Alberta Harm Reduction Conference

1. Alberta Harm Reduction Conference Check Yourself before you Wreck Yourself Greg Riehl RN June 1st, 2011

2. Key Messages Hopefully my journey and story will give you an idea or two on how to manage stress and look after yourself (and the people around you) while working in Harm Reduction

3. What are we going to do? • At the end of our time together we are going to share ideas that you have on how you look after yourself, and each other. • Reflective Practice • What, what for, and what next

4. Self Assessment to help prevent Burnout • How do you prevent burnout? • Client First philosophies? (what about you?) • Do you want to fix things?

5. What is the culture of Harm Reduction? • How does culture impact self care? • Everybody know it, nobody talks about it, and it’s not written down (culture?) • Support from those outside of Harm Reduction? • Do you want to fit in? and with whom? • Friends and family and clients • Do you try and assimilate them into Harm Reduction

6. Hero, Victim, Villain? Hero Victim Villain

7. Those people • Compassion Fatigue • Do more with less • Changes that are slow and incremental are not noticed – budget? Staff? Resources? Philosophy?

8. Sometimes it is Important to have a Routine • A big part of my routine is reading: Statement of Commitment to Co-workers • (Adapted from Marie Manthey, President of Creative Nursing Management in Caroline Flint’s Midwifery Teams and Caseloads 1993; p. 138)

9. Statement of Commitment to Co-workers • As your co-worker with a shared goal of providing excellent service to people and families, I commit the following: • I will accept responsibility for establishing and maintaining healthy interpersonal relationships with you and every member of this staff. Cont’d

10. Statement of Commitment to Co-workers • I commit the following: • I will talk to you promptly if I am having a problem with you. The only time I will discuss it with another person is when I need advice or help in deciding how to communicate with you appropriately. Cont’d

11. Statement of Commitment to Co-workers • I commit the following: • I will establish and maintain a relationship of functional trust with you and every member of this staff. My relationships with each of you will be equally respectful, regardless of job titles or levels of educational preparation. Cont’d

12. Statement of Commitment to Co-workers • I commit the following: • I will not engage in the ‘3B’s (bickering, back-biting and bitching) and will ask you not to as well. • I will not complain about another team member and ask you not to as well. If I hear you doing so, I will ask you to talk to that person. Cont’d

13. Statement of Commitment to Co-workers • I commit the following: • I will accept you as you are today, forgiving past problems, and ask you to do the same with me. • I will be committed to finding solutions to problems rather than complaining about them or blaming someone, and ask you to do the same. Cont’d

14. Statement of Commitment to Co-workers • I commit the following: • I will affirm your contribution to quality service. • I will remember that neither of us is perfect, and that human errors are opportunities not for shame or guilt, but for forgiveness and growth. Cont’d

15. Philosophy • Knowing what your philosophy is can help support your practice and preserve you • Strategy: make a workplace commitment and have each other sign it • Then post it!

16. Time to do some work • Tell me what works for you

17. “Our lives begin to end the day we become silent about the things that matter” MLK

18. Reflection is Important • “For me personally, I know that I need to separate myself from work for a holiday when I can not leave work at work.  I will start to think about clients and problems at home when I should be thinking about my own family.  Or I start to have dreams about work life.  Those are my first clues.” 

19. Reflection is Important • “I guess the important thing for me is......... can you fix my stress? I think most people can identify that they are stressed- but how to resolve/alleviate it?” • “The one thing I use to help maintain sanity in the workplace- is focusing on personal goals- things which are achievable that help me to feel control and success when I am stressed by outside factors. i.e. School actually helps me to alleviate work related stress, because I know I am investing in my own future and have control over how much effort i put in.” • “Also- lots of self indulgent reading/internet surfing.”

