provider wellness

Take control of Holiday stress

By Thomas Davis, DNAP, MAE, CRNA

“It’s the most wonderful time of the year
With the kids jingle belling
And everyone telling you be of good cheer
It’s the most wonderful time of the year”

~Song by Andy Williams

The earth is completing another trip around the sun and the holiday season is rapidly approaching. It is a time of the year when we are forced out of our daily routine and thrust into glitz and glamor of the holidays. Regardless of your culture or religious background, business as usual is cast aside and festivities abound in our homes, workplaces, and communities. In many ways, it’s the most wonderful time of the year, however, along with excitement comes expectations, obligations, and stress.

It’s the most stressful time of the year

Intrinsic to the holiday season are both internal and external sources of stress, however, taking time to plan and prepare will enable you to bypass many of the frazzled moments that commonly accompany festivities. Like it or not, we are creatures of habit and being forced out of a routine is known to cause anxiety and frustration. Holiday obligations disrupt the status quo and take time away from normal activities. Gatherings with the family or workgroup require proper attire, hair, makeup, childcare, not to mention the hostess gift and the dessert tray. In addition, children have holiday events at school that conflict with a busy work schedule and cause guilt if you ask for time off or guilt if you don’t.

My podcast interview with Cathy Horvath, DNP, CRNA and Chair of the AANA Wellness committee exposed the extent to which healthcare workers are feeling stressed. Her statistics reveal that 77% of our colleagues report frustration and exhaustion related to their work and 45-55% report feelings of stress and anxiety on a frequent basis. Even more telling, 50% of healthcare workers report feelings of depression with 13% stating that they have had suicidal feelings. The numbers are alarming, and the stress only increases during the holiday season.

Thinking that the workplace will provide a haven from the chaos at home may lead to disappointment when work does not provide the escape that is desired. Typically, patients have reached maximum co-pay by the end of the year and are in a rush to get procedures done before the ball drops in Times Square. The case load is high, the vacation calendar is full, and your work hours are longer just as you have a million other things to do. Yes, it’s a stressful time of the year.

The Mayo Clinic healthy lifestyle blog identifies the holiday season as a potential source of significant stress and advises that we become attuned to our feelings and acknowledge them. In addition, they recommend that we remain realistic by not abandoning healthy habits and by saying “no” to set boundaries. The Johns Hopkins wellness blog advises that we keep sight of what really counts and always respond with kindness, even when stressed. Building on the theme of reducing stress, author Kaleigh Carter notes the importance of physical activity, meditation, and sleep during the busy holiday season. Regardless of the source that you reference, all agree that the holiday season is stressful and that a combination of anticipation, planning, and preparation will make the stress manageable…and may even re-infuse fun into your life.

Practical tips for managing holiday stress

Ramp up your self-care. A healthy body is the first line of defense against stress and your body’s basic requirements don’t change with the season. Put differently, the body does not need more calories and less sleep during the holiday season. Taking charge of the body’s basic needs requires focus, discipline, and commitment. Self-control is empowering.

Nutrition. The body’s basic need for high quality fuel does not change just because holiday parties are on the calendar. Essential nutrients are still required, and harmful foods are still harmful. Unless you become a mega-cardio gym rat, your calorie requirements remain the same during the holidays and extra food volume will give you extra work to do when “lose weight” appears on your New Year’s resolution list. Go heavy on fruits and vegetables while limiting foods that are high in fat and salt.
Exercise. Keep moving and don’t let distractions pull you away from your exercise time. Participate in outdoor activities when the weather permits and move indoors when the snow flies. A gym membership offers the opportunity for a social aspect to your workout. Buy a mat and use online programs at home to assist with stretching, yoga, and meditation.
Sleep. When things get hectic, it’s easy to sacrifice a few hours of sleep, however over time the lack of sleep will take its toll. Get into a bedtime routine and allow your body to relax by quietly reading or meditating before retiring for the day. Keep a regular schedule that ensures the proper amount of sleep.
Seek the sun. Seasonal affective disorder is described in the DSM5 as depression related to a lack of exposure to the sun. Military personnel returning from duty in Alaska will affirm the negative effects caused by the long periods of darkness during the winter months. Similarly, OR personnel drive to and from work in the dark during the holiday season with little opportunity for sun exposure. Be creative, walk to a different area of the building, find a sunny spot for your lunch, and you’ll get the added benefit of exercise.
Take a break. Rather than slurping coffee on the run, plan a mid-day break into your schedule. Get out of the lunchroom and leave the gossip to others. Plan a 5-minute walking route that includes going up and down one flight of stairs and passes through a sunny location along the way. Be creative and find a quiet location to put a mat on the floor and do some stretches at work. Both your mind and body will thank you.

Anticipate and prepare for external stressors

It’s always easiest to pick the low hanging fruit and taking care of oneself physically is easier than dealing with all the external expectations/obligations of the holiday season, however, by setting goals and limits you can develop a plan to minimize stress. Here are some holiday stresses that may emerge from the festivities and knock you off track.

