www.RxForSanity.c om Rx For Sanity: Resuscitating a Passion for Healthcare ! Patricia L Raymond MD FACP FACG Rx for Sanity, Norfolk VA
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www.RxForSanity.com
Rx For Sanity:Resuscitating a Passion
for Healthcare !
Patricia L Raymond MD FACP FACGRx for Sanity, Norfolk VA
www.RxForSanity.com
“Does It Make Your Ears Wiggle?”
-N.E. Raymond
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Caught Between…
• Frustrated administrators who want a full (and happy) staff at yesterday’s prices.
• Angry caregivers who have to do more, faster with less staff and equipment, and are feeling squeezed like a grape!
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Sometimes you have to take your brain and stomp on it a little.
It just gets caked up.
Mark Twain
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Your Prescription for Sanity
• Triage: your professional life• Love: Family, finances, & mental
health• Laughter: Personal health
And we’ve only a little over an hour to change your
life!
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Triage: Your Professional Life
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Problems in Healthcare Human Resources today…
• Hiring freeze of nurses given economic crunch • Need for 'out of the box' solutions to enhance
retention, given limitations on new hires • Generational issues amongst staff • Wellness issues, or "Do as I say, not as I do" • Customer service and satisfaction scores
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“Please back in for prompter service.”
Sign on our endoscopy suite door
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No time for Metrics, Metrics, Metrics
• Benefits expenses per FTE• Vacancy rates as a percentage
of all employees• Turnover rates as a
percentage of all employees• Net revenue per FTE• Total salary expenses per FTE• HR employees per 100 FTEs
• WHO has time to keep up!
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“I thought of resigning in the last six months.”
• 37% of YOUR current employees responded “Strongly agree” or “Agree”
The reasons :Other – 38%
Career Advancement – 15%
Pay – 23%
Benefits – 5%
My Supervisor/Manager – 18%
2008 HR Solutions, Inc
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What’s “Other” at your hospital?
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Union Buster!• Data from nurses’ strikes
in New York State from 1984 to 2004 : 38,228 patients
• In-hospital mortality up 19.4 % – 138 more individuals died
• Hospital readmissions up 6.5 %.– 344 more readmitted
Do Strikes Kill? Evidence from New York State (NBER Working Paper No. 15855), J Gruber, S Kleiner
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You’re unique…
Just like everybody else.
pairshare
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If you had a magic wand,
& could wave it over your staff
& get them to do any one thing differently,
what would you choose and why?
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If the people in your hospital were singing a blues song
about their job,
what would they be singing about EXACTLY?
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It’s not my job.
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Exercise: The Perfect Day
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Rxs for Human Resources
• Ergometrics– Chair, keyboard, mouse– Desk & monitor set up
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Metrics Yourself:How do you measure up?
• ASHHRA’s
HR Leadership Self-Evaluation Tool
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Employee Engagement=Patient Satisfaction
• Teach them to own their own engagement
• Are your staff sitting back passively, waiting for someone to engage them? Change the culture!
Why the Lopsided Look atEmployee Engagement ??? HR Solutions
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Get your staff off their buts…(but THEY didn’t try to engage me…)
1. Adopt a more positive “can-do” attitude 2. Accept some ownership for being proud of where you
work.3. Ask for clarification if instructions from your
supervisor are somehow unclear.4. Set yourself up to be recognized. 5. Request a career planning meeting with your manager.6. Get to know your Senior Leadership.
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Get your staff off their buts…(but THEY didn’t try to engage me…)
7. Actively participate in, and contribute to, decisions that
affect your work environment.
8. Ask for feedback about your work performance and act on it.
9. If you don’t have the tools/resources to perform your job effectively, ask for them!
10. Seek learning, knowledge, and satisfaction from your
co-workers and most of all, don’t forget to instill FUN into
your everyday work activities.
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What’s “Other”?
• Are you working on disruptive behaviors
with your CMO, CNO or other administrators?
• NOT JCAHO zero-tolerance level issues, but…
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Medical costs fall about $3.27, absenteeism costs fall by about $2.73
for every dollar spent on wellness programs
• Use More, Pay Less– $25/mo x 3 mo, – then -$5 if 5-9/mo, -$10 if 10 or more
• Catch a Flight• W@W• Commit to Quit• Team behavior management games
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Recognition/Appreciation
Best in Class, Circle of ExcellenceOr noted for longevity only
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Other interesting ideas
• Buddy program• Administration lunch table• Nurse fellows program• Nurse shift bidding
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“The great use of a life is to spend it on something that will
outlast it.”
William James
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Professional Rxs: Find your Windmill
Where are the opportunities for you to make a difference with your
Passion and Position?
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Possible HR Windmills
• Employee wellness• Staff enrichment• Insidious intimidation (bullying)• Diversity • Recognition• Employee financial health
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Your mission in life is whereyour deep joy
and the world’s deep hunger meet.~Richard Nelson Bolles
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Attend conferences like this one, where you can interact with others
who share in your
problems and your passions!
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Love:Family, Finances &
Mental Health
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The Art of HealingW.H. Auden
Most patients believe
Dying is something they do,
Not their physician,
That white-coated sage,
Never to be imagined
Naked or married.
