Cast & Curious

Tag: Learning & Development

Learning and development (L&D) is a function within an organization that is responsible for empowering employees’ growth and developing their knowledge, skills, and capabilities to drive better provisions of healthcare.

  • Managing Stress, Building Resilience and Finding Meaning at Work

    Summary: This pandemic brought stress and the needed resilience to an all time high. Experts recommend finding new meaning at work to combat disillusionment. Join our #HealthXPh chat this Sat 9PM MLA Jan 29, 2022, share your experience and results!

    “I quit!!This is hardly the work I imagined when I entered med school! You risk your life and the safety of your family, for what? Getting rebuked for not extending an already extended duty??! What the f-!”

    MD

    I’ve seen more colleagues leaving this past 2 years than in 10 years I’ve been in practice. Many left because of the untenable healthcare system. Most, simply got burned out by this pandemic. Gone were the accolades and praises for health workers leading the fight against COVID-19. Instead, healthcare workers get ridiculed, criticised and accused of profiteering. People would rather believe popular but misguided personalities who propagate misinformation. Thus, vaccine hesitancy is at its highest.No wonder a lot of healthcare workers wonder- “are we still in the vocation that we all so loved before”?

    This pandemic “broke” many records in healthcare. Given the enormous level of burnout and stress healthcare providers receive at work, mental health issues is at its highest. The number of healthcare workers leaving the local health industry is also staggering, probably the highest in recent memory. Exit interviews among healthcare providers reveal predictable answers- seek greener pastures elsewhere or leave medicine until our healthcare system “figure out” this pandemic. If this diaspora continues, our healthcare system will probably collapse.

    What seem pretty obvious though is that in our healthcare system, care for healthcare providers is not a topmost priority. This is a difficult reality to swallow. Notwithstanding, healthcare providers should prioritize self care or we cannot sustain taking care of others. I am very interested in the thoughts and experiences of healthcare providers who continued doing their “calling”.

    “Why are you not leaving medicine? Have you found ways to manage stress at work? How did you sustain and build resilience? Did you find meaning in this thankless job? Or, are you are you simply zombie- riding the tides of this pandemic??” This will be the topic of our #HealthXPh chat. To guide our discussion, here are the topic questions.

    T1. How do you manage stress at work?

    T2. How do you build resilience at work?

    T3. How do you find meaning at work?

    All these questions obviously mattered even before. This pandemic however brought the level of stress and the needed resilience to an all time high. Many psychologist and mental health experts recommended finding new meaning at work as a way to combat disillusionment with the current healthcare work environment. Most of us agree on these recommendations, but “devil is in the detail”. Note my emphasis on the “how to” so many healthcare provider joining this chatr can try some out of what works for you. So come and join our #HealthXPh chat this Saturday 9PM Manila time Jan 29, 2022, share your experience and results!

    Image by WOKANDAPIX from Pixabay

  • How health workers learn and take care of patients in the new normal.

    COVID 19 pandemic forever changed the way humans live. Healthcare it seems, has to bear the burden of fighting this pandemic (and all other enemies of health ) while continually learning about this little known enemy. These we have to do at the same time and at a speed unheard of in the past.

    An Unknown Enemy

    The hardest enemy to fight is the enemy you knew little or nothing at all. In medicine, our chances of neutralising a disease weighs heavily on knowing the disease and its behaviour. That is, if there is literature about that disease and if we have time digesting this literature. Unfortunately, this novel coronavirus caught us all unprepared and there is, but little time for most front liners to learn this disease. Our knowledge of this pandemic is rapidly increasing per science’s standard, but we are still a long way to go for a standardised prevention and treatment modality.

    Learn, We Must.

    COVID-19 is far from over and the we may be looking already at the new normal. Nonetheless, we must learn and treat patients at the same time or we’d be repeating mistakes made in the past. Fortunately, I see beacons of hope from stories frontline on how health workers continue to learn and treat patients in unique ways. There’s an outpouring of collaboration and sharing of ideas and a healthy dose of criticisms too. I have seen learning technologies taking front and center of this effort. Suddenly, alternative ways of learning went mainstream in a matter of months.