Social gatherings with the workgroup and/or your family. Receiving an invitation to the annual office party or family holiday gathering gives you a sense of inclusion and the expectation of a joyful evening. The invitation also creates an obligation to add another item to your already packed schedule. Time, effort, and money are required to get the right attire, arrange childcare and put together a hostess gift. Once at the party, high calorie food is abundant and alcohol flows freely, both are challenges to your commitment for self-care. Here are a few tips.

Eat a small amount of healthy food before going to the party so that you are not ravenous when you arrive. At the party, commit to sampling a few items rather than filling your plate several times with high calorie, high salt, food. “All you can eat” does not mean eat all you can.
Drink alcohol slowly and commit to alternating each alcohol drink with a non-alcohol drink.
Make it about the people, not the food/alcohol. You work with these people daily, but do you really know them? Challenge yourself to learn something new about each person at the party. As you talk to colleagues, remind yourself of something that they do particularly well or something about them that you are grateful for.

Financial obligations. We criticize congress when they pass a budget and then spend millions of additional dollars for “off budget” items. Often, during the holiday season we imitate our government, throw caution to the wind, and throw “off budget” money at gifts and parties. Establish a reasonable budget for the holidays and stick to it. Find low-cost activities such as a family hike through the woods to replace the high dollar trip to the theater complete with twenty-dollar popcorn. Make a hostess gift such as an ornament rather than buying an expensive bottle of wine. When you finish buying gifts for the family, be finished. That one extra gift or stocking stuffer for each member of the family can add another $100 to the cost of the holidays. The bottom line is that unlike the Federal Government, you must pay your bills so pull the reigns and spend wisely.

Create good cheer and positive vibes for the Holiday season

The holiday season is a time for gift giving and the best gift that you can give yourself is an organized, low stress month filled with pleasant memories. Your internal dialogue sets the tone, and an optimistic and proactive attitude are building blocks for success. Start and end each day by practicing gratitude and think of three things that you are grateful for. The activity will reduce your negativity bias and help to remove the feeling of being victimized by the holidays.

The bottom line is that in addition to being the most wonderful time of the year, the holiday season can also be the most stressful time of the year. Be mindful of the tips put forth by Cathy Horvath in the podcast and use a combination of self-help activities, planning, and an optimistic mindset to set reasonable boundaries and ensure a memorable Holiday season.

Click here for the podcast with Cathy Horvath, DNP, CRNA

Tom is an experienced leader, educator, author, and requested speaker. Click here for a video introduction to Tom’s talk topics.

Redefine normal

By Liz Sanner Davis, certified personal trainer

A friend and I exchanged this text talk on January 1. “After the fireworks…back to normal – normal food, normal exercise, normal normalcy.” “Ha! Define ‘normal.’”

We laughed, of course, because, after all, what really is “normal food and exercise?”

Following all our joyful noise and fa-la-lollies, we agreed that perhaps we should redefine it.

Based on one’s intended lifestyle, normal simply isn’t the same for everyone. It can’t be. Your co-workers, John and Jill, have three children to consider, Emily and her spouse have hefty commutes, Cheryl has live-in elderly parents and Damont is the only unencumbered single male. But they have one thing in common. They work outside the home in the healthcare profession. Their normal is defined around their jobs.

Make nutrient-dense food and regular exercise ‘who you are’

and not just ‘something you do.’

Results from research on the positive impact of exercise completed by multiple healthcare, business and fitness professionals are very convincing. Harvard Business Review concluded several years ago that “incorporating regular exercise into your routine” improved concentration and prolonged mental stamina while lowering stress. A current impact-of-fitness study by Leeds Metropolitan University in England suggests that the level of focus and efficiency in the fit worker creates the extra time needed for going to the gym in the first place. Becker Hospital review names numerous hospitals in its list of 100 great places to work in healthcare based on their onsite fitness facilities. In addition, hospital studies regarding the effect of unfit, unhealthy employees on the bottom line of their organization’s budget, support the concept that providing for employee fitness pays significant dividends for both employee and employer. From the employee’s perspective, the professional reasons to get fit are many.

You will be sick or injured less often if you take care of yourself by exercising and eating a plant-based nutrient-dense diet. Although there is secondary gain when you are ill, there are personal risks for developing chronic conditions, risks to your coworkers who don’t want to get sick and further risks for patients who are already sick. People who take good care of their total wellness are able to work, they feel like working and their personal performance has greater potential for being optimal.

Your physical strength and endurance are greatly enhanced by being trim and fit. In a fast-paced clinic where every second counts, the fit employee can bend, lift, carry, push and pull quickly and efficiently without causing patient or personal injury in the process. Some applications for anesthesia jobs specifically state the requirement for an applicant to be able to safely lift and carry patients and equipment. If you have a sedentary healthcare job in which you rarely need to bend from the waist, more’s the pity, because without staying trim and fit, soon you won’t be able to.

