Tips on how to Navigate, Evaluate and Problem-Solve the Seven

Dimensions of Wellness

Sarah Albers MD, MPH, FACEP, CWSPMarlette Regional Hospital

Medical Director Wound ClinicEmergency Medicine Physician

Juggling

7 Dimensions of Wellness

1. Social2. Spiritual3. Intellectual4. Physical5. Occupational6. Emotional7. Financial

• Rating Scale • 5 – Very Satisfied • 4 – Satisfied • 3 – Fair • 2 – Dissatisfied• 1 – Very Dissatisfied

Social Wellness

• Relationships we have and how we interact with others

• Make eye contact and smile more

• Pay it forward• Practice being an

extrovert and say hi to everyone

• Be yourself• Be honest• Have fun• Thank your support

network• Ask for help

• Interdependence between people and nature

• How do you contribute to your environment and community?

• How do you preserve the beauty and balance of nature along your path?

• Bigger than oneself

Are you listening or just simply hearing?

Are you physically and mentally present when dealing with others?

Conflict

• Conflict can be the vehicle that carries meaningful change

• Acknowledge it• Breathe

• Helps dissipate some of the visceral reactions to stress

• Gives us a little mental space to develop a plan of action

The Breath and Stress

• Breathing shallow↓

• Blood is not oxygenated properly ↓

• Impair mental function↓

• Promote physical fatigue

• Slower breathing (5-7/min)↓

• Stimulates the Vagus nerve↓

• Acetylcholine release↓

• Heart rate decreases

Conflict Action Plan• 1. Separate the people from the

problem

• 2. Focus on Interests, not positions

• 3. Invent multiple options looking for mutual gain before deciding what to do

• 4. Insist that the result be based on an objective standard

1. Separate the people from the problem

• If we can separate the person from the problem, then the focus of conflict turns to the situation instead of a personal attack

• Rather than thinking: “What’s wrong with this person?”

• Try “What factors are influencing this person’s behavior?”

• Have they ever been in this situation before?

• Have their prior role models or bosses condoned this behavior?

• Need to understand the other point of view

2. Focus on Interests, not positions

• Interest-based bargaining • Negotiation strategy • Focuses on the interests

• what they really want • Rather than their positions

• what they think the solution is

3. Invent multiple options looking for mutual gain before deciding on solution

Shared decision making

Invent first, decide later!

• Ask “What if” questions• Encourage brainstorming• Separate problem into smaller

segment• Imagine what that solution

would look like

4. Insist that the result be based on an

objective standard

• Strongest objective standards • based on something outside of either

party’s relative power, influence, resources or interests

• Kelley Blue Book• Comparative home prices

• Legal precedent• Average salary ranges• Raw materials costs

To find meaning and purpose in life

To be tolerant of others beliefs

Personal values

• Self esteem• Healthy connection to others• Connection to source, higher power, spiritual

dimension

Relationships

Find the life underneath your life situation

• Narrow your life down to the moment: Just be• Your life may be full of problems (most life

situations are)• Do you have any life problems in this

moment? • Not tomorrow or in 10 minutes, but now…

• Use all your senses fully (see, hear, taste, feel, smell)

• See the light/sun• Listen to the sounds: Wind? Rain?

Quietness?

• Allow yourself reflective time and space to be silent and still

• Personal sanctuary • Surround yourself with joy, peace and

tranquility in your living area• Not just religion, higher power,

meditation, yoga, nature• Pay it forward• Practice Gratitude

• Gratitude journal/photo

Intellectual Wellness

Expand your knowledge and skills

In and beyond the classroom

Not just academics

• Reading/Audiobooks• Free online classes• New life skill• Hobbies/activities• Side Hustle• Being open to new ideas• Think Critically• Games

Stimulate and challenge your mind

• Move• Discover

• Rest/Sleep• Connect (Connection for protection)• Nourish (SHARP)

• Slash sugar• Hydrate• Add omega 3’s• Reduce portions• Plan meals ahead

Physical Wellness

• You have 1 body – Take care of it!• Most nutrient dense foods• Veggies → Fruits → Legumes → Whole grains →

Nuts → Seeds

• Moderation• Feed your body garbage it will feel like garbage• Stress eating

• People use food to help them deal with stressful situations

• Food Addiction• Sugar addiction – releases dopamine like drugs of

abuse

Dirty Dozen 2021

1. Strawberries (6th

year in a row)• 90% had at least

1 pesticide residue

• 30% had residues of 10 or more pesticides

2. Spinach3. Kale4. Nectarines5. Apples

6. Grapes7. Cherries8. Peaches9. Pears10. Sweet Bell Peppers11. Celery12. Tomatoes

PLU

• Exercise• GOYA, DO IT!• Pick something you enjoy

• Start slow and increase gradually• Doesn’t have to be in a gym

Sleep• Put your phone down• Shut off the TV• Avoid

caffeine/alcohol/drugs/nicotine• Ideal: go to bed and get up at

same time• Adults 7-9 h

• Kids/Teens 9.5 h• Babies 16-18 h

• Mind racing • post – its• Critical task list for tomorrow

Self Care

Balance

• Life - work balance vs. work - life balance• Are you giving more to other people than you have for yourself?