    Alternative ways of learning.

    As an educator, I am interested in how our health front liners continue learning amidst this pandemic. More importantly, I’m interested in making the process of learning more efficient, adaptive and more impactful to our current scenario. This way, we might be able to unburden our front liners and increase our chances of neutralising this enemy as well as the other diseases we’ve been fighting for years. This will be the topic of our discussion at #HealthXPh twitter chat August 1 9-10 PM Manila time.

    T1. How do you continue learning in the new normal?

    What changes- knowledge, skills or behaviour you had to acquire or change to do this? What was your top objective? What was your strategy or approach if any?What resources, technologies did you use? How do you balance your time learning and serving in the frontlines? What were your difficulties?

    T2.What are your metrics for measuring learning success?

    Metrics are a way of knowing we actually achieved the objectives we set earlier- that we learned something and that learning is what we aimed for in the beginning. For example, I usually set an objective of ” to learn diagnosing COVID-19 at the end of this 45 minute Zoom teleconference”. My key metric will be ” to get 75% of the correct answers on the post lecture online assessment related to diagnosing COVID-19″. Im usually dead tired after hospital work, so I use very specific metrics to have an impactful, realistic learning success.

    T3. How did this learning approach impacted your practice of healthcare?

    This pandemic already wreak havoc on everything we know existed, more so in healthcare. Guess were I learned about donning and doffing PPEs before actually attending a formal training on doing so? I also had to invest time, finances to alternative ways of learning. I also had to redo health processes inside the hospital and clinics to incorporate learning I got from these alternative pathways.

    Log in to your twitter account and don’t forget to join our discussion at #HealthXPh twitter chat August 1, 2020 9-10 PM Manila time. Append #HealthXPh to all your tweets around these three questions:

    • T1. How do you continue learning in the new normal?
    • T2. What are your metrics for measuring learning success?
    • T3. How did this learning approach impacted your practice of healthcare ?

    Change does not happen overnight in healthcare but this pandemic pushed us to disrupt healthcare in scale and speed un heard of in the past. This include learning how to learn.

    Image by Freepik

  • Turning Quarantine into Quality Time

    Most healthcare workers and facilities were caught unaware by the corona virus pandemic. Orthopedic surgeons who answer ER calls for acute extremity trauma weren’t exempted from this onslaught. After a short stint at the pandemic frontline, I was back lining COVID-19 front liners with hospital’s emergency incident command (HEIC) group. After about a week with HEICS, a friend told me I was on the verge of collapsing. I made it through another week, just in time for another pull out for yet another task. I thought I was out of the frying pan.

    An article in JAMA Internal Medicine predicted a pandemic of behavioral problems and mental illness in the general population as a consequence of COVID-19. Health workers are already experiencing burnout and “moral injury” even prior to this pandemic. Moral injury “describes the mental, emotional, and spiritual distress people feel after perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations” says Dr. Williams. The uncertainties of COVID-19 fight all the more add to this burnout and moral injury. Little has been discussed about the health workers own mental health.

    There are myriad of reasons why many health workers does not verbalize anxiety while frontlining. Front liners are very busy saving others, often to the point of self neglect. Personally, anxiety was at its during the mandatory 2 weeks post front lining quarantine. Doing nothing while on isolation could wreak havoc on mental health if left unaddressed. For example, I had bouts of the “interns’ syndrome”- diagnosing myself to have contracted COVID-19 based on clinical symptoms of the disease. I also had sleepless nights thinking about the “what if” scenarios if I contracted the disease. Yet I survived the isolation days thanks to a network of social support (including social media) that worked from a distance, and these four essential “steps” I learned from the writings of Adam Grant, a Wharton professor. Here are those essential steps:

    Labelling. The same JAMA Int Med article predicts a substantial increase of mental health issues during and probably after pandemic. Problem is, not many in this generation have prior pandemic experience. Even with health workers who deal with a lot of stress may find this pandemic-related anxiety, on a different level. Most psychologists and psychiatrists would just call it “anxiety” but I don’t think I had this level of anxiety before. I will call it “Post Front lining Stress Disorder” just to highlight the elevated anxiety level . Not totally a very scientific way of labelling but yeah, I am very anxious post front lining.

