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FoPC - Year 3 > Sustainability, Resilience and Occupational Health > Flashcards

Sustainability, Resilience and Occupational Health Flashcards

1
Q

How does prevalence of depression and anxiety in medical students compare to the general population?

A

Higher

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2
Q

What are examples of mild to moderate mental health conditions?

A
  • Depression
  • Generalised anxiety disorder
  • Panic disorder
  • Social anxiety disorder
  • Obsessive compulsive disorder

Post-traumatic stress disorder

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3
Q

What are different methods of supporting students with mental health conditions?

A
  • Promoting well-being
    • Learning exercises focusing on dealing with stress
    • Providing and promoting online resources on keeping healthy
    • Providing sessions on techniques such as mindfulness and meditation
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4
Q

What is resilience?

A

Resilience = person’s ability to resist adversity without resulting in physical or psychological disability

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5
Q

Resilience encompasses several dimensions, what are some of these?

A
  • Self-efficiency
  • Self-control
  • Self-regulation
  • Planning
  • Perseverance
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6
Q

What are some of the personal strengths underpinning resilience?

A
  • High frustration tolerance
  • Self-acceptance
  • Self-belief
  • Humour
  • Perspective
  • Curiosity
  • Adaptability
  • Meaning
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7
Q

What are some of the behaviours supporting resilience?

A
  • Building / having support networks – positive relationships
  • Reflective ability
  • Assertiveness
  • Avoiding procrastination
  • Developing goals – realistic plans and ability / motivation to follow them through
  • Time management
  • Work – life balance
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8
Q

What are some of the challenges to resilience within a medical career?

A
  • Burnout, sources of this are
    • Personal
      • Perfectionism, denial, avoidance, micromanaging, unwilling to seek help
      • Being to conscientious
    • Professional
      • Culture of invulnerability
      • Culture or presenteeism
      • Blame culture/silence
    • Systemic
      • Overwork, shiftwork, lack of oversight
      • Chaotic work environments
      • Lack of teamwork, fractured training
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9
Q

What are some different sources of burn out?

A
  • Personal
    • Perfectionism, denial, avoidance, micromanaging, unwilling to seek help
    • Being to conscientious
  • Professional
    • Culture of invulnerability
    • Culture or presenteeism
    • Blame culture/silence
  • Systemic
    • Overwork, shiftwork, lack of oversight
    • Chaotic work environments
    • Lack of teamwork, fractured training
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10
Q

How can burn out present in medical students?

A
  • Repeatedly failing or nearly failing
  • Handing in work late
  • Poor attendance
  • Absence due to illness
  • Behavioural issues
  • Fitness to practice issues
  • Lack of engagement with the course
  • Poor communication with staff, peers and patients
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11
Q

What can resilience in practice lead to?

A
  • Can lead to
    • Reflection
      • Did I make the right decisions
      • Discuss with peers
    • Lead to improvement
      • Do I need to learn anything to prevent the same thing happening again
    • Lead to returning wiser and better
      • How will I communicate better, will I change my practice in the future
  • But this can only do so much, some things are too powerful to be resilient too
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12
Q

What are some factors aiding resilience?

A
  • Intellectual interest
    • Job satisfaction, career progression
  • Self-awareness and self-reflection
    • Recognise and accept personal limits, establish boundaries to doctor-patient relationship
  • Time management and work-life balance
    • Ensuring time for hobbies, leisure, relaxation and self-expression
  • Continuing professional development
  • Support including team working
    • Supportive relationships within and out of medicine
  • Mentors
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13
Q

Coping reserve is formed from what?

A
  • Personality traits
  • Temperament
  • Coping style
  • Organisational and sociocultural issues
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14
Q

Other than resilience, what are some other factors reducing the risk of burn out in recent times?

A
  • Professional attitudes
    • Changing sense of perfectionism, presenteeism, culture of silence
    • Better support
  • Societal attitudes
    • Changing culture of blame
    • Public acceptance of mistakes
  • Structural changes
    • Improved shift patterns
    • Better work-life balance
    • Less fractured training
    • Regular breaks
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15
Q

What are some negative and positive inputs to someones coping reserve?

A
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16
Q

What is an occupational and environmental history?

A

Occupational and environmental history = chronological list of all patients employment with the intention of determining whether work has caused ill health, exacerbated an existing health problem or has ill health had an impact on the patients ability to work

17
Q

What are some questions to allow you to determine if illness is linked to work?