Occupational Wellness

Occupational Wellness

Unpaid Work

• Work performed by a family member who is not being paid

• Caregiving• Childcare • Cooking• Cleaning• Shopping/errands• Yardwork• House Maintenance

• U.S. • Women average 4 hours of unpaid

work a day • Men average 2.5

• India• Women average 6h/day• Men average less than 1 h/d

• Norway • Women 3.5h/d• Men 3h/day

Unpaid work

• There is no country where the unpaid work gap is zero.

• On average women do 7 years more of unpaid work than men over their lifetimes

• Bachelor AND masters degree

• 2003 Bureau of Labor Statistics conducted a national time use survey that measured housework and childcare hours

• Men have more time for recreational activities (playing games and exercising)

• Women did more unpaid work and more work altogether

Equal partnership

• 3 R’s• Recognize unpaid work is being

done• Reduce the number of hours that

unpaid works takes• Redistribute the work that can’t be

reduced so men and women share it more equitably

ACEP Advice

• Pamela Bensen MD, MPH, FACEP• First woman to train in

Emergency medicine• “Find someone wonderful to

watch your children, and someone fantastic to clean your house.”

ACEP Advice

• Pamela Bensen MD, MPH, FACEP• First woman to train in

Emergency medicine• “Find someone wonderful to

watch your children, and someone fantastic to clean your house.”

Emotional Wellness

An awareness, understanding and acceptance of one’s feelings

Includes ability to manage effectively through challenge and change

Compassion Fatigue

• Profound emotional and physical exhaustion• Gradual erosion of all the things that keep us connected to our

helping/caregiving roles: • Empathy• Hope• Compassion

Burnout

1. Emotional Exhaustion - the fatigue that comes from caring too much, for too long

2. Depersonalization – the depletion of empathy, caring and compassion

3. Decreased sense of accomplishment – an unconquerable sense of futility: feeling that nothing you do makes any difference

• Highly prevalent

2019 Medscape National Physician Burnout, Depression & Suicide Report

Financial Wellness

• Want - desire to possess or do something,

• Wish for• For fun or leisure• Can live without

• Need – essential or very important for you to work and live

• Reoccurring

Recurring Monthly Payments

• Mortgage• Car(s)• Student Loan• Credit card• Cell phone• Internet• Insurances (home, life, health,

car, disability…)• Utilities

• Subscriptions• Groceries• Maintenance• Entertainment/dining

Big Rocks

• Credit Card and Bank Statements for past 3 months

• Highlight

• One Time expenses • >/= $50

• Recurring monthly purchases• Online

Fixed Variable Big RocksHouse Water, Electricity, Gas Amazon/Online purchases

Car(s) Groceries Costco

Cell phone Kids (sports, clothing, activities, equipment, school), animals, Education

Target

Cable/Internet/Phone Eating Out/Entertainment, Home Depot, Cabela's, Hunting, Tools

Gas for cars Vacations Clothing, Accessories, Shoes, Personal care

Subscriptions Repairs, House, Car, Health Toys (boat, golf cart, atv, snowmobile, cars)

Insurance Gifts, Holidays,Celebrations

Decorating, Hobbies, Furniture

50/30/20 vs. 50/20/30

• 50% Needs • Housing• Utilities• Groceries• Car

• 30% Wants• 20% Savings

• 50/20/30• 50% Needs• 20% Wants• 30% Savings

• $ 4000/month Take home• 2000 Needs• 800 Wants• 1200 Savings

Juggling

Multitasking

What is on your list?1.2.3.4.5….

Caring for yourself 2021

• 1. Get enough sleep• 2. Don’t eat garbage• 3. Vary your daily grind• 4. Exercise• 5 Do something pleasurable and

enjoy the little things in life

• 6. Focus on what you did well or the positives for your day

• 7. Learn from your mistakes• 8. Laugh and connect with

someone• 9. Relax, pray or meditate• 10. Use your imagination and

visualize your dreams

References

• Gates, Melinda, Moment of Lift• Hultell, Melin, and Gustavson, “Getting Personal with Teacher Burnout”; Larrivee, Cultivating

Teacher Renewal• National institutes of health https://www.nih.gov/health-information/social-wellness-toolkit• https://epmonthly.com/article/pam-benson-blazed-trails-ems-first-female/

• National Wellness Institute https://nationalwellness.org/• https://www.nationalcenterforemotionalwellness.org/

• https://www.wsj.com/articles/breathing-for-your-better-health-1422311283• https://www.heath.Harvard.edu/staying-healthy/why-stress-causes-people-to-overeat• https://www.nytimes.com/2021/04/19/well/mind/covid-mental-health-languishing.html• https://apple.news/AX73EwhJVTIa7OxSWhWXvTQ

Thank you.

Sarah Albers, MD, MPH, FACEP, CWSPsealbers@gmail.com