Mar 23, 2018
Really enjoyed this interview about practical tips to mitigate burnout and work on one's self as a leader. Gary is part of the Lead360 team working with APhA:
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Welcome to the pharmacy leaders podcast with your host Tony Guerra the pharmacy leaders podcast is a member of the pharmacy podcast network with interviews and advice on building your professional network brand and a purposeful second income from students residents and innovative professionals okay welcome to the pharmacy leaders podcast in Nashville still and right now I'm in with Gary Keil who is part of the pharmacy leadership and education Institute but he actually has an expertise in burnout and pharmacists burnout and this has been a recent not a recent issue from we've been burnt out for quite a while but it's we're doing a better job of addressing it and I know students are working with self-care in the classroom so I wanted to get an expert in and talk about it so Gary welcome to the pharmacy leaders podcast hey thanks Joanie I'm happy to be here yeah so that's the one thing that's interesting is students tend to be a little bit more aware but it certainly doesn't mean that students are doing what they need to do so the APHA leaved 360 program that folks may know about but may not buy something fairly new we started it last fall APHA foundation and APHA decided that this self-cares you know self-leadership if you will was important enough to create the entirely 360 Institute so that includes the Lea 360 program that I'm a part of the late of the mentor 360 and then I think it's men managed 360 that's what they're doing so we've got these three different tracks that are going our lead 360 program specifically focuses in on the individual you know what are we as pharmacists doing more importantly as people just to try to start to address our stress our crazy chaotic lives that quite honestly is leading to a tremendous amount of straight burnout if not a lot of morbidity and mortality that we're starting to find ok so walk me through the lead 360 program so tell me how many days it is or if it's a day and then within that day how it works so told me start to finish what that's about absolutely so the first programs we did one was in DC and one was in in in Indianapolis and these are just about a two and a half day program where folks would come in do a little bit of pre-work of just thinking really about their lives because most of us quote-unquote don't have time to even think about what's giving us yeah that's not true everyone has 24 hours in a day you know like Gandhi had 24 hours in a day so two Olympic athletes right so but we asked people to kind of reflect on what's happening in their world and then when they show up over the course of the two days say we have them walk through various things like really what is the image of leadership versus the hard work of leadership and I don't like to say the hard work of leadership even though it is because it should be enjoyable it actually should be enjoyable when you think about it so we start talking about what is the image versus the work let's save leadership and then we start unpacking things like what are your personal values your personal strengths your personal interests in your personal needs and so we call it the vision VISN because a lot of people have vision but you know they're just kind of thinking it's just sight until we tie it into values so over the course of the next really day and a half we start diving deeply into things like if you're not living your passion how can you expect to create an environment where other people can live their own passions it's something called the law of the lid I don't know if some people are familiar with John Maxwell but he basically says no organization can rise above where their leader is and quite honestly if a leader is stressed the followers start mimicking the leader stress because we look up to our leaders right and so by the end of the program we really start forming a what are called personal action plans so what are you going to do Monday when you get back to the same toxic environment so sometimes people get really excited at potential and possibilities have changed and they go right back into this toxic suit so we have accountabilibuddy x' is what we call them because we know if you don't have an action plan you don't do anything but if you don't involve anyone else the chances of you actually doing that are probably 25% maybe tops now the so these programs are the kind of the extended version last Thursday here at the APHA meeting just a couple days ago we did a 10 hour immersive on this program for 21 pharmacists so it was pretty phenomenal but that's like drinking through a fire hose you know get a lot of information but the 21 people at the end at 6 o'clock p.m. they were still ready for more it was amazing to watch so that's that that's kind of the shortened version but the most important one is called the virtual 360 and so what that is that's a three month very light but deep touch over the course of you know those three months to really start to personalize it so we have between three and four people in what we call pod groups and the coach really helps the pod members account you know they stand accountable to themselves as well as to really personalize the information that they learned in the bigger program so it takes it longitudinally and we're hoping actually to use some of these folks next year as kind of coaches themselves so we're starting to build out not just the original material but the opportunities for for others so that's the delete' 60 program okay so I want to talk first about a little bit about accountability I'm a big fan of Gretchen Rubin who's wrote The Happiness Project but she wrote a recent book called the four tendencies and if I'm get this right the four tendencies are that you can either do things on your own and you tend to not have problems with most things there's the rebel and this is how you meet external expectations who will fight you with the expectation but then and this is where I think many pharmacists fit in is the obligor so the obligor needs a personal accountability and don't make appointments or though they'll arrive at appointments they'll do things when others tell them and they'll do things for other people but they won't do them for themselves so let's I don't mean to say let's be more selfish but tell me maybe look what maybe let's do three different actions that we could do now that could help us so the first thing is how do we remember or how do we make sure to put our needs ahead of those others so that we can serve them at the best capacity I love that now I'm very familiar with her work and it's absolutely beautiful so I tend to think of pharmacists as wounded healers that is a sound bite so pharmacists definitely are wounded healers because we usually had some kind of person or some kind of event in our lives that happened and somebody helped us and so we decided at a particular point in our life that we were going to give back that very easily turns into self-sacrifice okay so if there are anyone who's listening to this okay that's alright but how long can you keep it up it's