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Rest | Danny van Leeuwen Health Hats - Part 2

That Sinking Feeling of Stress

By | Advocate, Caregiver, Consumer, ePatient, Family man, Musician | No Comments
You know that sinking feeling you get in the pit of your stomach when something is seriously wrong?  Often accompanied by inability to focus on the here and now (your music, your kids, your grandkids, your partner), trouble sleeping, mind racing? Happens when you get bad news, when someone treats you like crap, when you think you’ve made a serious mistake, grief. It’s the fight or flight stress reaction.  Today I got that sensation when I was playing my sax, trying to memorize a piece. I so struggle with memorization-always have-from the days of anatomy and trying to remember bones.  Anyway, I thought,why the heck am I feeling this stress reaction playing music?  I’ve felt it more often lately-stress at work mostly. It affects my sleep, I struggle to focus. It’s an energy sucker. I only have so much gas in my tank-I hate wasting it on this stress reaction. What can a person do? I’m not one that’s had success with meditation. There are some interesting tricks:  I do love the one of pressing on the space above my upper lip below my nose.  I think it’s so comical it helps for a second, but doesn’t last past the press. Focused breathing deeply always works, but again doesn’t last. Talking to someone, getting whatever off my chest occasionally works -and it lasts.  There’s compartmentalization, denial – I’m not too good at those either. My PCP gave me Ativan to take before I go to bed, but I haven’t tried it. Actually, just having it in the cabinet has almost eliminated my need for it. Powerful stuff, eh – proximity without ingestion. Stress is a part of life. Unavoidable, part of the human condition. The challenge is to keep the cycle short, less frequent.  How do people manage who have this sensation all day for days, weeks, months, years on end?  Must be crazy making. Managing stress is a magic lever of best health.

Focusing on the Basics

By | Caregiver, Consumer, ePatient, Family man | No Comments

I just want to focus on the basics! 

In life I reach for the sky. I’m wired that way. I’m frustrated by less. In my health journey or anyone’s health journey where I’m along for the ride I want the best possible health given the circumstances. However, its complex, it’s hard, it’s a long journey to the sky. So I think, OK, let’s focus on the basics.  The journey is built on the basics. But what are the basics? No brainer, logical, common sense stuff – the magic levers – good diet, sufficient exercise and rest, family/individual/work balance, stress reduction, an aligned team? Unfortunately, the basics shift, vary from person to person and from team to team. Basics can be the hardest to attain. When under new or added stress – the basics suffer. Good habits suffer. I learned from a fabulous grief counselor, to attend to the basics first, then I would be better able to handle the unmanageable, unpredictable stresses of death, dying, and grief. Eureka, it was true. Attention to sleep, diet, exercise increased my capacity and resilience. I need help with the basics – reminders, tracking, companionship. Lord, help me with my defensiveness and resistance to help.  I can’t make it without. So hard to accept. The health journey is paved with the basics.
Photo by Patrick Hendry on Unsplash

Oatmeal for Break

By | Consumer, ePatient, Family man | 2 Comments
Today, I’m a bit overwhelmed with my self-committed obligations: write a blog, finish the family birthday calendar, print the Xmas cards, be a good member of my in-person and virtual teams (professional, community, family), take my medicine, play music, exercise, eat well, rest enough… OMG. Why do I do this? Am I nuts? What would I do instead?  It’s all so fun, except when it isn’t. What would I be if I didn’t do all this stuff? A shell, a zombie, a wraith? The zen of balance. Mostly I feel balanced. My barometer at work is: feel like I can manage 3 days a week and wonder if I can manage 2 days a week.  If it’s the other way around it’s too crazy. If I can handle it more than 3 days a week I’m not pushing the envelope enough.  So, it’s oatmeal for breakfast.  Thank God I love oatmeal. Have a good week!

Sabbatical Ends

By | Family man, Leader | No Comments
As many of you readers know, I’ve been on sabbatical for the past 7 months after being laid off. It’s been a gift to my health – rest, catharsis, grandkids, networking, exercising, music, writing, teaching, exploring, and thinking. I’ve played in the world of entrepreneurs and start-ups, simulation, mobile health, and e-patients. Attended 5 conferences (New Orleans, Orlando, Raleigh, Washington, Boston) and met hundreds of new people. I spent 5 months working with a team designing simulation tools for patient and provider experience and decision-making. You might know simulation from video games and mannequins. Many lessons for health care in the start-up world. Refreshing energy. Taking an idea to a product to market. I also help start a monthly mini unconference called Pain Points in Healthcare with my friend, Dr. Kal Kalwa – networking with young entrepreneurs. I’m now a patient reviewer for PCORI  I’m learning about usability – the intersection of technology and work/life flow. I’ve written for the Society of Participatory Medicine. I interviewed for many jobs that could be exciting, but didn’t thrill me. Wanted to be a leader in a mission driven, patient centered organization eager to utilize my unique combination of skills and passion. My friend, Bevin Croft, found an opportunity for me. After a long courtship, Monday, I start as VP of Quality at Advocates (check them out). Their handle is ‘First, we listen.’ Don’t you love that!  My portfolio includes regulatory, improvement, experience, and informatics. So a new chapter, another hat. I plan to continue to blog at least weekly. Maybe a fresh perspective. Thanks for traveling with me.