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Family and Medicine
• “Being a physician is one of the few socially acceptable reasons for abandoning a family.” Ann Int Med 2001
• Divorce rates 10-20% higher than general population
Ann Int Med 2001Sou Med Jou 2000
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Financial stresses
• 35 to 45 y/o average personal debt equals 95% of annual income
• Most spend less than 1 hour per month on retirement planning
• 2 of 3 HCPs does not have a will
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Exercise: Focus Points
• People• Work• Food• Clothing
• Shelter• Money• Fun
Repeat q 3 months
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Personal & Family Rxs• Take control
– Make time for family/ delegate or hire out– Network with other professionals
• Fee only financial advisor• Marital counseling
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Laughter:Personal Health
& Wellness
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The Science of Wellness
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The Science of Wellness
• Stop smokingTobaccoFreeNurses.org
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The Science of Wellness
• Stop smoking • Eating habits
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The Science of Wellness
• Stop smoking • Eating habits• Exercise 30 minutes
daily
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Exercise as MedicineCardiovascular disease, CHF,
CVA, PVD, Type II Diabetes, Obesity, Dyslipidemia, Cancer (breast, colon, prostate, pancreas, melanoma), Asthma, COPD, Osteoarthritis, Rheumatoid Arthritis, Cognitive
Dysfunction
Booth, J Applied Physiology 2002;93:3-30
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Hi,
This is a hassle to remind you to Have you exercised today? Remember that your health is more important than what you do. Meditate and journal today too. Be in balance. Breathe. So get to it!
You'll be sent one of these hassles roughly every 2 days.
Thanks, -- The HassleMe Team http://hassleme.co.uk/
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HassleMe http://hassleme.co.uk
Because sometimes in life,you just need to be nagged...
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The Science of Wellness
• Stop smoking • Eating habits• Exercise 30 minutes
daily• Sleep 8 hours a night
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Aging and sleep• Lancet 1999• 8 hours verses 4 hours in normal college students• glucose intolerance identical to early adult type
diabetes• TSH & cortisol levels like elderly
Mall study:
13 % less max happy with each hour < 8
7 = 87% 6 = 74%
5 = 61%
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The Science of Wellness
• Stop smoking • Eating habits• Exercise 30 minutes daily• Sleep 8 hours a night• See a physician
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Scott Adams/Dilbert: W.A.D. found
1998- 2 polyps
1999- 2 polyps
2002- no polyps
2007- 5 polyps
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The Science of Wellness
• Meditate/ breathe/ journal/ spiritual
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Spirituality & medicine
• Meditation– Psoriasis, heart disease, chronic pain– UCLA meditation tapes to BP patients 73%
reduction in medication, 50% stop meds altogether
• Journaling– Smith Annals Internal Medicine COPD RA
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Spirituality & medicine
• Optimism– Mayo clinic: pessimists risk factor for
premature death, overall lower level of health, more use of medical resources and higher medical costs
– Internal Medicine News: pessimism worsens lung function; pessimism equivalent to 20 pack- year smoking
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The Science of Wellness
• Meditate/ breathe/ journal/ spiritual
• Happiness list
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may my mind stroll about hungry, and fearless, and thirsty, and supple.
ee cummings
may my heart always be open
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ColonoscopyJoke.com RxForSanity.com
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The Science of Wellness
• Meditate/ breathe/ journal/ spiritual• Happiness list
• Have Sex• Reassess quarterly
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The Caerphilly Study: Smith, Frankel, Yarnell, BMJ 1997
• N=918 males(45-59 y/o), 10 year f/u• Stratified to self-reported frequency of
intercourse– Low: Less than q month– Intermediate– High: BIW or more frequent
• Data adjusted for variables of age, social class, systolic blood pressure,
smoking, baseline CAD, cholesterol
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The Caerphilly Study: ResultsLow
FrequencyIntermediate Frequency
High Frequency
All Cause Mortality
1.9 CI 1.0-3.4P<0.04
1.6 (CI 1.0-2.8) 1.0
Coronary Heart Disease
2.1 CI 0.9 -5.1
P<0.10
1.8 (CI 0.8-4.0) 1.0
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Women vs. MenQuality vs. Quantity
• Sexual dissatisfaction for women is an independent risk factor for MI– Abramov, Psychosom Med 1976
• Lack of sex associated with death in men• Lack of enjoyment associated with death in
women• Duke Study on Ageing
– Palrnore, Gerontologist 1982
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Rx Yourself Now:
If you really want to do something you’ll find a way.
If you don’t,
you’ll find an excuse.
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The Science of Wellness• Stop smoking• Moderate your eating habits• Exercise 30 minutes daily• Sleep 8 hours a night• See a physician • Seek the spiritual• Make a “Happiness List”• Have more/better sex• Reassess quarterly
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SSDT: Not sex!
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This is your prescription for sanity:
• Choose your windmill• Focus Points• Happiness List
• Have more (or better) sex
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“Does It Make Your Ears Wiggle?”
-N.E. Raymond
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Don’t wait for a second opinion!
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