Should we review the safety of our work environments with rosters, time and expectations?
All work places are subject to Work Health & Safety regulations and the obligations are on employers to risk manage, monitor and improve the workplace to ensure a safe environment. Issues of fatigue can effect workplace and patient safety so clearly this needs to adequately assessed.
Is the suicide hotline you mentioned only for those acutely unwell and thinking of suicide or can it be used for those who are depressed acutely/considering self harm?
Whatever you say to the patient in a discussion should be documented. It depends – if you’re very adept with extractions and can remove those broken root tips – you may not need to discuss it with the patient – or if you can confidently remove the endodontic file. When I was a practicing dentist I used to say to patients “there’s a slight chance that this root might break and if that happens I can still get it out but with slightly more surgical procedure”. I used to like to advise them if it was going to be a simple extraction or if it was going to turn into a more difficult extraction. The more invasive the treatment the more comprehensive the pre-operative discussion should be.
You mention in your powerpoint slides that withdrawal is a concerning symptom. I find that having a "disconnect week" is beneficial. You forget about work and do normal stuff ie. clean house, garden, shopping, catch up with paperwork, walk, breathe, do an exercise class. I think that withdrawing for a while is good. Do you think it’s worthwhile to have significant ‘alone’ time or ‘away’ time or is it better to always maintain some contact?
It all comes down to balance. The idea of some alone time, quiet time or a pyjama day is brilliant – I couldn’t recommend it more. In our busy lives sometimes the last thing you need to be doing is talking or listening to someone. But it’s about balance. If spending time alone becomes all you are doing, you’re missing out on all of the other positive things that life has to offer.
Do you think medical education should incorporate stress management? As a current student, I've been impressed with the efforts to encourage good self-care, yet the timetable and expectations doesn't practically allow for inclusion of these strategies in everyday life.
Absolutely. I think it’s particularly relevant for people in high stress jobs, such as healthcare practitioners. Medical education in many cases does not adequately prepare health practitioners for the realities of study and professional life. Stress management, work life balance, resilience, mindfulness are all elements which could be of assistance. MIPS does try to assist in this area by providing education on work life balance, professionalism issues etc to students and young practitioners.
Really liked the attentional focus technique. Are you able to suggest another couple of quick tips for anxiety and stress that we can practice in the workplace?
• One particular technique is something called “worry time”. It’s the idea that the hypothetical worries that float into our heads are not entirely meaningless – the worry is important to you in some way. Just trying to forget about it often isn’t going to be successful, so rather than doing that you commit to yourself that you’ll worry about it another time. So note a particular worry and designate a time to sit down for 10 minutes and just worry about that one thing. Often if you let your brain focus it’s full attention on this worry – you’ll exhaust it and the worry seems to be less consistent at reoccurring. This is a practice technique – so the more you do it you can re-train your brain to worry less.
What is the cost associated with the Mindstep program or cost for patients if I am to refer?
MindStep is currently available through a number of Health Insurance Funds, you can contact mindstep@remedyhealthcare.com.au to learn more about our partners, or invite your patients to call their health insurance fund to find out if they are covered. If you have private health insurance with Australian Unity, with whom MIPS has an alliance, there is no additional cost to access the service. See details of the other benefits, for MIPS members including the alliance with Australian Unity.
With the MindStep program - can a client self-refer? Or does it have to be a referral from a healthcare professional?
• MindStep is designed for people with anxiety and depression, these people may be identified from a health practitioner referral, health insurance claim or self–referral. When an Australian Unity member calls in to enquire or self-refer, they go through a short clinical triage/screening process and if appropriate will be offered MindStep. Where there individual exhibits extreme symptoms such as suicidal ideation, then this is not a suitable program the health coach will aim to escalate to a medical practitioner or crisis hotline.
Is stigma an issue with other practitioners, colleagues and insurers and how is this dealt with?
• I think there’s been so much work done on reducing stigma – I think it’s getting better but it’s definitely still out there. Often in fields where we’re expected to be ‘above’ these sorts of things it’s often harder. What I’ve found particularly disappointing is the perceived stigma within the healthcare profession. It is a regrettable human element but should not be a influencing factor. Ultimately it is AHPRA who regulates your ability to practise and any conditions of practice.
Are your programs career stage sensitive?
Health coaching and MindStep are not career sensitive programs and can be accessed by students through to mature professionals.
Can you talk about the benefits of practicing Gratitude?
The resilience project is really interesting stuff. The idea is that it’s really easy to focus on what’s hard and what’s difficult. So we should actively try to take a moment and think about what we can be grateful for. This topic has some currency at the moment and no doubt it’s a good thing to express gratitude.