endurance – Resilient Responder

January 7, 2017

How’s Your Morale?

I was talking to some colleagues the other day and the subject of morale came up. There is a general consensus that morale in our agency is bad. But it’s not just our agency, I find that is true in other agencies too. Why is that? Any ideas?

In a recent survey of EMS employees, 60% of the participants said their personal morale was good. The interesting twist was the same respondents said that only 40% of the department’s morale was good. How is it possible that the majority of individuals in an agency have a good morale, but the agency as a whole does not?

Bad is Stronger than Good

Baumeister et al (2001) said that people are more likely to remember bad things than good things. It has a stronger psychological effect. We spend more brain power processing bad news than we do good news. Therefore, we remember negative experiences with more clarity.

Remembering bad things longer than the good is actually adaptive (Baumeister et al, 2001). In other words, we need to remember bad things so we can survive. It signals a need to change, a need to adjust our behavior or avoid situations that caused the bad emotion or outcome. That is why the mind takes more time to process bad experiences. It wants us to be safer the next time we encounter a similar situation. If we only remember the good, we are more likely to repeat the things that put us at risk.

So it is not unusual when we go around talking with each other that the conversation centers around the negative experiences we have. The problem is this becomes our perception of the whole rather than simply an interpretation of singular events. Have you ever tuned into the daily news expecting to hear only good things? It just doesn’t happen. There may be a few human interest stories, but overall the news is bad. And the job contributes to our overall negative perception because we see the bad things that happen to people up close and personal. Bad becomes normal.

Change the Focus

I encourage you to conduct a personal experiment. Deliberately look for the good things about the job. Focus on the ways you have helped your patients; how your coworkers work well together. Look for the positive supports from your supervisors and administration. (Yes, it is there!) Make a list so you can remember.

Then, when you talk about the bad experiences, counter it with something good you have noticed. When a coworker relates something bad, listen and then add a positive note. Not in a judgmental way, but just as a “by-the-way” statement.

If we take a positive focus instead of being led down the negative path, I wonder if the agency-wide morale will improve. At least the perception of it. Based on the statistics I have seen, it is probably pretty good already. We just cannot see it past the bad news that hides it.

What is your perception of morale? Add to the conversation by leaving a comment below.

Follow this blog and I will let you know when the next post comes out.

Thanks for reading!

Reference

Baumeister, R. F., Bratslavsky, E., Finkenauer, C., & Vohs, K. D. (2001). Bad is stronger than good. Review of General Psychology, 5(4), 323-370. doi:10.1037//1089-2680.5.4.323

December 13, 2016

Introspection or Rumination? What Does the Cow Do?

You have a patient with respiratory distress, tripod position, BP 220/116, breath sounds diminished, chest pain, diaphoresis, SpO2 88% on room air…classic CHF. You immediately apply CPAP, NTG paste, start an IV, 12-lead, 15-lead. You are on the way to the ED! The patient seems to be improving. You keep monitoring him during transport. His SpO2 is 95% with CPAP. The BP is 200/98. No obvious STEMI on the ECG.

You run through the protocol. Have you missed anything? Is there anything else to look for? Can’t think of anything so you continue what you’re doing until you get to the hospital.

When you transfer the patient to the ED bed, you notice he does not move his left arm. In fact, it is flaccid. He has no history of stroke. You checked. On the scene, he moved all extremities equally because he initially tried to keep you from applying the CPAP. He used both hands at the time. He stood and pivoted from the chair to the stretcher without appearing to stumble.

It must have started during transport. How did you miss it? Great! Now the medical director will want to see you. Just what you need.

So begins the cycle of thinking. What did I do wrong? Did I do anything wrong? Should I have done something different? How did I miss that stroke!?!

Introspection versus Rumination

Two four-syllable words that have deep significance for resilience. One is helpful and the other not so much.

You ruminate when you think about something over and over and over…..

You focus on the bad things. You think about what went wrong. You worry about what someone will say. You worry that you’ll get in trouble. It is rarely productive. You ponder, mull over, cogitate; but never come to any helpful conclusions.

Cows ruminate. Yep. They have four stomachs. When they eat, they chew their food, swallow it, and it enters the first stomach where it begins to be processed. Then the cow regurgitates some of the contents and chews on it again. Yuck! I guess the cow doesn’t mind, though.

Rumination for us is similar. We have a problem. We “swallow” it for a time. Then we bring it back up and chew on it again. Unlike the cow, this is not always a one-time process for us. Our ruminating can get us into a vicious cycle that is hard to break. We end up thinking negative things about ourselves and our abilities and maybe even our worth.

Introspection, on the other hand, gives us the chance to examine the problem so we can find a solution. It sounds similar to rumination, but instead of focusing on the negative parts of the problem, introspection focuses on solutions.

Introspection is productive. Instead of thinking about our self-worth, we work on self-improvement. Rather than focusing on the one thing that went wrong, we remember all the rest that went right.