Personal Appearance is more convincing and comforting to patients and coworkers when you look and feel rested, energetic and fit. And don’t believe for a moment that in this world of social change and cultural acceptance, one’s appearance gets a pass. It doesn’t. Who can take you seriously if you’re a healthcare worker who is unhealthy by choice? It isn’t incumbent on the patient to suspend disbelief in the care rendered by an obese nurse or physician whose presentation reflects a preference for unhealthy self-care. The patient needs the reassurance provided by a dedicated healthcare worker who has a healthy BMI to accompany their competence. Both play a role in your profession.

Working, and working with you, will be pleasant. Scrooge wasn’t just cheap, he was ornery, and ornery is neither inspiring nor fun. A great job in a name-brand hospital that can boast glass breaking research and a to-die-for benefit package will not, all by itself, make you pleasant to be around. It is true that a stellar work situation offers a lot to make you smile, but cap that off with the deep body glow you radiate after working out and eating a fresh peach before arriving at work, and everyone around you will want to be there, around you. Regular exercise and a diet that fuels your disposition bumps up stellar to superior.

You’re the face of the organization. The status and stature of the organization within the greater community and beyond is confirmed by stats provided by patient satisfaction based on both the medical outcome and overall experience. While carefully avoiding any mention of the staff’s physical attributes or deficits, the plethora of patient-satisfaction surveys always include questions regarding friendliness of staff, willingness of provider to listen, advice from the provider for staying healthy, amount of time spent with the patient and overall care. Those answers are affected by the healthcare team’s individual and collective level of wellness, general disposition, physical ability to do the job with ease and by being fully engaged and consistently on the job; all of those positive behaviors and interactions are a direct result of the food, fitness and overall healthy habits that you practice. As well, though your benefits likely include sick days in one form or other, you’re not entitled to abuse yourself and, thereby, cost the organization. The corporate budget suffers when employees are absent, chronically ill or if dissatisfied patients choose to get their care elsewhere. Your definition of normal food and normal exercise is rooted in your respect for yourself and for your organization.

What you have to do and the way you have to do it is incredibly simple. Whether you are willing to do it is another matter. ~ ~Peter Drucker

Some suggestions for how to get that deep-body glow at work

Drink water during or between cases – 8-10 measured glasses a day and spread them out if you possibly can. Your body will adjust quickly to the new volume because exercise strengthens all muscles including those that control bladder urgency. Coffee, however, doesn’t function like water and isn’t included in the count.
Stretch during breaks. There are a dozen different ways and times to stretch at work; bend slowly to touch toes once between each patient; stand against the wall and shrug or do one or several arm circles overhead and meditate simultaneously; do a few simple squats, bent-knee leg lifts, side to side neck rotations; do slow isometric rows by squeezing scapulae only. Get even more active on longer breaks by jogging down one set of exit stairs and lunging back to the top. During lunch several sets can be done on stairs or down a quiet hallway. Bonus tip: Stretching can and should be done at the back of an airplane during a long flight.
Use proper fitness techniques for bending lifting and carrying. Picture Sponge Bob with a four-cornered flexible core. Support your movements using your entire trunk including squeezing abs, spine-in-line posture, retracted scaps/broad chest, and flexible pelvis. Bending over by using the lower neck and locked knees is potentially an unplanned day off work and corporate budget buster.
Bring nutrient-dense lunch and snacks to work and pack them from your own food stock. Low-fat, low-sugar, low-salt, low-carb, high fiber, vitamin and protein rich foods are qualifiers; tacos, fat-filled wraps, cheesey burgers and everything-but-the-refrigerator cookies are not. Repeat this mantra often: Food is fuel, sugar is cruel.
Cardio for at least 20 minutes to warm up for the work day. This is important. Cardiovascular exercise strengthens your heart and breaks through the mental cobwebs to fire you up physically for the day. Everyone has 24 hours to budget so trade out 30 minutes of yours in the evening with 30 in the morning; slog down 1 cup of water and hop on the bike, the treadmill, a Peloton spin bike like the one advertised by the young, gorgeously toned couple on TV, or get outside in a safe neighborhood and knock off 20 min of fast-paced, sweaty heart-throbbing cardio before work. Don’t forget to stretch two minutes afterward. You can still go to the gym for weights or kick-boxing class after work with Damont!

The same voice that says, “Give Up,” can also be retrained to say, “Keep going.”

~ Lisa Bargstadt, personal trainer

We all like to get things done quick-as-a-bunny, yesterday. Your patient wants his broken femur to heal in time to ski in February while you may want to fit into that little black dress in time for a wedding next week. And though fitness trainers may willingly sell you an expensive package of promises and an optimistic healthcare worker may give an injured skier some reason for hope, getting fit and staying that way will take time – your time in real time. That’s just the truth. In the meantime, if you’re consistent and dedicated, you can jumpstart the process to becoming a trim, fit healthy worker who elevates and validates the healthcare profession by redefining your normal.