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Wellness Section Newsletter - May 2011

circle_arrowWellness Section Receives Teamwork Award - Wellness Section Newsletter, May 2011
circle_arrowWellness Section Applies for 2011 Grant - Wellness Section Newsletter, May 2011
circle_arrowMeditation: A simple way to reduce stress - Wellness Section Newsletter, May 2011
circle_arrowFoods to “De-stress” when “Distressed” - Wellness Section Newsletter, May 2011
circle_arrowAll Stressed Out in the ED - Wellness Section Newsletter, May 2011
circle_arrowRestorative Yoga for Stress Relief - Wellness Section Newsletter, May 2011

Wellness Section Receives Teamwork Award - Wellness Section Newsletter, May 2011

The ACEP Council has awarded the 2011 Teamwork Award to the Wellness Section. Congratulations to all of our members for working together to promote wellness for emergency physicians.

 


Wellness Section Applies for 2011 Grant - Wellness Section Newsletter, May 2011

Thanks to Vicken Y. Totten, MD and other members of the Wellness section who have worked hard to design a project and apply for an ACEP section grant. The project is titled “Resilient Emergency Physicians: the personal, chronobiologic and organizational characteristics of emergency physicians who are burnout-resistant over their careers. It would be exciting to find out what characteristics are associated with resilience and what keeps these physicians working in the emergency department for years. Notification of Grants Awarded is scheduled for mid June. Let’s hope that this project receives a Grant so that we can start the process of obtaining this valuable data.


Meditation: A simple way to reduce stress - Wellness Section Newsletter, May 2011

Lori Weichenthal, MD, FACEP
Sarah McCullough, MD, FACEP 
 

Over the past twenty years, a wealth of research has been conducted that supports that meditation helps with relaxation and stress reduction. There are many forms of meditation but in this article we will focus on one form that is easy for beginners. Ideally, it is best to mediate for at least twenty minutes every day but if you only have five minutes that will work too.  

Begin by taking an upright seated position. This can either be in a chair or on the ground. If you are on the ground, create a solid foundation with your knees and buttocks on the floor or on a cushion. If you are seated in a chair, plant both feet firmly on the ground. Extend your spine up for your foundation, resting each vertebra comfortably on top of the other. Let your shoulders relax and raise the crown of your head directly toward the sky. Rest your hands in your lap or on your legs and then lower your eyelids so that they are in a position that is neither open nor closed, as if sleeping. 

Breathe gently, normally and quietly through your nose. Begin to count your breaths. When you inhale, concentrate on “one” and when you exhale, concentrate on “two” and so on all the way to “ten” and then begin the count again. The idea is to slow down and to be simply present and aware of the breath.  

If you attempt this practice, you will find that it is not long before thoughts begin to intrude in your attempt to focus on the breath. This is the way of the mind and is no problem. When you become aware that your mind has wandered away from the breath, simply label what you were thinking about as “thought” and return to the breath. Continue this practice for the time period that you have set aside. 

A good basic online resource to learn more about meditation can be found here: www.mayoclinic.com/health/meditation.


Foods to “De-stress” when “Distressed” - Wellness Section Newsletter, May 2011

Lori Weichenthal, MD, FACEP
Sarah McCullough, MD, FACEP
 

Food is something that we often turn to in times of stress. Does your emergency department (ED) have a nurse or physician that always brings in “comfort” food on the night shift? In my department, chocolate covered peanuts, licorice, and chips are some of the top foods that are brought in and when the stress level goes up, these snacks get devoured. Recently, I decided to investigate whether there might be some foods that not only provide the comfort of eating but also may have some nutritional benefits that help fight stress. Here is a list of some of the stress-relieving foods that I found. 

Rather than reaching for the chips, next time consider a handful of almonds. They contain vitamins B2, E, magnesium, and zinc which are believed to help the body deal with stress. Another option is blueberries which contain antioxidants and vitamin C. Even if fresh blueberries are not available, you can likely find them in the frozen food or dried fruit sections at the grocery store. Bananas and oranges also have properties reported to decrease stress, as do dried apricots. Perhaps instead of another cup of coffee, you should choose a glass of milk toward the end of your shift. It is high in antioxidants, B2, B12, protein, and calcium. If you are lucky enough to work in a hospital that has sushi in the cafeteria, choose the tuna which has many nutrients believed to lessen stress.  

