resilience on the front-line · resilience on the front-line believe you can create the...

Resilience on the Front-Line

Believe YOU Can Create the ExtraOrdinary Life YOU Deserve

Raquel Jex Forsgren, Resilience Coach, CReC, Yoga Therapist, C-IAYT, and Founder of Front-

Line Resilience Health, LLC

Today’s GOALS

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Understand What Resilience REALLY Means

BELIEVE That You Can Build Your OWN Resilience

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4 Learn and Practice SIX Resilience Concepts to Help You Feel Better

COMPASSION FATIGUE: Preventing It OR Managing It

Close Your Eyes

Source: Permission Given by DRIVEN, 2018

RESILIENCEis Important

For ……..


And For …………….

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It’s Endless

Source: Power Point Free Images and On-Line Free Stock Images

• A progressive and CUMULATIVE process that is influenced by the nurse’s repeated, continuous, and intense exposure to stress, particularly in oncology

• As a person’s level of compassion fatigue INCREASES, their ability to empathize with others DECREASES

• Burnout and secondary traumatic stress make up COMPASSION FATIGUE

Source: Sacco et al., 2015; Yoder, 2010; RUSH DNP Project, 2018

What IS Compassion Fatigue?

Emotional Effects

– Anger

– Cynicism

– Hopelessness

– Apathy

– Feelings of Being Overwhelmed

– Lack of Empathy

Source: Sacco et al., 2015; Yoder, 2010; Nevelle & Cole, 2013; Maslach, 1982; Power Point Free Images; On-Line Free Stock Images

For You, Symptoms and Effects of Compassion Fatigue is a Bit More SPECIFIC

Difficulty breathing

Rapid heartrate

Nausea

Dizziness

Headaches

Chest pain

Panicky feeling

Source: Sacco et al., 2015; Yoder, 2010; Nevelle & Cole, 2013; Maslach, 1982; Macmillenhired.com; Power Point Free Images; On-Line Free Stock Images

Have You FELT Any of These Somatic

Effects Lately

Under-Developed Resilience Creates Our OWN Diseases & Conditions

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Heart Disease

Sick All The Time

Stress and Anxiety

Sleep Issues


Even SMALL setbacks feel like disasters

AND

Can take a while to RECOVER from

LOW Resilience Combined with Compassion Fatigue Has a BIGGER Impact ……..

May Even Forget Why You Wanted to Work with Patients in the FIRST Place


Disciplined in My Eating and Exercising

Self-Aware of Their Emotions for the First Time

Not as Fatigued During the Day

Self-Esteem Has Changed for the Better

Empowered Because They Can Start Small

In-Control and Can Let Go of the Day Easier

Balanced and Not Reacting Like They Used To

Nurses and Nurse Navigators I Work with Define Resiliency and How It FEELS to Them

Source: Northwestern, RUSH, MDACC, Advocate, UCSF

Feeling My Grief Over Losing My Patients Now

I Feel a Little Messy Inside

My Body Doesn’t Feel Numb for the First Time

• Bouncing back from setbacks is EASIER and ….

• You start to view adversity as an OPPORTUNITY to grow

HIGH Resilience Feels Like ……..

Source: Permission by DRIVEN, 2018

FACT

We Build Resilience by CHANGING the

Wiring of Our Brains

Prefrontal Cortex is the ABSTRACT, Creative and Strategic Brain

Limbic Brain Holds Our Emotional Response (FEAR)

The Goal is to BUILD Connection and Enhance Regulation

TWO Parts to the Brain Are Involved ……


Preconscious processing filters external stimuli down to what matters most to the brain

Includes our internal model of the world from our experiences

Most of the brain is association-related

Our biases and beliefs become clearer

Preconscious Processing is ASSOCIATION Related


Amygdala uses direct inputs and processed inputs to scan for threats

It activates Hypothalamic-Pituitary-Adrenal (HPA) axis if threats are present (fight-flight)

We are in a state of Sympathetic Nervous System activation now more than ever before

Amygdala is actually bigger in people who are always in Fight or Flight Mode

Our Brains Still Scan for Threats … ACTIVATES the Fight or Flight Response


Affects state of mind before we are conscious of sensations in our body

Our bodies go into this state before we realize what is going on

Proactive conditioning is needed to downregulate amygdala activation so we avoid going into Fight-or Flight-Mode

CONSCIOUS Processing is What We Need to Keep From Being Triggered


BECOME

1 2

3

4

5

6


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Purpose

Goals

Values

= VISION

You DESERVE to Live an EXTRAORDINARY LIFE

Source: Personal Images

Living Your VALUESwith Integrity & Congruence

Values are like principles that you LIVE YOUR LIFE by ….

Get URGENT About Making Changes

Why do you WANT to change? Why do you feel you DON’T

NEED to change?

Take STOCK in Areas of Your Life

What areas of your life are most meaningful to you? Are your goals and daily activities

in line with that meaning?

VISION Get Clear on What You Want for YOUR Life to Be

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EXAMINE Start, Stop, or Continue

1 2

3

4

5

6


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= COMPOSURE

Feeling Calm and in Control

Self-Love

Emotions

Bias


Being Patient ANDCompassionate

ALLOW Yourself to Love that Patient. That Family Member. That Co-Worker. YOURSELF…

Regulating Our Emotions

EVERY Day

Emotions Need to Be Felt, Heard, and Seen and Never Stay the Same. Lean into the emotion.

Interpretation Bias Based on Our EXPERIENCES

We’ve All Experienced Life Differently, Responded

Differently. Which biases affect your interpretation?

