Facebook Live with Chief Wellness Officer Dr. Peter Yellowlees

welcome to our Facebook live we’re still
just starting a new year so we think this is a really good time to talk about
ways to take care of yourself and also ways to take care of your friends and
your colleagues and your loved ones in short this is what we call wellness and
so our guide today is Dr. Peter Yellowlees he’s the UC Davis health Chief Wellness Officer and he’s pretty pretty good guy for this and he is also a clinical
psychiatrist and he has studied and written about wellness and burnout for years so
Peter great to have you here good well thank you, Rick, it’s great to
be here and thanks everyone. So wellness is often at this time you’re tied to new
year’s resolutions and you talk about how with resolutions it tends to be don’t eat meat and go to the gym more but you really talk about taking care of yourself whole
you know I think that’s true I think you know it’s important to obviously do you
know have the usual things that people do resolutions arm you know the exercise
and the weight and things like that and but at the same time you know I think
really lifestyle is much more than that and and and the primary thing that
drives most of us is relationships and friendships and so I think you know
people need to really focus on that and try and spend more time nurturing their
friendships nurturing their relationships and and maybe doing some
of these things that they wish to do like trying to lose weight with their
partners well you know this is this is another point that you’ve made often and
we’ve made a big deal about it here you should Davis health which is that better
health for you better wellness for you is it better is better wellness for
whether it’s the people you take care of in your profession or the people that
you love right I think that’s absolutely right and it’s very interesting if you
look at health care one of the the most significant I guess vulnerability
factors about anybody’s health is actually to be lonely and to be by
yourself not to have friend not to have networks and in context if you look at
the average person you know most people have for a fun I’ve really close
intimate friends that’s the sort of average and those are people that you
can talk to could potentially have an intimate
conversation with them about some of your difficulties on your problems and
it would really help you if you’re in trouble and and I think focusing
particularly on those four or five people often though might be a spouse
maybe a brother or a sister and just two or three other really close friends but
that’s the sort of average that people have and you’d be amazed how many people
actually don’t have that average and in fact really don’t have good intimate
nurturing friendships so is it eight to say this since this is a facebook live
but does spending too much time on social media get in the way of those
relationships oh there’s no doubt account absolutely and I mean there’s
actually a series of sort of disorders not sort of psychiatric illnesses per se
but you know Internet addiction and overuse of the internet and things like
that where we were wearing my psychiatrist
hat we do see patients who turn up you know who are literally spending six or
eight hours a day on the internet or or using video games or or longer than that
and and where in fact it’s a major problem in their lives and they’re just
simply not taking part in their normal social requirements all right so that
does not mean sign off of this Facebook live in fact fair feel free to share it
but when we’re done go outside I think that’s okay and if you’re watching this
Facebook live from your phone and you’re walking along be careful we’re gonna
talk about that now because you have a series of tips about ways to basically
take care of yourself whole and and one of those is to be certain to take time
out for yourself could you explain that a little bit yeah I think there’s a big
movement about mindfulness which is really at a very simple level about
staying in the moment about about actually being aware of what is around
about you know so if you’re eating you know
taste the food eat it slowly move it around in your mouth and really sort of
try and sort of be aware of all the different qualities of the food you’re
having similarly if you’re out for a walk
look around you while you’re walking don’t don’t look at your device all the
time and and and and smell the smells of the park
listen to the dogs barking in the distance and try and really sort of
become part of your environment and you’ll find that that’s actually a very
good way of relaxing and of distracting yourself perhaps from you know the
normal worries that we all have in life you know you’ve pointed out that to do
this take some practice that we’re not we don’t tend to want to do this
naturally what does it say about our you know overhyped stressed-out lives we
live I think I think you’re absolutely right I mean I think we need to take
individual time for ourselves one of the exercises I actually suggest to
physicians on are quite a regular basis is is when you’re going home
you know and when you’re maybe driving or cycling or walking home however
you’re going home try and think about something that is positive that’s
happened during the day think about some little thing you’ve done where you’ve
done some good or you’ve just been friendly to somebody maybe you know been
supportive of a colleague by listening to some of their issues and just think