A
  • A description of the present and previous jobs from leaving school.
  • Identifying any exposure to chemicals or other hazards e.g. stress, overwork, adverse working environment, in this situation is the fact that role largely sedentary exacerbating or causing his back pain?
  • Did the symptoms improve when not exposed / not at work e.g. at weekends, holidays?
  • Determine the duration and intensity of exposure e.g. was it so noisy it was impossible to communicate
  • Is personal protection used e.g. what kind of mask? Or equally is an appropriate chair / desk provided?
  • What maintenance is in place for the protection measures?
  • Do others suffer similar symptoms?
  • Are there known environmental hazards in use?
  • Any hobbies, pets, worked overseas, moonlighting?
18
Q

What is a fit note?

A
  • Evidence of assessment by a doctor as to whether patient is fit to work in general
19
Q

For a fit note:

  • what is the purpose
  • who can complete one
  • what does it provide
  • when is it required
A
  • Purpose is to facilitate earlier discussion about returning to work and rehabilitation
  • Can only be completed by doctor
  • Advice to patients as employees, not binding on the employer and does not affect statutory sick pay
  • Required if the patient has been off more than 7 consecutive days (including non-working days)
20
Q

What are the different fit note options?

A
  • Phased return to work
    • Start with reduced hours each day and build up – help build capacity again and allow time for rehab
  • Altered hours
    • Work at different times of day e.g. are early mornings hardest?
  • Amended duties
    • Change in work practice or content e.g. less time sitting or breaking up the day differently to allow more movement – shorter surgeries, built in breaks etc
  • Workplace adaptation
    • e.g. changes to seating to support back better.
21
Q

What is an option for patients off work for longer periods of time or with more complex needs instead of just a fit note?

A

Refer to occupational health

22
Q

What is done at occupational health?

A
  • They support and help people stay in work and live healthy lives
  • Role in ensuring health of the working population by preventing work related ill health and providing specialist rehabilitation advice
  • Provide independent and impartial advice to employees and employers on effects of work on health and effects of health on work
  • Advice on mental health and ill-health retirement
  • Ensure compliance with health and safety
  • Recommend and implement policies to maintain health and safety
  • Can make an organisation do any “reasonable” changes for the size of organisation
23
Q

What are some of the effects of unemployment on health?

A
  • Association between worklessness and poor health
  • Higher mortality
  • Poorer general health, chronic illnesses
  • Poorer mental health
  • Higher medical consultation and hospital admission rates
  • Evidence that re-employment leads to improved self-esteem, mental and physical health
24
Q

What is sustainability?

A

Sustainability = able to continue over a period of time

25
Q

What are examples of sustainability in the NHS?

A
  • Low carbon clinical care and the environmental
    • Prioritise environmental health
    • Substitute harmful chemicals for safer ones
    • Reduce and safely dispose of waste
    • Use energy efficiency and switch to renewable energy
    • Reduce water consumption
    • Purchase and serve sustainably grown food
    • Improve travel strategies
    • Safely manage and dispose of pharmaceuticals
    • Adopt greener building designs
  • Ability of NHS to continue over time
    • Lots of staff migrate to UK
    • Funding
26
Q

How is low carbon clinical care achieved?

A
  • Prioritise environmental health
  • Substitute harmful chemicals for safer ones
  • Reduce and safely dispose of waste
  • Use energy efficiency and switch to renewable energy
  • Reduce water consumption
  • Purchase and serve sustainably grown food
  • Improve travel strategies
  • Safely manage and dispose of pharmaceuticals
  • Adopt greener building designs
27
Q

What provides the NHS with the ability to continue over time and be sustainable?

A
  • Lots of staff migrate to UK
  • Funding
28
Q

Describe what ‘low carbon’ clinical care would look like?

A
  • Be better at preventing conditions
    • Contraception, access to clean water, proper sanitation, education on hygeine
  • Give greater responsibility to patients in managing their health.
  • Be leaner in service design and delivery
    • Combining clinics, use ‘lean’ principles to eliminate repeated investigation, using email and telephone
  • Use the lowest carbon technologies
    • Dialysis water recycling, heat exchangers, reduction in packaging
29
Q

Describe how the new 2018 GP contract improves sustainability?

A
  • Will reduce workload and improve recruitment
  • Added additional professionals to team
    • Pharmacists, psychologists, link workers, advanced nurse practitioners
  • Roles taken over by health board
    • Such as vaccination
30
Q

What are some examples of additional professional roles added by the 2018 new GP contract?

A
  • Pharmacists, psychologists, link workers, advanced nurse practitioners

FoPC - Year 3 (5 decks)

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