing possibility thinking. Because when we no longer fear change but see it as something that is exciting and something to look forward to, it opens us up to be more collaborative and innovative.

White Paper - (Brain) Fitness First Why self care matters - the business of wellness for busy health care professionals - Dr Jenny Brockis

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Our Future and High Performance Thinking Making workplace wellness “business as usual� applies to all and every place of work.

Health coaching or mentoring is now seen as an important part of any results orientated wellness program. In the U.S the ROI is reported as being $3 for every $1 invested in wellness programs.

Wellness programs do far more than just maintain health and wellbeing - they boost engagement and productivity: Optus has reported a $1.6 million productivity gain through implementing a workplace wellness program.

That’s why enrolling in brain fitness training and mentoring can be so powerful.

Creating our high performance brain enables us to regain that sense of accomplishment, the confidence of our competence and inspiration to do our best work.

References: Workplace Wellness in Australia. Aligning action with aims: Optimising the benefits of workplace wellness 2010 Pricewaterhouse Coopers Berry, Mirabito and Baun. What's the hard return on employee wellness programs? Harvard Business Review Dec 2010 Stress and Wellbeing in Australia Survey 2013 Australian Psychological Society Foresight. Mental capital and wellbeing: Making the most of ourselves in the 21st Century. Government Office for Science.

London 2008

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About Jenny Passionate, eloquent and inspiring, Jenny's keynotes and workshops provide cutting edge insights into how the neuroscience provides the perfect pathway to navigate our complex, complicated and busy world.

Her mentoring and coaching programs empower individuals to become more 'brain aware' and develop or upgrade the skills needed to thrive in today's busy, complex and rapidly changing world.

As an author of three books, Brain Fit! Brain Smart, and Future Brain, blogger and media commentator Jenny continues in her quest to promote the development of a brain friendly culture that nurtures and develops all brains at work.

When not speaking, writing or researching, Jenny enjoys spending time with her husband and two young adult children, travelling the world and challenging her long-standing fear of heights.

You can contact Jenny jenny@drjennybrockis.com www.drjennybrockis.com www.linkedin.com/drjennybrockis +61 408092078

White Paper - (Brain) Fitness First Why self care matters - the business of wellness for busy health care professionals - Dr Jenny Brockis

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