about that and concentrate on something positive that you’ve done because no
matter how bad a day we’ve all had there will be something somewhere but you can
find but has a sort of positive feel to it and then focus on that and think
about that and think about how you know maybe other people involved in that
interaction have felt and almost try and examine that a little bit more and by
the time you get home if you’ve done this you’ll actually find you’ve managed
to sort of convert yourself nicely from the hassles of the day through to
whatever is going to happen with you in the evening does that translate to if
you have a friend colleague roommate loved one at home telling them about the
good parts of your day rather than the what we tend to do is unload our
frustrations on them I think that’s from it I mean you know it’s very easy to to
look at any of a negative and they’re the things that instantly
come to our minds typically when we think about what’s been going on and so
I think looking at the positive elements of what we’ve done even if they’re small
positive elements important you know another point that you have made is to
say no and I know you talked about this during the holiday seasons when
everybody is crazed and there’s so much to do and is to is to say no to other
events talk a little bit about what that means and how hard that can be
it can be very difficult and I mean I’m probably an example of someone who
doesn’t say no enough but you know I think we have to you have to learn to
monitor yourself and to learn to try and work out you know what is a reasonable
load that you can cope with and what is unreasonable and I think that’s a
difficult thing to do and it’s clearly changes at different times in your life
depending on what’s going on around you how much time you’ve got how many other
things you may have to do in your instance but but really it comes down to
self monitoring and and working out what is a reasonable set of things that you
can manage and then if you’re going above that so that’s when you really do
have to start thinking about saying no you can’t say yes all the time
any tips or on technique or what to tell people when they’ve invited you to a
party or maybe it’s an extra work demand so let’s look at the would command I
mean I get asked do a lot of things I’ll give you a personal example Facebook
like for example takes but life right okay so so you know I the first thing I
ask is how long does it take what’s the commitment can I actually fit that into
my day and we went back and forth on a time and it had to be scheduled you know
after I finished my clinic in the morning I didn’t want to do this partway
through my clinic right so you know find a decent time for it find a time that
suits you and suits the people who want to be involved I mean I have a personal
philosophy where I generally say yes to everything the first time but then I’ll
say yes but let’s let’s give it a trial maybe just do it once or do it for three
I’ll go on that committee for a year and and say yes but and put some sort of
limit on it so that if in fact it’s not working out you can get out of it
perfectly reasonably because the the problem with a lot of the the things we
say yes to is they become very long term yeses whereas if you can turn them into
a sort of more regulated yes then then actually that’s a much better way of
doing if you’re just joining us this is of course the Facebook live and we are
talking about wellness and how to take care of yourself and really how do we
burn out to which we’re gonna get into in just a bit our guide is dr. Peter
yellow easy as a UC Davis health chief wellness officer a man who knows a
little bit about these subjects he’s also clinical psychiatrist please ask us
questions if you’d like feel free to share this and we hope to give you some
good tips so another tip that you talked about is exercise is important you
walked up the stairs to get here as a matter of fact but it’s not just go to
the gym you talk about finding things that you’ll want to do so that you do
them that’s exactly right I mean for instance I deliberately walk
around the campus I deliberately don’t take lift for less than three stories
there’s a whole lot of ways of getting exercise that is is easy to do and you
just build it into your day as a normal part of life a lot of people nowadays
are getting a changing their desk so they stand at their desks or maybe have
some exercise sort of gadgets associated with that with their chairs there’s a
whole lot of ways that you can you can use to sort of you know almost have sort
of hidden exercise that is actually very helpful for us all
and I imagine that whether it’s across our campus or around your neighborhood
is one of those ways to stay mindful that’s exactly right I mean you know
it’s it’s fun walking and there’s lots of interesting things to do and you know
the best way of actually getting regular exercise that is enjoyable is to
actually get a dog I have three dogs and go walking you know twice a day with
them and and we we cover probably about a mile a half to two miles every day and
the dogs enjoy it I enjoy it and I get to meet all sorts of people around the
neighborhood I’m with I’m a dog guy and just hanging out with a dog makes you
forget about the bad things exactly dogs are therapy dogs are gray I like that
dogs are good medicine that’s gonna be that’s right so you have another point
and and this is this is a real complex one which which is to not avoid problems
right so I think you know we naturally tend to avoid or run away from things