With introspection we learn. With rumination we make ourselves miserable.

Do you introspect or ruminate?

Leave a comment below. Follow me and I will let you know when the next blog comes out.

Thanks for reading!

December 6, 2016

Change on Your Terms

How do you like change?

If you’re like most people, you’re not crazy about it. Some change is good. Some not so much. It can even be painful if it means you have to lose someone or something you love. There are times when the status quo is preferable.

But, change happens whether we want it to or not. So how do you manage it without it overwhelming you?

So far, we have talked about two dimensions of resilience: determination and endurance (Taormina, 2015). Another part of resilience is adaptability.

Adaptability helps you cope with unexpected or unpleasant situations by keeping you flexible and resourceful. You are able to adjust to the changes you experience. You make purposeful efforts to change the way you think about your environment so that you feel more comfortable with the outcome.

You know what? You may be more adaptable than you realize. Have you ever been married? You had to adjust to having a new person in your life. Have children? That definitely requires adaptability!

The thing is, these are changes that you want…usually. You probably initiated them yourself. You might not even have thought of it as a change that would cause you stress because it was generally a positive experience.

So what do you do when change is forced on you?

Well, if it is change at work you could quit. That would certainly be the easy way out, but it is usually not the best response. After all, if you’re like most people, you need the job. (And you probably like the job, at least before the changes.)

What if it is a change in your family? Someone becomes seriously ill, or has a chronic illness, or has died leaving you extremely sad with an empty place in your heart. That one is especially hard because it is more personal!

Believe it or not, you can adapt to this change too. Really, you say? Keep reading.

Adapting to change requires changing the way you think about it. That is how resilient medics cope without losing their minds. Instead of looking at how the change has inconvenienced you, find the ways it will benefit you. If you cannot find a personal benefit, how will it help in a broader sense: your agency, your family, your finances, etc.

What can you contribute to the overall mission that will make the transition smoother? How can you be a part of the solution?

Use change for your personal growth. Use it to help you become the best medic, and person, you can be. You can be an example for other, less resilient, medics and maybe help them find a different way to look at change too. Your adaptability is another way to help someone else while you are helping yourself.

What changes have you experienced? How did you adapt?

Leave your comment below. We would love to learn from your experience!

Taormina, R. J. (2015). Adult Personal Resilience: A new theory, new measure, and practical implications. Psychological Thought, 8(1), 35-46. doi:10.5964/psyct.v8i1.126

December 1, 2016

Endurance: the Strength You Have Inside

In an earlier post, I talked about the dimensions of resilience: determination, endurance, adaptability, and recuperability (Taormina, 2015). Each of these are important aspects of understanding how you can live with and manage the stress this job causes.

I want to talk about endurance today. Endurance means getting through hard times, unpleasant situations, or difficult problems without giving up. You do this all the time.

What about that bad trauma? It may seem hopeless and it certainly is not pleasant, but you don’t quit in the middle and say “it’s not worth it”. Right? No, you endure. You get the job done and do everything you can do to get that patient to the definitive care he needs.

Then there’s the cardiac arrest. Maybe it is a child or a parent. It reminds you of something personal and you really don’t want to have to think about it. So, you push those thoughts aside and work that code to the best of your ability. You give that patient every opportunity possible. Maybe it works and maybe it doesn’t, but you did your best. That is what matters. That is endurance.

What gets to you is giving in to the negative thoughts that almost always arise. You wonder if there was something else you could have done. You tell yourself you are a black cloud, especially if you are having “one of those days.” Or, maybe, you blame someone else. They didn’t do what they were supposed to do. Usually, though, when you really look at it, you know everything went as well as it could under the circumstances.

You are not what you do. Does that make sense? You are not what happens around you. You are not the cause of all the bad calls you got today or any other day.

What you are is a person who, unfortunately, had a bad run. Nothing you could do about that. You just happened to be the available and closest truck to the call. If you could predict where the next call would be, you could go the other way. But it doesn’t work that way. (Oh, for the crystal ball!)

How can you turn those negative thoughts around? How can you give yourself the benefit of the doubt? It is okay to review the call. That’s how we learn. Just don’t dwell on it. If you did make a mistake, own it and learn from it.

Odds are you did just fine. Odds are you do just fine every day. You endure because you can. You endurance-athlete-runner DO have what it takes.

Give yourself some grace and remember who you are: a person who has dedicated your life to helping other people. That is a very noble and worthy person to be.

What have you needed to endure lately? Leave a comment below! I would love to hear from you.

Taormina, R. J. (2015). Adult Personal Resilience: A new theory, new measure, and practical implications. Psychological Thought, 8(1), 35-46. doi:10.5964/psyct.v8i1.126

Bad is Stronger than Good

Change the Focus

Share this:

Introspection versus Rumination

Share this:

Share this:

Share this: