from sick care to health care-leadership does matter

From Sick Care to Health Care

Resistance Recovery

Resilience

John Robertson -FORTLOG Services -not for public use without written permission

Coming together is a beginning;

keeping together is progress;

working together is success.

Henry Ford

It matters what leaders do, or don’t do

Gruenter & Whitaker

What is Stress?

"The nonspecific response of the body to any demand made upon it" (Selye)

"Demands on the person which tax or exceed his/her adjustive resources" (Lazarus)

"A particular relationship between the person and the environment that is appraised by the person as taxing or exceeding his/her resources and endangering his/her well-being"


EUSTRESS vs. DISTRESS

Two intensity levels of stress: EUSTRESS & DISTRESS

Eustress = Positive, motivating stress

Distress = Excessive, debilitating stress


TWO TYPES OF DISTRESS

Cumulative Stress (“Burnout”)

• slow erosion of functioning

• cynicism

• incomplete work

• lateness

• impulsive need for change

• chronic physical illness

“Critical Incident”

(Traumatic)

• normal coping overwhelmed

• adaptive functioning interrupted

• symptoms of posttraumatic distress evident

DEFINITIONS

CRITICAL INCIDENTS are unusually

challenging events that have the potential to

create significant human DISTRESS and

can overwhelm one’s usual coping

mechanisms.

John Robertson -FORTLOG Services -not

for public use without written permission

Culture and Norms why crisis intervention causes a response

Beliefs, Thinking, Values, Feeling

Doing

Laws and customs; Rituals; language; ways of life; Techniques; methods

NB – conscious, easily changed, explicitly learned, objective knowledge

Visible

Norms; roles; beliefs; philosophy

Values, attitudes; tastes; desires;

assumptions; expectations; myths

Invisible

NB – unconscious, difficult to change, implicitly learned, subjective knowledge

What kind of leader are we? From Peter Urs Bender Leadership from Within

The leader-from-without

• Says one thing, does another

• Leads through fear and control

• Sees separate interests

• Tries to hold on to power

• Wants things done his/her way

• Tells others what to do

• Sets unrealistic deadlines

• Is externally motivated – money, power, fame

• Is driven by fears and pressure

• Disregards/ puts down feelings

The Leader-from-within

• Walks the talk

• Leads with trust & by example

• Sees shared interests

• Shares power; empowers others

• Encourages personal initiative

• Invites ideas and feedback

• Sets reasonable deadlines

• Is internally motivated – values & principles

• Seeks satisfaction, well-being

• Sees caring / feelings as essential


Developing the Leader within you The Position Myth

POSITION

PERMISSION

PRODUCTION

PEOPLE

DEVELOPMENT

PERSONHOOD

Role

Results

Relationship

Reproduction

Respect


AUTHENTICITY – AVAILABILITY, ACCESSIBILITY –Character -winsome – MENTOR – from both leaders and to others

To live one’s life in such a way that we would be willing to sell our

parrot to the town gossip

COMMITMENT - PLAN 4 Values, an equipper a candle loses nothing by lighting another

ENTHUSIASM - Passion -vision, Inspiring –caught not taught SHEPHERD – ones that show the way because they go the way [not

a rancher who drives the animals!]

SERVICE = SERVANTS = SERVANTHOOD – disciplined

in one’s time/talent/treasures, proactive – It would be my pleasure vs. Its not my job

Defining Leadership ACES


Healthy Human

–aka resilience


A + B + C = D [for Resilience] Attitudes + Beliefs + Connections = Definition of new Norm

Attitudes;

• Physical

• Emotional – Emotional regulation

– Delay gratification

– Realistic high self-esteem

– Creativity, sense of humour


Beliefs;

• Cognitive – high EQ

– speaking and reading skill

– capacity to plan

– problem solving ability

• Spiritual

– Faith that one’s life matters

– Seeing meaning in life, even pain and suffering

– Sense of connection with humanity


Connections;

• Social/relational – Secure attachment

– Basic trust

– Ability to recruit others for help & support

– Positive peer relations [address toxic types]

• Moral

– Ability and opportunity to contribute to others

– Engage in socially and/or economically useful tasks


Note: Positive Definition +

Achilles' heel issues

Positive definition

• Positive [not against this/that; don’t like this/that…]

• In our control –

• Environment – thinking about the impact of doing what is of

value, priority – how will affect family, work, friends…

• SMART Goals/Objectives

Achilles Heels

• DIY approach is preferred

• Individual expectation of self is out of kilter with

their individual capacity

• Beliefs not integrated wholly – [head to heart] John Robertson -FORTLOG Services -not for

public use without written permission

Coping – Self, Peer and Family care

• See handouts

• Pre-incident preparation

• During incident intervention

• Post incident support & follow through


CRISIS INTERVENTION

• An active, short - term, supportive, helping

process.

• Acute intervention designed to mitigate the crisis

response.

• Not psychotherapy or a substitute for

psychotherapy

Goals:

1. Stabilization

2. Symptom reduction

3. Return to adaptive functioning, or

4. Facilitation of access to continued care

(adapted from Caplan, 1964, Preventive Psychiatry) John Robertson -FORTLOG Services -not


Critical Incident Stress (CIS)

is also known as

“Post Traumatic Stress,”

which is not the same as PTSD.

CIS is a normal response

of normal people to

an abnormal event



PTSD

A. Traumatic event

B. Intrusive memories

C. Avoidance, numbing, depression

D. Stress arousal

E. SX > 30 days

F. Impairment



Elements of CISM (Everly & Mitchell, 1999)

• Pre-incident education, preparation

• Demobilizations (large groups of public safety)

• Crisis Management Briefings (large groups primary,

secondary, or tertiary victims)

• Defusings (small groups)

• Critical Incident Stress Debriefing (CISD; small

groups)

• One-on-one crisis intervention

• Family CISM

• Organizational intervention / consultation

• PASTORAL CRISIS INTERVENTION

• Follow-up and referral John Robertson -FORTLOG Services -not


SIGNS AND SYMPTOMS OF DISTRESS

I. COGNITIVE (Thinking)

II. EMOTIONAL

III. BEHAVIORAL

IV. PHYSICAL

V. SPIRITUAL



Terminology

• Resistance

• Resilience

• Recovery

• Stress

– Eustress

– Cumulative

– Critical incident

– Distress

• leadership

• Compassion

– Fatigue

– Satisfaction

• Vicarious Stress

• Burnout

• Support Network

– Family

– Peers

– Friends

from sick care to health care-leadership does matter

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