we’re afraid of and that’s just our basic sort of you know human make up and
in a work situation in particular but obviously also at home whilst that may
seem to be this sort of easy shortcut initially it’s actually not the best
long-term approach because you know that you’ve got to solve this problem at some
stage where you’ve got to do something about it
and so really you know facing up to the the problems that you’ve got and trying
and managing them and maybe you know working with other people to solve them
it’s a much more healthy approach I mean the worst thing you can do is to have
something hanging out of your head all the time so you know to do that I mean
you know use lists prioritize certain things and actually cross them off your
list when you’ve done them so you bring up something my I’m not sure this works
because I am a bit of stress puppy myself but one of my techniques is to
write make lists and sometimes that thing that you’re thinking about it to
in the morning is to get up and write it down is that am I just fooling myself
does that actually help I don’t think getting up at 2:00 in the morning
running around well because otherwise every cigarette
think about it I’d rather be sleeping through it alright make a list to take
that off the list but I think but I think actually writing list is a good
thing to do and because it not only gets you to see what are all the tasks you’ve
got to do but more importantly you can prioritize some so I actually keep a
list on my desk at all times at work and I have two sides to it one side is
basically sort of writing and longer-term tasks and the other side are
sort of quick clinical messages I’ve got to sort out all the things that I can’t
but I know we’ll only take a few minutes so I try and divide between sort of
longer tasks and shorter tasks and then you know literally cross them off as I
go and sometimes underline them if they’re real priorities they’ve got to
be done today but I think you know getting yourself organized like that is
is crucial in terms of just how you can live a relatively stress-free life
particularly in the work situation then you were talking about that really
difficult problem that sits out in front of us and and that’s it’s true for I’m
sure everyone whether you’re a student or you whether you’re a faculty member
here at UC Davis health so is there a good first step is there a sort of a
technique or is it just depend on the job just to get started so I think the
first step is if you’ve got tasks you don’t want to do decide when when is the
last time you can send them in or you can finish it okay put that date down in
front of you and then ensure that you have it finished several days before
that and so don’t leave things to a last-minute and and if you and so I
actually if I’ve got papers to review or things that I need to do I actually put
a date on top of them and say and that date for me is a date but I’ve got to
have finished with that mm-hmm do you sort of backtrack and say okay back to
finish this by the 25th I should have started this on the 22nd sort of thing
yes sometimes I mean I think you do that sort of partly self body unconsciously
you look at your list and you see them as a sort of three important dates
week and so you know but if you’ve got you know you divide your time so once
again if you are just joining us we are talking about wellness and burnout we’re
gonna ship to Britain just a second here actually our guide is dr. Peter yellow
is he’s the UC Davis health chief on this officer man who has written
extensively about burnout particularly physician burnout and he’s getting
effective book just coming out no man coming out right well it’s one out and
then six months ago and will be another one about sort of burnout solutions
later on this year this is how you get burned addicts right the two books in a
year so but let’s talk about burnout but actually that’s the point I’m gonna
interrupt you that red okay because if you really enjoy what you’re doing okay
well there you go so there’s another tip no seriously burnout is an issue it’s a
serious issue in you I know we’ve talked a lot about how it affects physicians
and how in essence they it affects their patients and their family around us talk
about burnout in general that way so let me first of all just quickly describe
what burnout is because it’s a very broadly used term and often isn’t well
understood so burnout because it’s a three sets of
symptoms I mean the first are basically symptoms around feeling tired and
exhausted and physically physically sort of burn the second is is having a sort
of cynical feel to you a cynical mood whereby you start thinking of patients
not as people but as cases or as numbers or just people you think the things that
you’ve got deal with and I can imagine that’s your teacher your thinking your
students that way for a project manager you think your clients that way
absolutely so your tasks become less personalized basically oh you’re not
your task but you but people you’re working with less personalized and then
the third area and it’s really a feeling of a loss of meaning in your life and so
why am i bothering to do this what’s the point why did I bother to become a
why didn’t why did I go through all the training to become an accountant because
really it’s not worth it I’m not doing anything terribly useful so there’s
three sets of symptoms and and we know occurs in very widely across all
professions but the health profession – undoubtedly have higher levels of