Helping

By | Caregiver, Clinician, ePatient, Leader | 2 Comments
As a nurse, caregiver, informaticist, and consultant, I help others. Intriguing concept – helping – much dynamic tension. Altruism, emotional gratification, self-satisfaction, egotism, persistence, profit, dependence. After nursing for several years I joked that nursing was an acceptable form of nosiness. I’m involved with people at intimate moments in their lives. I am gratified to participate. As an informaticist, helping clinicians and patients utilize electronic tools, the hardest work is listening to what help was needed and ensuring that the tools served the users rather than the other way around. It’s not about the tool, its about the patient, caregiver, and clinician. Caring for family members,  I’ve struggle with the tension of what I wanted to do to help and what help was wanted. Akin to parenting power dynamics. Occasionally, I’ve had to stop helping because we crossed a boundary of tension: My contribution wasn’t really helping, my feelings were hurt, I felt trapped, I was treated poorly, I wore out. As a consultant, I often found a misalignment between the help asked for and the help wanted. Confusing and disheartening. There’s a lot of helping in health care. How can helping be cleaner, regenerate, be powerful? Attending to personal, organizational, and system health of the helper – magic lever to best health. Fitness, rest, communication, leadership, fiscal soundness all help the helper. What challenges do you face as a helper or receiving help?

A new threshold – laid off

By | Caregiver, Consumer, ePatient, Leader | 9 Comments

As you were recently informed, due to the need to reduce operating costs, the Hospital is required to eliminate positions. Unfortunately, your position is one of those affected by this difficult decision.

A definite threshold in a health journey. Going through the stages of grief exiting one space and excited by new prospects as I enter the next. This is where some earlier posts on my blog come in: ResiliencySuperpowersRest, Improvisation.
What have I learned these past few weeks about the industry? Frantic rush to merge, expand, and cut expenses – dynamic tension between these simultaneous imperatives. A few organizations are well poised to consider, now what – many are not. The challenges of creating systemness and alignment from diverse cultures and entities, always endemic in health care, are now more pressing. Rapid, intense change causes teams within organizations to constrict, contract, protect. Leaders can leverage this stressful opportunity to create alignment by focusing on the patient, providers, and staff experience. Who can disagree with this beacon? Focusing on patient experience across the continuum of care is intrinsically rewarding – spiritually healing – and makes business sense because positive experience prevents leakage and increases loyalty. Clinicians are critical – they understand healing. Leaders need their help applying their craft to organizational health. Their jobs are harder, they need superpowers more than ever. They know where the system is weak and wasteful, just look at their workarounds – pearls  for change. Patients want their journey to be simpler and kinder – it’s far cheaper and more effective to anticipate their needs rather react to their dissatisfaction. Everywhere we find relationships requiring information and communication – patients, caregivers, providers, staff, leaders. Automate that sharing of information – bidirectional where possible.
I need to rest and heal to prepare for the intensely exciting new vistas ahead. I have worked my whole career to be ready for this moment. Be still my heart.

Sleeplessness

By | ePatient | 5 Comments
“Care keeps his watch in every old man’s eye,
And where care lodges, sleep will never lie.”
― William ShakespeareRomeo and Juliet

My perspective on sleeplessness has changed over time. Once it was my enemy and I fought it tooth and nail. Now it’s my companion, familiar, irritating, and intriguing. I go to bed early, fall asleep easily, awaken at 1 or 2 am, might go back to bed after an hour. I’m almost always up at 4 or 5. I love power naps. I really have the energy to do what I need or want to do -most of the time. I do hit a wall from time to time. I used to tell my primary care doc about it and she would suggest a sleep apnea study. Not interested. I tried Ambien once and Tylenol PM twice. Didn’t help, didn’t like the after effects. My acupuncturist says that in Chinese medicine sleeplessness between 1 and 3 relates to anger, and 3-5 to grief.  My perspective changed when I started keeping a log of my sleep. I sleep on average 5-6 hours a night. I used to sleep 7-8 hours a night. I don’t worry about it much now and seldom complain about it. It’s my companion.

Rest – another magic lever

By | Clinician | 2 Comments

I’m on vacation with my family on Cape Cod, playing, eating, napping, and swimming. For best health we need rejuvenation. All components of individual health: spiritual, mental, and physical, depend on rest and relaxation. These days most healthcare organizations exist in a constant state of change. Change is seldom restful. I suspect organizations need rest and rejuvenation for their best health. The front line bears the brunt with interrupted work flow and changes in staffing and technology. Those touching our patients, clients, consumers feel less worn when they can depend on a steady routine of care and service. One of the hardest jobs of leadership is to care for the front line so they don’t burn out. We can set realistic timelines, support flexibility in hours to promote work/life balance, and make sure that changes at least make some of the work easier. We can promote positive storytelling that links staff back to the mission – why they do the work they do. What a dilemma: ever shifting environmental challenges necessitates the constant change that exhausts staff.

How does your organization rest and rejuvenate?