How To Be Positive In A Negative Workplace Mark A. Meier, MSW, LICSW ANNA North Carolina Statewide Convention & Southeastern Kidney Council Annual Meeting.

How To Be PositiveIn A Negative Workplace

Mark A. Meier, MSW, LICSW

ANNA North Carolina Statewide Convention&

Southeastern Kidney Council Annual Meeting

Objectives1. Describe the interaction of ethics,

professionalism, and boundaries in the dialysis setting

2. Discuss the insidious nature of professional bullying

3. List the behaviors that support and lead to a healthy workplace environment

My Disclaimer I tell jokes that most people don’t find funny I sometimes swear, so I will apologize in

advance I am no self-help guru…I believe the path to

being happy and positive is only achieved through dedication and effort

I am still crabby and negative at times…just ask my kids they would be happy to tell you!!!

Ethics Boundaries

Professionalism

A Healthy Workplace

A Professional“Characterized by or conforming to the

technical or ethical standards of a profession; exhibiting a courteous, conscientious, and generally businesslike manner in the workplace”

Webster’s Dictionary

And… Recognition and respect for what your

purpose is for being in the dialysis clinic.

Characteristics Of A Professional

Respectful Welcoming Knowledgeable Motivated Concerned Empathic

Accurate Empathy

“refers to how well the professional can step into the patient’s world and see

and experience life the way the patient does.”

Aaron Beck, PhD

What Is It Like?“Patients with renal disease are challenged by

many stressors, including loss of biochemical and physiologic kidney functions, development of digestive and neurological disorders, bone disease and anemia, inability to function in the family and to maintain one’s occupation, decreased mobility, decreased physical and cognitive competence, and loss of sexual function”

Kimmel, MD & Peterson, MD

Seminars in Dialysis, 2005

Important Aspects Of Being A Professional

1. Competent

2. Integrity

3. Critical Thinking

4. Patient Advocate

5. Appearance

6. Courteous Behavior

Why Are Boundaries Important?

1. Define the Professional Relationship

Zone ofHelpfulness

Under-Involved

Over-Involved

National Council of State Boards of Nursing

Important Boundary Issues

1. Developing friendships

2. Self-disclosure

3. Gifts and favors

4. Dual relationships

5. Intimate relationships

Intimate or Sexual Relationships

1. No!

2. No!

3. No!

What Does It Mean To Be Ethical ?

“Being in accordance with the accepted principles of right and wrong that

govern the conduct of a profession”

www.dictionary.reference.com

Ethics - Caveats Difficult Uncomfortable Constant Open to interpretation Defining Lack of training

Bullying

What is it Teamwork Communication Leadership

What Can I Do?

“How To Stay Negative

In A Positive Workplace?”

Staying Negative Accept the status quo, don’t dream big Complain about problems without offering

solutions Allow yourself to be a victim of your

circumstances

Staying Negative Swim in the “Pool of Negativity” Choose not to deal with stress Refuse to see the wonder of it all

Staying Negative Accept the status quo, don’t dream big

Staying Positive

Challenge “what is” and dream big One person can make a difference Overwhelming problems cannot be solved all at

once, but every step helps Believe your ideas matter and are important Remember, Ryan was 6 when his foundation was

born

Staying Negative Accept the status quo, don’t dream big Complain about problems without

considering solutions

The Problem? Abysmal fistula rates across the United States

We blamed patients We blamed payers We blamed CMS We blamed each other We blamed just about anyone we could find

A Solution Fistula First Is it perfect, No Has it provided a

building block, Yes Has it increased the

number of patients with Fistulas?

Staying Positive

Offer Solutions Problems are solved with new ideas or

improvements on previous ideas Complaining promotes negativity and pesimissm Solutions promote optimism and hope Complaining is easy, but solves nothing

Staying Negative Accept the status quo, don’t dream big Complain about problems without

considering solutions Allow yourself to be a victim of your

circumstances

The Victim Role Victim’s are not…

Responsible for change or their actions Motivated to improve their position Expected to achieve Positive, content, and certainly not happy

Staying Positive Take Control of Your Life

Understand what is making you unhappy and address it

Recognize that you have the control to change your life

Understand it will be a challenge, but don’t be a hostage to your fear

Staying Negative Accept the status quo, don’t dream big Complain about problems without

considering solutions Allow yourself to be a victim of your

circumstances Swim in the “Pool of Negativity”

The “Pool of Negativity”

24 hour cable news Internet news “Reality” shows Constant bombardment of opinions and

debate Polarization of opposing views

Staying Positive Take a break from the negative

Turn off the news Spend time listening and reading about positive

issues and change Actively seek out others who have balance in their

lives

Staying Negative Accept the status quo, don’t dream big Complain about problems without considering

solutions Allow yourself to be a victim of your

circumstances Stop swimming in the “Pool of Negativity” Choose not to deal with stress

Dialysis Is Stressful

New Conditions for Coverage Bundling

Health Care Is Stressful

1. Individuals who are very, very ill

2. Profound emotions (pt’s, families, yours)

3. Challenging colleagues

4. Lost hope

5. Death

Something To Think About…“The expectation that we can be immersed in suffering

and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet. This sort of denial is no small matter. The way we deal with loss shapes our capacity to be present to life more than anything else. The way we protect ourselves from loss may be the way in which we distance ourselves from life. We burn out not because we don't care but because we don't grieve. We burn out because we've allowed our hearts to become so filled with loss that we have no room left to care.”

Naomi Rachel Remen, Kitchen Table Wisdom

The Impact Of StressOn Your Body On Your Thoughts

and FeelingsOn Your Behavior

Headache Anxiety Angry Outbursts

Back Pain Irritability Social Withdrawal

Chest Pain Restlessness Crying Spells

Heart Disease Lack of Focus Relationship Difficulties

Hypertension Forgetfulness Crying Spells

Decreased Immunity Worrying Drug or Alcohol Abuse

GI Distress Depression Increased Smoking

Sleep Difficulties Anger Overeating

www.mayoclinic.com

Staying Positive Learn to effectively manage stress

Develop a support system Face and talk about your concerns Exercise, exercise, exercise Manage your sleep and diet Take your vacations Allow yourself to laugh

Staying Negative Accept the status quo, don’t dream big Complain about problems without considering

solutions Allow yourself to be a victim of your

circumstances Stop swimming in the “Pool of Negativity” Choose not to deal with stress Refuse to see the “wonder of it all”

Meet Ron 46 year old man on HD x 3 years Chronically noncompliant with every aspect

of treatment except coming to HD. Known cocaine user Withdrawn and “uninterested” in his care Was deemed among other things, “a loser”,

“a waste of time”, and “a degenerate”

Staying Negative Choose to give up on people Choose to judge situations without full

knowledge of all circumstances Continue to live your life with the belief that

you know best Continue to expect from others what you

don’t expect of yourself because then you will always have something to complain about

“Relativism”“Making matters worse is people’s

natural inclination to be easy on themselves, judging themselves according to their good intentions-while holding others to a higher standard and judging them by their worst actions.”

Maxwell, 2003

Ron Into Ron’s life came an unexpected couple of

people from a church service he attended. Ron’s attendance to dialysis started to drop

over the course of a few months. Scheduled care conference and…

Ron Was attending a treatment program for

cocaine users Had developed close ties with the church and

was in a peer mentor program Had started a job Transplanted

We Have To Remember

There are no promises in this life Crazy stuff happens all the time Being positive takes work and effort

It Begins With You…

You have the control to be positive You have the ability to change what is

making you unhappy If you wait for others to make you happy, you

might wait a long time

Thank You!

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