After your shift is over, you can have something to eat in the comfort of your own home to help you “de-stress.” Consider a salad of leafy greens with some turkey or, if you are in the mood for a more substantial meal, you can put some beef in a marinade before you go to work and then grill it when you get home. Beef contains zinc, iron, and B vitamins which are mood stabilizers. You might choose brown rice or sweet potatoes along with grilled asparagus or steamed broccoli to accompany your meal, all rich in nutrients believed to combat stress. Turn off the TV and other distractions, sit down at the table, and relax and enjoy eating in a calm environment. I think you will feel satisfied that another shift has passed and you will be ready to either take on your additional activities of the day or get some quality sleep.


All Stressed Out in the ED - Wellness Section Newsletter, May 2011

Lori Weichenthal, MD, FACEP
Sarah McCullough, MD, FACEP
 

So you had a hard day in the department and you come home and tell anyone who will listen (your partner, a friend, your dog, a plant) that you had a stressful day. Do you ever wonder what that really means? 

Stress is a normal part of life. Events press on individuals and they responds back. Dr. B.M. Hegde states that “stress is the single most important growth related stimulus for all living organisms on the planet.” Studies have shown that people work most effectively with some degree of pressure upon them. If it is too slow, we are not efficient and if we are too busy, we also do not work well but there is a certain place in the middle, when there is just enough stress on us where we are most effective in the tasks that we perform. 

So if stress is normal, when we talk about being “stressed out” what are we truly talking about? Perhaps what we are trying to say is that we are distressed. Depending on which sources you read, distress is created when we have an abnormal response to a stressful situation, when we do something out of obligation rather than because we desire to do so, or when we are convinced that we are not up to the task that we have undertaken. 

With these thoughts in mind, some colleagues and I got together and created a top ten list of things that distress us at work. The following is our list, in no specific order:

  1. Handling multiple interruptions/distractions
  2. Dealing with manipulative/drug seeking patients
  3. Working with the reluctant consultant
  4. Facing our own mistakes/missing a critical diagnosis
  5. Dealing with unrealistic expectations of patients and families
  6. Managing violent patients
  7. Delays and barriers to care
  8. Lack of teamwork
  9. Excessive paperwork and bureaucracy
  10. Working while sleep deprived, on weekends or during holidays

I am sure that you all have your own list and I encourage you to share it with the section at wellness-section@elist.acep.org .  

Creating a list of distressful situations, however, is not enough. Once we know what puts undue stress on us, we need to find ways to respond. If possible, we should try to encourage change in our hospital and department that limit some of the above circumstances for us, our colleagues and our patients. At the same time, we need to develop tools that help us cope with life when we are feeling distressed. This newsletter is full of ideas of how we can make small changes in our lives such as paying attention to our diets, exercising and using meditation and yoga to fuel us for when times get rough. Please read and enjoy and if you have your own methods that help you manage distress, please share them with the group on the list serve. 

References 

  1. Hegde BM. Stress Management for Hyderabad University. Internet post, March 23, 2010.
  2. Groopman J. How Doctors Think. Houghton Mifflin Company 2007.

 


Restorative Yoga for Stress Relief - Wellness Section Newsletter, May 2011

Lori Weichenthal, MD, FACEP
Sarah McCullough, MD, FACEP
 

The following is a yoga sequence that can help you recharge whether you feel stressed due to a difficult day in the department or from an intense physical work out. Restorative yoga use props so that you can hold the pose for a prolonged time to allow for full relaxation and enjoyment of the breath. Each pose should be held for at least five minutes and up to fifteen minutes. To do these poses you will need a minimum of two pillows, loose comfortable clothes to wear and a quiet place to practice. If you do not have time to do the entire routine, feel free to try one or two of the poses. 

pose1
Supported Child’s Pose
 - Start by kneeling on the ground with 2-3 pillows in front of you. Bring your ankles together and your knees wide apart. Bend forward so that your torso is resting on the pillows. Take the time to make adjustments so that you are comfortable. Turn you head to one side and place your arms, palms facing the ground, on either side of you. Close your eyes and breathe deeply. Half way through, turn your head to the other side.  

pose2
Prone Twist
  - Place your knees on one side of the pillows and stack them one on top of the other. Twist your torso and lower it to the pillows. You can twist your head away from your knees or toward them, whichever is more comfortable. Make sure to repeat on the other side. 

 pose3
Supported Bridge
 - Turn over to your back and place the pillows behind you. Bend your knees and recline your torso onto the pillows with you arms stretched out at your sides, palms toward to sky. Close your eyes, relax and enjoy. 

 

pose4
Legs Up the Wall - Place a small pillow underneath your pelvis at a wall. Prop your legs up the wall and rest your arms on either side of you with palms facing the sky. You can also rest your legs on an ottoman or a chair for the bent-knee version of this pose.


 


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