burnout than say the equivalent lawyers or engineers and physicians in
particular have probably about twice that level of burnout that Aboriginal
physicians have nurses have higher levels of burnout than than other
equivalent professionals as well but not quite as high as physicians so it’s a
significant issue and the bottom line is the the the reason why we worry about
people getting burnt out is not just because of the impact on them and the
potential for them to maybe respond badly by perhaps ultimately getting
depressed or having relationship problems or drinking too much or just
just you know having difficulties in their home life but in the workplace
people who have burnt out a much more likely to change jobs and they are much
more likely to not work so well and so we know that high levels of burnout or
associated with poor patient care more mistakes and so Burnap becomes is it
basically without any doubt at a patient safety issue and it’s an issue that is and I imagine that would translate if
you are to non-physician about a minute somewhere outside of the medical
community that it’s the same thing you you either weathers your students or
whatever that you you do less a less good job for them absolutely I mean
there’s no question about that we just got a question that I think is really
important for this moment because you just described what burnout is so can
you tell us what how that’s different from fatigue so is there a difference
between burnout and fatigue so one of the sets of symptoms of burnout is
fatigue so absolutely so people literally you know they say they they
feel like they’re walking around with a 20 pound back
pack on their backs all the time and they’re exhausted and just generally
physically tired they may be not sleeping so well they you know perhaps
they put on a bit of weight they’re not exercising as regularly they’re just not
keeping themselves physically as fit as they should be so so the questioner is
absolutely right it’s one of the one of the three constellations of symptoms but
but I think the question is also asking how do you differentiate how do you know
you’re not just physically tired and it was been it’s been a rough couple of
weeks as opposed that you get into the burnout stage well I think first of all
look around you and look at what your work situation is look at whether in
fact you’re also getting a bit cynical and I’m losing meaning in your work and
whether you’ve got some of the other symptoms of burnout but but I think what
the question is getting at is that a lot of us have certain components of a
burnout sin syndrome and we have them for a few weeks we go through a bad time
things resolve everything gets better and we lose our symptoms and so a lot of
the symptoms of burnout basically you know will ultimately disappear on their
own accord in many people but the whole constellation of three sets of symptoms
tends to be more serious so then well there’s this layers to this
next question which is what do you do next
so if you are feeling that you now have that whole constellation what what what
are the things you can do well I think this is really important because up
until probably five years ago there has been a tendency to blame the person with
better and to say look you know you’re somehow weak you’re not resilient it’s
your problem okay now that’s complete nonsense okay absolutely and I would
imagine any field where that person is given great responsibility like the
medical field for example it’s even worse because we’re assuming that this
is a person who should be able to control things right right and so what
you have to remember if we use the medical healthcare field as an example
there’s most people who go into healthcare the highly effective people
and they have to pass all sorts of exams they have
many hoops to become a nurse or a doctor or other sort of provider in particular
and they’re very resilient effective people and to then suddenly sort of say
oh well you know for some reason you’re not strong enough and you’ve got
symptoms of burnout and it’s your fault just doesn’t make any sense
so what we do know from research in the last sort of probably about five years
and from from a number of very large studies is it at least 80% of the causes
of burnout or organizational and it’s a fact that people are working in a system
that you know doesn’t support them or in which they feel uncomfortable and so the
answer to burnout is primarily about changing the system it’s about changing
the culture of the environment so that it’s okay to look after your colleagues
it’s okay to ask for help it’s okay to be supportive of each other rather than
just everybody having a stiff upper lip and avoiding each other which is what a
lot of health care professionals tend to do and and it’s about actually making
the workplace more efficient and and doing things in a better way so but
you’re not wasting time you’re not doing silly busy work but is that could be
done by somebody else who perhaps isn’t nearly as qualified as you are and and
effectively you’re you’re ending well and we should point out to any UC Davis
health folks that are watching is that this is dr. yella Lisa’s charge is to
change those systems to make it better for everybody but what if you’re
somebody who can’t change the system what if you’re somebody in the middle
whether it’s with us or some other place what do you do when you really can’t
change the organizational system whether it’s a demanding boss or just an
understaffed office or something like that