20. Nine Circles - Self-Care Tips for Caregivers and Service Providers • Do something with a tangible reward at the end (ie. Build a compost bin, fix a toaster, paint your nails, bake a cake, grow your own food, organize a drawer, etc.) • Look at your life from four angles: spiritual, mental, emotional, physical. What can you do to balance these four areas of your life. Baby steps! • Seek counseling via an Employee Assistance Program (EAP) or local community health organization to talk about your feelings and concerns and to stay on top of your mental health. • To do: Write out a To-Do list before you leave work then leave work at work. Have paper and a pen by your bed so that if you wake up at four a.m. thinking about the meeting agenda you haven’t yet created, you can write it down and get back to sleep, knowing you won’t forget later on. • Celebrate the small victories in a day: your client made eye-contact for the first time, you completed three items on your list of things to do, a colleague complemented you on your quick return of their message, etc. Cont’d

21. Nine Circles - Self-Care Tips for Caregivers and Service Providers • Celebrate the small victories in a day: your client made eye-contact for the first time, you completed three items on your list of things to do, a colleague complemented you on your quick return of their message, etc. • Take a warm bath with Epsom salts. Deep condition your hair. • Call a friend. • Exercise: walk to and from work, run, swim, cycle, get a gym pass, have sex, etc. • Disconnect with the world – connect with yourself and your interests: Turn off phones and computers. Read that book or watch that film you’ve been meaning to. • Laugh. Cry. Scream. • Debrief with a colleague. Cont’d

22. Nine Circles - Self-Care Tips for Caregivers and Service Providers • Eat your favorite junk food and watch that cheesy tv show you’re embarrassed to admit you like. • Play and cuddle with kids or pets. • Punch a punching bag. Scream into a pillow. • Have a Crafternoon! Gather your favorite friends and crafting/art supplies and create! • Volunteer somewhere fulfilling. • Seek alternative forms of healing: energy healers, massage therapists, laugh therapists, etc. • Learn something new: take a cooking class, learn Spanish, learn to re-upholster your ugly furniture, etc. • Get some sun! • Nap and get some sleep. Cont’d

23. Nine Circles - Self-Care Tips for Caregivers and Service Providers • Take a long time to prepare, eat and then clean up after a meal. • Stop multitasking. Do one thing at a time. Enjoy making your cup of tea, drinking it, placing it on the bedside table to turn the page in your book – you get the picture. • Listen to music. Close your eyes or dance or both! • Retail therapy: the toilet paper can wait – get those shoes you’ve been eyeing! • Take in your community: go to the zoo, to an art gallery, the museum, local shops or local landmarks/parks • Remember: you are no good to others if you haven’t taken care of your needs first. Ultimately, remember we are not here to save lives, but to provide support, education & care that will empower people to save themselves if they so choose…it is up to them, not us.

24. How do you look after yourself? • Most important to my self-care is having colleagues who know and work in a similar environment with similar staff and clients, and who I can talk with when I need-these are other RNs that I trust and respect. • The other significant things I do for self-care are: • reflect on the day/client/situation • listen to music • enjoy my hobby – genealogy • spend time with my immediate family-husband and kids • have an occasional nice glass of wine • Have fun!!!

25. Sample Tool - What do you do to check yourself? • During the past week or so, • I have had trouble sleeping, Y_N_ • I have had crying spells (I am a sensitive person), Y_N_ • I have been mean to my partner (or students, co-workers, etc) Y_N_ • I have been more sarcastic than usual, Y_N_ • I have been seriously considering a job/career change Y •     Y_N_ • On a scale of 1 to 10, with 1 being “not stressful” to 10 being “extremely stressful,” my current level of stress is _______ • On a scale of 1 to 10, with 1 being “very healthy” to 10 being “very ill,” my current health compared to what it was this time last year is _______

26. Sample Tool - What do you do to check yourself? • I have had trouble remembering my drive home from work Y _ N _ • I have forgotten to pee Y _ N _ • I have consumed more alcohol than I know I should Y _ N _ • I have difficulty focusing when shifting from one task to another Y _ N _ • Do you find yourself thinking about work at home? Y _ N _ • Do you find it difficult to leave work thoughts or planning at work? Y _ N _

27. Self Care -Ultimately it is up to you Consider seeing a doctor, nurse, or someone you trust for a check-in and a check-up. Consider having some relief from care-giving. Discuss with a social worker the resources available in your community. Consider starting or joining a support group for care-givers

28. Thank you for your time • Greg Riehl • gregriehl@sasktel.net • I will post this presentation on slideshare.net • Thanks again…