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Intro Anesthesia > Promoting Professional Wellness > Flashcards

Promoting Professional Wellness Flashcards

1
Q

Stress is how many % of all medical visits?

A

60-90%

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2
Q

AANA’s Wellness Initiative:

Name of person initiating who became addicted to anesthetics

A

Jan Stewart

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3
Q

AANA’s Wellness Initiative

2 Objectives

A
  1. Jan Stewart Memorial Wellness Lecture Series
  2. Broad Based Wellness Services for memberss Covers MANY issues that affect professional and emotional well-being.
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4
Q

Key element in quality of care

A

Relationship btw fitness for duty and patient safety

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5
Q

Chemical dependency/addiction % among SRNAs, CRNAs, MDAs, Residents

A

10%

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6
Q

MDA greater or less than other physicians?

A

greater

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7
Q

Anesthetists highest drugs abused statistically

A

OR drugs + other drugs

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8
Q

Aristotle’s

“Nothing in excess”

defines what?

A

Well-being

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9
Q

Fear of disease

Fear of failure

“Change in behavior depend on perception of severity of problem, perceived susceptibility, the benefit of change, barriers to change, and perceived self-efficacy”

A

Health Belief Model

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10
Q

6 Components of Wellness

(Hettler)

A
  1. Physical
  2. Emotional
  3. Emotional
  4. Occupation
  5. Social
  6. Intellectual
  7. Spiritual
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11
Q

These things define what?

Satisfaction with self

Acceptance of physical appearance

Valuing unique characteristics and abilities

A

Sense of worth

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12
Q

3 Dimensions of Self-Direction

A

Sense of worth

Sense of control

Emotional awareness & coping

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13
Q

Sense of control 9 components

A
  1. belief in competence
  2. confidence
  3. self-efficacy
  4. knowledge
  5. skill
  6. choice
  7. influence
  8. expectations
  9. control
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14
Q

Components of what?

  1. Ability to express/disclose feelings
  2. Response to life expectations
  3. Sense of energy, appropriate responses to challenges, negative emotions, and enjoyment of positive emotions
A

Emotional awareness & coping

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15
Q

Feeling of deep sympathy for another is stricken by suffering or misfortune

A

Compassion Fatigue

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16
Q

Reduction of capacity of NMS to carry out its function. Causes sleep deprivation, boredom, work overload, physical exhaustion…

A

Physiological fatigue

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17
Q

10 Principles of Wellness

A
  1. Create long-term goal
  2. Connect to your collegues
  3. Enjoy what you do
  4. Physical well-being
  5. Keep in touch
  6. Manage time
  7. Make plans
  8. Take time for self
  9. Be realistic
  10. Don’t think you can do it alone
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18
Q

Symptoms of what

  1. mental, social, physical manifestations
  2. exhaustion
  3. loss/inc apetite
  4. h/a
  5. sleeplessness or oversleeping
  6. crying
  7. feeligns of “alarm” frustration, or apathy
A

Stress

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19
Q

AMA & APA sees dependency & addiction as diagnosable and treatable:

4 components

A
  1. Availability of drug + urge
  2. Urge is part of neurochemical makeup
  3. Stress contributes to potential: Genetic predisposition and familial dysfunction, risk escalates
  4. Cascade of behioral changes occur: progressively deteriorates
20
Q

Pleasure comes from increase _____ in the brain?

A

Increased dopamine

21
Q

Long term addiction

Change in brain

A

Loss of glutamate control

in prefrontal cortex

changes how brain processes info

and controls behavior

22
Q

Looking at cocaine for a drug abuser has physiological changes seen in brain in what pleasure part of brain?

A

Amygdala

23
Q

Last defense (think things thru) in brain.

Decision making

Priorities

“I won’t do drugs”

A

Prefrontal cortex

24
Q

Perception of drug procurement is more important than… (“feeding my 6 month old” i.e.)

Over-valuing drug high over …

What part of brain?