COMPOSURE Feeling Calm and IN CONTROL of What We Think, Feel, and Do

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FEEL, Let Go, AND Transition LIST

1 2

3

4

5

6


3030

3

= REASONING

Building IT Before You Need It

Problem-Solving

Resourcefulness

Anticipate & Plan


Problem-Solving Before

Something Gets BIG

Problems Get Bigger and Bigger the More the Story Plays Out in

Our Minds …….

Finding the Resources and USING Them

The Coach, the Class, the Book, the YouTube, the Podcast, the

Friend, the Shrink.. Which Ones Could You Use?

Anticipate & PLAN with Realistic Optimism

Do You Know That a Change is Coming? How Do You Prepare for That? What Could You Do?

REASONING Build IT Before YOU Need IT

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IMAGINE with Your

Minds

WRITE MAP IT

1 2

3

4

5

6


3333

4

= Health

When We Create More Energy, We FEELBetter About Ourselves Leading to

Confidence and Motivation

Nutrition

Sleep

Exercise


Nutrition CAN Be Integrated

The Day You Move, Inspires You to Eat Differently. What Could You Change In Your

Nutrition That Would Give You More Energy?

IMPROVE Your Sleep with Tricks and Techniques

Do You Know What Keeps You Awake? Do You Know How

Much Sleep You REALLY Need?

Movement = Exercise

It’s Not All About Making it to the Gym or the 60-Min Yoga Class It’s About Movement!

Health Let SMALL Steps Be Your Motivation

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EXPERIENCE with the Body WRITE

EXPERIENCE with the BREATH

1 2

3

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5

6


3737

5

= TENACITY

Confidence in Handling Whatever Comes Your Way Because You

KNOW How

Persistence

Realistic Optimism

Bouncing Back


Persistent in Your

DRIVE to Feel Better

Small Steps Forward Every Day, Even If You Fall Back by 15!

Positive Outlook and

KNOW Stuff Happens, Too

Self-Awareness, Curiosity About What You Are Thinking and

Feeling, and Knowing You Can Handle with the Power of YES

Leaning Into Your Feelings

and Then SHIFTING

Do You Feel Like You Get STUCK in an Emotion or

Feeling? Leverage the breath and your mind to lean into it.

TENACITYThe Confidence to KNOW You Can Handle Anything Coming Your Way

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WRITE an AFFIRMATION

EXPERIENCE Using Imagery and Breath

1 2

3

4

5

6


4040

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= COLLABORATION

Dropping the Armor and Embrace Vulnerability

Support Network

Social Community

Perceptions


Build a NETWORKfor Yourself

Being around people we trust and that we share things in

common help us. How often do you drop the armor even

though you trust them?

Integrate Things You Enjoy with YOUR People

How many people and things do you do that you really don’t want

to or are not aligned with your vision and goals?

Perceptions of WHO or

WHAT We Should Be

Have you placed expectations OR judgements on yourself?

Has someone else? Do you let what someone says get on the “inside” or can you just “look

at it” and move on?

COLLABORATEDROP the Armor and Embrace Vulnerability

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THINK and FEEL WRITE NOTICE

How Does This All Really Change MY

Brain?

FACT

It’s About Small & FREQUENT Practice

100 billion neurons

70,000 synaptic connections per neuron

Resilience skills are what strengthens the resilient neural pathways in the brain

With Our NEURONS ….. They Encode Our Thoughts, Actions, Beliefs, and Memories


2Those Neurons

that Fire Together….

Creating a NEWNeuronal

Pathway Making it Easier for Us to Think in a New

Way!


REMEMBERGet Clear on What You Want in Life

Build Your Composure

Anticipate & Plan

Take Small Steps Daily for Health

Keep “Getting in the Ring”

Get Rid of the Armor and Trust

INSPIRENotice How You Feel – You DESERVE to Live an

ExtraOrdinary Life – a Perfectly IMPERFECT ONE

ACTIONLeave Here Today with a Commitment and Intention

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References and Sources for You to Leverage

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References:

1. Burnett, H.J., and Wahl, K. (2015). The Compassion Fatigue and Resilience Connection: A Survey of Resilience. Survey.

2. Gilman, et al. (2015). Strategies to Promote Coping and Resilience in Oncology and Palliative Care Nurses Caring for Adult Patients with Malignancy. A Comprehensive Review.

3. Flarity, K., et al (2013). The Effectiveness of an Educational Program on Preventing and Treating Compassion Fatigue in ER Nurses. Advanced Emergency Medicine.

4. Jones, A., (2017). Oncology Nurse Retreat as an Effective Strategy to Manage Compassion Fatigue. Clinical Journal of Oncology Nursing.

5. Nevelle, K., Cole, D., (2013). The Relationships Among Health Promotion Behaviors, Compassion Fatigue, Burnout, and Compassion Satisfaction in Nurses Practicing in a Community Medical Center. Journal of Oncology Nursing Administration.

6. Potter, P., et al (2013). Developing a Systemic Program for Compassion Fatigue. Nursing Administration Quarterly.

7. Burchard, B. Highly Performance Habits (2017)8. Brene Brown, Rising Strong (2015) and Daring Leadership (2018)9. DRIVEN, (2018). Resilience Coach Program.

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Attentively searching she observes, Relieves pain (her specialty)

Shares helpfulnessKnowledgeably. She

Challenges the subversiveness of cancer. Engages itHead on with medicinal Astuteness, suggestions

To ease andReassure

With the realityOf lab measured

Promise …..

Ned Haggard, Hope Stays Late

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