    T1. Are you dealing with pandemic related mental health issues as a health worker ? How did you came to terms with this?

    Reframing. I’m not exactly an introvert, but I’m comfortable being alone. I read books, hike mountains, travel places and photographed landscapes on my own. The enhanced community quarantine however is prohibitive to some of these activities. So I reassessed my isolation, tried to understand and looked for “productive” opportunities in each of these perspectives. The fear of dying alone doing nothing is I’m afraid what inspired me to reframe my isolation.

    T2. What or who was your inspiration for “reframing” your isolation?

    Distraction. The most insane part of the isolation ordeal for me is distraction . I tried cooking, vlogs, zoomongering and social destalking- unfollowing apocalyptic people and news online. I’m pretty surprised about the things I can and can’t do while in isolation. What’s more important was the act of trying to distract myself from a sordid state of self isolation. Just a warning that although “distraction” may alleviate misery on the short term, some “distractions” like alcohol or drugs have destructive effect on people.

    T3. Whats the funniest distraction you did while quarantined or isolated?

    Amelioration. There was a point in my distracted state that I realized, distraction isn’t enough. I have to protect my (and the people I love) health. I have to help protect my work and colleagues and my embattled nation. I have to learn, do or produce something relevant to this COVID-19 pandemic. I learned HEICS ala “The Matrix” in 2 weeks time. But thats another story.

    T4. What was the most productive thing you’ve done while isolated or quarantined?

    Join #HealthXPh twitter chat on April 18 at 9PM Manila Time as we suggest ways of turning quarantine into quality time. Note the following guide questions and append #HealthXPh to all your tweets!

    • T1. Are you dealing with pandemic related mental health issues as a health worker ? How did you came to terms with this?
    • T2. What or who was your inspiration for “reframing” your isolation?
    • T3. Whats the funniest distraction you did while quarantined or isolated?
    • T4. What was the most productive thing you’ve done while isolated or quarantined?

    See you all!

    Image by Freepik

  • The Doctor is In, Love: How health professionals balance love and work

    People in different professions deal with work related pressures, fatigue, and challenges. The medical profession is one such field. Recent studies have shown the detrimental effects of extended work hours to the professional’s mental health and personal well being. Although stories abound, the effects of work related pressures on the personal relationships of health professionals is still a controversy.

    As in any profession, there are perceived advantages and disadvantages of going into an intimate relationship with a health professional. In the medical profession, what constitute a life enhancing, long lasting or nurturing intimate personal relationship at least controversial. Even health professionals don’t agree on what constitute a successful, life enhancing or nurturing relationship!

    T1. As a health professional, what defines a life enhancing, intimate relationship for you?

    Our society often demand almost superhuman performance on health professionals, that sometimes intimate relationships suffers. The extended work hours for example, often eats up on time intended for our personal relationships. The objective, emphatic but emotionally protective way of communicating by healthcare professionals at work often backfires when applied to interpersonal, intimate relationships.

    T2. What work related factors affect the intimate, personal relationships of medical professionals?

    How health professionals balance their personal and professional life is an art itself. More so with intimate relationships. By experience, it has never been easy. Tipping the balance either way may wreak havoc on the other or worse, destroy both. There are numerous, often funny and sometimes scary anecdotes of health professional’s “love life” gone awry. The demands of healthcare profession is often blamed, although early stage recognition of attributing factors is never even considered. As in work, early diagnosis and “treatment” could have save a potential life enhancing intimate relationship. What constitute “treatment” for a failing health professionals intimate personal relationship is another practice guidelines we have yet to develop.

    T3. As a health professional, what coping mechanism have you employed to nurture a life enhancing, intimate relationship?

    How health professionals cope with the demands of work and sustain a life enhancing intimate personal relationship is the topic of our chat this Saturday, February 15, 9 PM Manila time. Join us in our #healthXPh tweet chat!