I mean I think that’s obviously the situation a lot of people find
themselves in and I think you know you do have to try and work with the system
so you need to talk to whether you’re reporting to you need to
develop networks of colleagues try and find out how people have made changes in
other areas because it’s actually usually possible to make some small
changes and even making some small changes and getting rid of what I call
us some of us stupid things we do I mean we all do stupid things at work which
which really are ridiculous and which could be biased and so as stupid things
are often irritating things you know they annoy us and if we can in fact just
just change a few of those we actually feel better we’ve had some sort of small
victory even although maybe the environment we’re in is it’s really not
very so and at what point do you take the next step I mean you’re a clinical
psychiatrist you you clearly deal with patients and I know that you deal with
has some features that our doctors when do you make that judgment how do you
make that judgment that maybe it’s time to seek professional help
yeah I think I mean I think that’s a really important thing I first of all
most people with burnout don’t need to see someone like me that’s very
important and burnout is not a psychiatric illness okay it’s a it’s
basically a disorder but it’s primarily related to you know organizational
stress okay so so the answer is primarily to focus on the organization
and changing the way would that operates okay but that’s no doubt that some
people who if they get burnout then then that can progress and it can be a
vulnerability factor to developing significant depression or anxiety or
perhaps even substance abuse and so you know if in fact you find that you’re so
burned out that you’re missing lots of days of work but you’re making mistakes
or that you know you’re suddenly getting poor performance evaluations or that you
know you know your general level of capacity has gone down and then they’re
certainly red flags that should make you at least wonder whether in fact it’s
possible you might be getting say depressed or anxious to a level where
you maybe should seek professional help so another piece to this is we often can
recognize this in spouses and colleagues friends and it’s a difficult subject you
know that person is upset angry frustrated and you can’t say you know
your person who I love so much actually you burned down because they
they’re they’ve they’re angry about their situation how do you address that
yeah and I think and I think it’s very difficult to address that with people
that you both know and/or love and and maybe a slightly different approaches
for both but but you know the most important thing is to actually discuss
it and to bring it out and and you can usually do that along the lines off you
know first of all can we have a private chat we maybe go somewhere where
nobody’s going to interrupt us because I’m concerned about you what I want to
discuss some issues that are really important so you know maybe go to a
local coffee shop rather than do it actually in the clinic sure and go
somewhere where we’re going to have some privacy but you know we’re you know any
discussion you can have you’ll be a straightforward discussion and then
literally be straightforward be honest with people you know say look you know
you know I’m a friend of yours I want to try and help you you know and I wonder
if you’ve noticed if you’ve been different for the past six months right
or I wonder if other people have have asked you how you’re feeling because you
know I’m a just I’m just concerned about you so actually be fairly direct with
people that you that you think there may be a bit different from the usual be
gentle about it but be straightforward and be non-judgmental I mean you’re not
in any way trying to say it’s their fault and and you’ll find that if you do
that most people will will actually respond in a very positive way about
saying yes I know I’ve know I’ve been different I know I’ve been a pain I’ve
been you know under a lot of pressure look you know thank you for at least
acknowledging what’s been going on right I imagine that it’s actually probably a
good first step for them just to be able to have somebody knowledge
they’re that they’re struggling at that point that’s exactly right the people
who are struggling know they’re struggling okay it’s not a secret for
them it’s but the problem is it’s a secret for everyone else and everyone
else is looking at them and it’s almost too afraid to to sort of talk to them
about it and so if you can break through that sort of cone of silence which is
what we often find then and have a a rational unemotional but you know
straightforward discussion with somebody you’ll be surprised how many people will
acknowledge that really is a problem and then they maybe can go back to some of
the things you were talking about trying to address the system or something like
that and look at what the issues are and work out how best to help on it and
maybe to circle back even further maybe they just need the company of a dog that
may have been our best tip for all of this we’ve been talking about wellness
and and general health and burnout with dr. Peter jelly’s he’s the UC Davis
health chief on this officer this will of course live on Facebook as you know
please share like us send it around and and if you have other questions you can
even post here and you might get an answer thank you for joining us thank
you very much

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