Why wellness - a presentation for medical students and interns

By Kate Jurd, Learning Technologist, Toowoomba Hospital QLD Australia

Student and physician suicide is increasing – and these tragic events devastate the medical profession and our community.

A 2013 Australian, Beyondblue survey found one in 10 doctors and one in five medical students had experienced suicidal thoughts in the previous year.

A study published in the Journal of the American Medical Association reviewed 200 previous studies looking at the mental health of 129,000 medical students from 47 countries.

It found that 27 per cent of medical students had experienced depression, while 11 per cent reported suicidal ideation during medical school, and only 16 per cent sought treatment.

Wellness = Professionalism = Performance

We tend to place a huge amount of emphasis on knowledge and technical skills and tend to ignore the non-technical or soft skills, (empathy, kindness, compassion, reliability) however these go hand in hand, and you need knowledge and the soft skills to provide supportive care for patients.

These attributes focus on professional qualities and a professional attitude (Professionalism) Wellness forms the basis of professionalism


Attributes of professionalism
Reliability, punctuality,
Good communicator
Self motivated
Willing to work in a team
Caring attitude to patients

If you are not mentally emotionally well and are reactive to people around you – this will have an impact on how you perceived by your colleagues and will be detrimental to your performance.

Physical wellness, emotional wellness, mental wellness, spiritual wellness

The more well you are… the better state of mind, body and spirit and the more effective you are as you interact with other health professionals and how you care for your patients. Wellness is key

The more well you are the better you communicate with patients

The more well you are the better you are at working in a team

The more well you are...the better you will perform

If we look at wellness in terms of 3 buckets-
Vitality, Connections and Contribution.

Concept taken from Jonathan Fields, Good Life Project

The first bucket is about caring for your mind and body.

The second bucket is your relationships – family, friends, peers, work, community.

The third bucket is about your purpose and contributing to the world – this is believing in yourself and feeling good about what you do.

Keeping these buckets filled is the way to stay well, be professional and perform well

Vitality = is the state of your body and mindset - mental and physical wellbeing. If your vitality bucket is full then you are more:

• Energized
• Fit, strong
• Aware of and capable of being in the moment
• Optimistic about the future and what it holds
• Peaceful and calm, able to dissipate stress
• Able to bounce back from adversity
• Immersed in a process of growth
• Having gratitude
• Fueled by a sense of meaning
• Happy

Connections:
This is about Nourishing relationships – family, friends, work colleagues, patients
– being part of a community
– belonging – when this bucket if full you have good relationships and have a sense of belonging in the health profession and your community

Contribution – contributing to the world, to the hospital you work in and to patient wellbeing, a sence of calling; purpose

It’s about feeling like you’re accessing your full potential, your strengths, your gifts, the deepest parts of your humanity, leaving nothing unrealized or untapped.

finding meaning in what you do – believing in yourself, having self compassion

Strategies to keep the buckets full

Wellness logbook - set wellness goals and reflect regularly on how you are going.

Importance of sleeping well, eating well and exercise

Schedule exercise activities into your weekly routine - get an exercise buddy.

If you dont like going to the gym or playing sport there are other ways to get the excercise you need. The idea is to move more.
Schedule your exercise activities into your weekly planner and stick to them.

At the weekend do something you enjoy:

Walk, hike, trail run...

Intern advice get outdoors, get some fresh air ...be in nature.

Also vitality means eating well (and healthy)

Challenge yourself - give up one of your most unhealthy vices for your first rotation
such as drinking sugary drinks, ordering takeaways or eating too many sweet treats.

....and try and eat more healthy wholesome foods.

Plan what you eat, make a list and schedule your shopping and cooking - make batches and freeze

Make healthier food choices
Fresh local produce is best - triple your vegetable intake

Reduce: sugar, processed food, starchy carbohydrates such as potatoes, white pasta, white rice.

And sometimes all you need to do is hit the Pause button – STOP
Recharge.

Take a moment to breathe
5 deep breaths before you start a new task, speak to a patient or speak to your supervisor.

Start small, 5 minutes a day.
Steps to get started
Sit comfortably in an upright position.
Notice the sensations in your body, scan from head to feet, notice any tingling, notice the feel of your body on the chair.

Focus on your breath - notice where it enters the body and where it leaves the body.
Breath in to the count of 4 and breath out to the count of 5
Continue
Notice the sounds in the room, those that are close and those that are far away

If any thoughts enter your mind - just notice and let them go.

Continue with the breath, slowly in and out.

Journaling goals, both learning and personal on a daily basis is worthwhile reflective practice.

Acknowledging gratitude and positive accomplishments is a powerful tool for self growth.

At the end of the day write down 3 good things that happened and one thing you are grateful for.

You can change the way your brain looks at things by using affirmations, developing a mantra or directive phrase.

The idea is to reframe the negative thoughts and develop new scripts. eg 'slow down, Ive been here before' or 'stop, focus' breathe. I can do this.

Self kindness and self compassion are key to strength and resilience. Being open and honest and recognising that being vulnerable is courageous and accepting failure as a learning event for future growth.

Illustration Jo (Johnine) Byrne
@SeeYourWords adapted from the work of Krisin Neff

Build peer network: To also help fill your connections bucket – start building your peer network – start building relationships now, join in on the activities, be involved with the students in the year above you, interns, residents etc you will learn and gain a lot from one another – nourish these relationships – they will be extremely beneficial as you move forward in your career.

Support: Don’t forget to think about your support network – partners, siblings, parents – those you feel comfortable talking to and asking for advice – keep them in the loop.

These can range from Changes in sleep and appetite
Feeling down most of the time
Increased self criticism and irritability – getting angry in the workplace with colleagues – Lowered performance in the clinical setting

this is a sign of stress and not being well—affects professionalism and performance

You are not alone - ask for help - dont struggle on your own, we have been there too!

Find a GP and see them. Have regular check ups.

Acknowledgement to Dr Shahina Braganza
Emergency Physician Gold Coast Health
shahinabraganza.com (http://shahinabraganza.com) | @ShahinaBraganza

Shahina provided assistance with this presentation - concepts based on the wellness talk she gave at Gold Coast Health.

Plus reference to Jonathan Fields: the Good Life Project www.goodlifeproject.com
(wellness buckets)