    Image by Gerd Altmann from Pixabay

  • The Pursuit of Happiness in Healthcare Workplace

    “Mam, where’s our patient?!” As the OR nurse calmly enumerated a litany of reasons why our patient isn’t yet on the table as scheduled, I’m welling up with frustration. “Excuse me” I said. I silently went back to the empty OR dressing room. I threw a one-two punch -high kick in the air, closed my eyes, took a deep breath and sat momentarily. Grabbing my hospital coat, I went to the patients room, talked to the patient and tried fixing whatever I could, so the patient can have the procedure on a later time. I did that with all the warm smile I could muster. Deep inside? I was screaming for reason. “Am I still happy doing all these, despite the challenges?”

    The news and internet is teaming with bleak stories of healthcare workers worsening mental health, burnout and job satisfaction. WHO recently updated its definition of burnout:

    Burn-out is a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed. It is characterised by three dimensions: (1) feelings of energy depletion or exhaustion; (2) increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and (3) reduced professional efficacy. Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.

    WHO, 2019

    Evidence points to a staggering 1 in 2 healthcare workers has had or is experiencing burnout. Yes thats 50% of health workers! Burnout evidently affects health professional mental status and is tied to job satisfaction according to recent studies.

    T1. Have you experienced or is experiencing burnout in the healthcare workplace? Please describe.

    Don’t get me wrong. I’m not turning a blind eye to the systemic problems besetting the health care industry. The causes of health workers burnout are multifactorial and systemic.

    Work system factors of the systems model of clinician burnout and
    professional well-being.

    I am for systemic solutions and we need it yesterday, or maybe five years ago. But while our health leaders are drafting solutions, we’re left to cope with burnout and find happiness in an adverse workplace. By that I mean, finding happiness on a personal level, cherry picking “tips and tricks” to cope with burnout, perform above par at and still appreciate the career we so love doing. It’s not unusual nowadays to be approached by a colleague asking “How do you find happiness in this shit hole of a workplace?!” Cynical, but a very positive way of looking for happiness in the chaotic sea of workplace challenges.

    T2. How do you find happiness in your healthcare workplace? Please elaborate.

    Systemic solution are often innovative to induce radical changes in the health care industry. The US National Academy of Medicine came up with a systems framework for addressing health professionals mental well being. I’m hopeful our health leaders will get their acts together and come up solutions to this problem. These solution need to trickle down to the grass root health workers fast. By fast, I mean five years ago. In the meantime, we’re left to cope with burnout and find happiness in the workplace. If these personal “tip and trick” miraculously worked for us, we happily share it to our colleagues and sometimes with our bosses or managers.

    T3. What workplace happiness would you share to a colleague or even to your boss and managers?

    Join #HealthXPh tweet chat this Saturday 9PM Manila time as we discuss coping with health professions burnout by finding happiness in what we do. This should guide you through the discussions:

    • T1. As a health professional/student, have you experienced or is experiencing burnout in the workplace? How did you cope up with it?
    • T2. As a health professional/ student, how do you find happiness in your workplace?
    • T3. What workplace happiness would you share to a colleague or even to you boss and managers?

    See you all on Saturday!

    References:

    National Academies of Sciences, Engineering, and Medicine. 2019. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. Washington, DC: The National Academies Press. https://doi.org/10.17226/25521.

    Shanafelt TD , Balch CM ,  Bechamps GJ , et al . 2009. Burnout and career satisfaction among American surgeons. Ann Surg 2009;250:107 15. doi:10.1097/SLA.0b013e3181ac4dfd

    Rosales, Rheajane & Labrague, Leodoro & Rosales, Gilbey. (2013). Nurses’ Job satisfaction and Burnout : Is there a Connection?. International Journal of Advanced Nursing Studies. 2. 10.14419/ijans.v2i1.583.

    Jabonete, Fritz Gerald & Dayrit, Aubrey. (2018). Reported Work-related Stressors among Staff Nurses in Metro Manila, Philippines.

    #HCLDR. (2019, December 5). Reconnecting To Joy in Work [Blog post]. Retrieved from https://hcldr.wordpress.com/2019/12/05/reconnecting-to-joy-in-work/

    Credit: Image by Halcyon Marine Healthcare Systems from Pixabay