A

Prefrontal cortex

25
Q

Second step

A

Early downstream involvment

26
Q

Network of these areas in brain with addiction

A

Nucleaus accumbens (dopamine)

Amygdala (neg feedback-Gaba)

Hippocampus (where, who and what; part of the craving)

Prefrontal Cortex (perceive, final “say so”, priorities btw getting infection/losing job vs getting drug - overvalues experience in the drug use)

27
Q

Main neurotransmitters involved

3

A

Dopamine

GABA

glutamate

28
Q

Rob bank, kill, compulsive drug-seeking altered in what part of brain?

A

Prefrontal cortex

Overweighs this information at this point. Normally PC would say it is not worth it.

“Didn’t like what the drugs caused in family, etc, but liked how the drugs made him feel and have no intention of quiting”

29
Q

Conspiracy of silence

anything that allows addict to avoid consequences

A

Enabling

30
Q

Treatment:

Predominant form of chemical tx

inpatient/residential options

must have aftercare contract

A

12-step program

31
Q

Laymens Terms

12 step

A
  1. Admint
  2. Hope
  3. Surrender
  4. Inventory
  5. Confess
  6. Readiness
  7. Ask God
  8. List of amends
  9. Make amends
  10. Continue the inventory
  11. Pray/meditate
  12. Help others
32
Q

Example of state-based program

state physicians’ programs

look beyond licensure violations of cause of behavior, hold nurses/providers accountable, prevent harm to pt, retain experienced practitioners in the profession

A

KARE program

33
Q

drug addiction is a acute or chronic relapsing disease of the brain?

A

chronic relapsing

NOT time limited, NOT curable HIGH relapse risk

  1. typical s/s
  2. demonstrated brain lesinos
  3. predictable natural course
  4. risk factors
  5. early warning signs
  6. dx criteria
  7. recommended tx
34
Q

Pleasure-sensory pathways

when showing picture of drug/related to user

pleasure-reward system

A

via Dopamine, Glutamate, GABA

Nucleus Accumbens

Prefrontal Cortex (perspective: establishes priorities)

Amygdala (decides good or bad, pleasure/or not)

Hippocampus (memory: where when who)

Higher dopamine concentration the greater the experience

35
Q

Sends info (dopamine) to all three areas (Amigdala, Nucleus Accumbens, Prefrontal cortex):

initial pathway pleasure reward

A

VTA

Ventral Tegmental Area

36
Q

list 4 substances involved with addictive disorders

A

alcohol

opioids

cocaine

amphetamine

inc dopamine - higher dopamine higher the high

37
Q

which experiences increase dopamine in nucleus

A

ALL EXPERIENCE (good and bad)

38
Q

Sends negative feedback to VT area

A

Nucleus Accumbens

via GABA

39
Q

Amygdala, Hippocampus, Prefrontal Cortex use what main neurotransmitter

A

Glutamate

40
Q

3 steps in pleasure sensory pathway

A
  1. Brain lesions of the changes made (inc value of HIGH, “normal” values reordered
  2. early downstream involvement of amygdala and hippo (imprinting cues, craving, depression during abstention)
  3. late downstream anterior cingulate gyrus & orbital frontal region of prefrontal (loss of inhibition, compulsive drug seeking)
41
Q

Progressively OVERWEIGHS information: integration of priorities, and inhibition abilities are faulty

A

Prefrontal cortex

42
Q

why dont substance users WANT to quit

A

out of control

helpless to connect with rational thought

CANNOT ask for help

43
Q

most difficult obstacle to overcome

A

denial

normal psych defense

protects from painful/difficult facts/ideas

44
Q
A
45
Q

most common mechanism for assistance

A

intervention

12-step for chemical dep

46
Q

example of Peer-to-peer assistance program

A

Alcoholics Anonymous

47
Q

Resource for help

A

AANA Peer Assistance Helpline

800 654 5167

Intro Anesthesia (5 decks)

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