Chapter 5: Clinician Resilience Flashcards
Define resilience
It is not the resistance to suffering, but rather is the ability to suffer deeply while still maintaining the ability to feel the full spectrum of human emotions.
Define burnout. What is Maslach’s triad? What is the prevalence of physician burnout? Do external or internal factors contribute to burnout more?
Maslach’s triad is:
1. exhaustion
2. distancing techniques of depersonalization and cynicism
3. reduced efficacy
Burnout is one of the costs of caring.
45-60% of physicians expeirience burnout.
External factors related to healthcare systems may contribute to burnout more than individual’s characteristics.
List the costs of caring
- Eustress
- Distress
- Burnout
- Compassion fatigue
- Secondary traumatization
- Vicarious traumatization
- Second victim syndrome
- Posttraumatic stress disorder
- “The doctor’s disease” = loss of humanity that professionals experience as they advance more in training and profiency
- Demoralization
- Dehumanization
- Moral distress
- Moral injury
- Soul loss = losing human connection with self and others
- Suicide
List 10 resilience factors that can be developed
1.Realistic optimism
2.Facing fear
3.Moral compass
4.Religion and spirituality
5.Social support
6.Resilient role models
7.Physical fitness
8.Brain fitness
9.Cognitive and emotional flexibility
10.Meaning and purpose
What is Continuing Human Education (CHE)?
- A counter-curriculum of re-humanization to battle the “hidden curriculum” that leads to detachment
- A play on Continuing Medical Education (CME)
- We need human-based medicine (a play on evidence-based medicine)
- studying medical humanities can be part of this
Define mindfulness
the intentional cultivation of sustained attention to the present moment with a compassionate heart.
How can mindfulness help clinician resilience?
- Instead of trying to fix suffering, you allow the present moment to unfold
- Provides a means to traverse edge states, in which we are on the edge between health and pathological conditions
- enhances providers’ performance, well-being, and empathy
- very important to have capacity to look inward, to be curious about how we respond to suffering
- Facts about Mindfulness-based interventions: 1- more is better (“dose makes a difference”). 2 - Equally beneficial across all healthcare disciplines. 3 - Very effective in group settings.
What is an “edge state”?
- Coined by Joan Halifax
- Edge States are the internal ecosystem in which we are on the edge between health and pathological conditions.
- Edge states are where courage and suffering meet freedom and wisdom
- Attending to these edges is essential.
What are equanimity and compassion?
- Equanimity is the capacity to maintain mental balance in the middle of a storm.
- Compassion can be described as the feelings of warmth and concern for the suffering of another with a motivation to improve another’s well-being.
- Taken together, the balanced stance of equanimity can protect the compassionate heart.
- Caution - Indifference can masquerade as equanimity. Pity can masquerade as compassion! But indifference and pity can lead to burnout.
Mindfulness can cultivate these capacities.
What are some tips to start a mindfulness practice?
*Start now
*Notice the sensations of the body and adjust to find a bit more ease if you can
*Drop into stillness and softly close the eyes
*Turn your attention toward your breath—sensing it in the body rather than thinking about it
*When the mind wanders away from feeling the breath, gently bring it back
*Let go of any judgments that arise with an internal smile
*After 5minutes, close your practice and notice this new moment
What is “the yoga of burnut?”
Instead of preventing burnout, we embrace it as an invitation to enter a spiritual practice of transforming suffering into joy.
(A potential individual-level solution to burnout)
What is the concept of the Wounded Healer?
We may need to experience suffering ourselves to have greater compassion – but when we suffer, we can either shatter or we can break open into greater compassion.
(A potential individual-level solution to burnout)
How should we shift our perspective on suffering, in order to promote clinician resilience?
We should recognize that suffering connects us with the universality of the human condition. It can be an entry point into wisdom, transformation, or illumination..
(A potential individual-level solution to burnout)
What is the compassion revolution?
- subject matter experts in compassion
- human-based medicine the same way we have evidence-based medicine
- continuing human education
What is transformative learning?
the concept that disorientation is a necessary precursor for transformation
(A potential individual-level solution to burnout)