like running you know like running an ultramarathon which you know which I do but if you if you don't take in nutrition if you don't rest if you don't take time for yourself there's no way you're going to finish the quote unquote long run and so the biggest thing is to always take time out every single day don't say I'm gonna do something on the weekend don't say I'm gonna do something next week every single day you should have a dose of health a dose of sanity a dose of relaxation and so if it's even ten minutes even if it's 15 minutes in a day if you add that up over the course of a year that's a tremendous amount of change so don't put things off it's the biggest thing but think of your life as as a plane that is going down you know because it will psychology course do it by the way uh but it has to do with the thought of put your accident oxygen mask on first I mean we know we hear that we hear that kind of ad nauseam but it is so true if we don't do that we will absolutely burn out and interestingly enough when we become stressed at about a three out of ten on a stress CO and how many of us get the luxury of even going down to three on a daily basis we damage our brains and we put our patients lives in jeopardy we know their stuff and so if we want to be a wounded healer and keep that up do it do work for ourselves because we're saving our patients how's that that's perfect okay so first thing we're kind of talking about that obligations and and trying to make it so maybe you have a coach or somebody that'll keep you accountable to the things that are most valuable to you so maybe on the second level so we go into our work environment let's say that it's not aligned with our values maybe there was some pressure to get a job just because you needed a job based on some financial debt or things like that what are some ways that without changing the job what are the some ways that maybe we can get out of that woe-is-me and get in more of a positive mindset of it they've actually said you know that number $75,000 is a happiness number where you don't really get much happiness after it so you know you're you basically got somebody who's in a job making 100 to 120 thousand dollars a year saying woe is me and so on the outside people are like whoa is what you know what's your problem but tell me a little bit about some techniques or some tips tactics that we could use to help with burnout if we aren't able to currently change our environment yeah and and most of us can't really change our environment well but we can absolutely influence our environment and so I like I like to think of things in in health terms and running terms and the couch to 5k program some people have heard about I actually don't like the couch to 5k program because it because it takes things too quickly okay it takes things too fast and so the first thing is to just simply take stock of your current situation so if you're on the couch be happy on the couch you know if you are stressed actually appreciate it because stress is a good thing or at least it can be if there are parts of your life that are stressing you just simply look at them under a different lens so look at them differently saying okay is is there some kind of positive to that because we can have bad stress but seeing in a different way and it actually changed as our physiology we know that right so you look at things differently but the bigger thing is let's just start to unpack what is absolutely vitally important to your values because if we go against our values we live was what's called an ngon concordant life okay so self-concordance means we will lie to ourselves we will lie to others will justify everything we do in order to harmonize the image of our life with the reality of our life it's not that we change the life is that we change the story and so so we know we do that self-compassion is critical so if if no one is familiar with Kristin Neff any ffs and her Kristin is with a K she's a researcher and she's looked at self-compassion and so we know flat-out that until we have self-compassion we're actually not going to change we will go debt into that Diskin coordinate state and just simply lie to ourselves in lie to others so stand in front of the mirror and be okay with wherever you are because you got there you can get someplace else do it in small steps so don't try to change too many things too quickly and so again it's like that couch to 5k well okay catch the 5k should actually take some people upwards to a year and a half but you know these programs are six weeks a lot of people they finished the 5k but they kill themselves sure yeah so now we've kind of talked about going into the workplace we've talked about some external expectations most people have some partner of some sort or another and a lot of times when I'm afraid to ask my wife for time off to do something like coming to APHA and because I don't want to disappoint her I don't want to put more work on her but then when I do she's like oh yeah you totally need to get away because you have been such and such and I didn't see it I didn't realize that I'd been a bit more grumpy or I've been you know things have been bad so um how do you engage your partner and congratulations on your engagement actually but how do you engage your partner in saying I need this or I need help like on the weekend I don't say I need three hours off I say I'm gonna go run 20 and then that seems to be fine but and but I make sure to do it like between 5:00 a.m. and 8:00 a.m. so we can still make it a church and things like that but how do we involve our partners in making our own lives better absolutely yeah so the accountability that we that we need is how we do it is just as critical and so you know getting back to say our partners or or our bosses for that matter there's something called non-violent communication and people can look it up NVC is a beautiful way of communicating amongst people it doesn't really matter if it's for your partner your boss or anyone it'd be this is just as valuable for patients as well it's a way of couching what we feel so no one can take away our feelings no one can say no you don't feel that you know it's a big and so nonviolent communication just simply is a way of communicating where you say when this happens I feel this okay so when I don't exercise I feel sluggish I feel angry I didn't know this stuff I feel kind of grumpy right I need your help in order for me to not experience that are you willing to help me on because obviously if we catch it in that way this is all of our feelings and it resonates in them saying I want to help you out because we are nurturers by you know by kind of nature if you will but there's also a negative impact if we don't help because you know like our spouses if we're kind of cranky with them hey I got a deal with us I've become the fourth child absolutely and so if they see the benefit for them there be more likely to support us and so but we start the conversation with our own feelings we have to own our feelings that's one thing that's kind of squared let's talk about how we say that because when sometimes when I talk to my wife I'll say I'll say something and immediately I'll know that that was wrong and what and it was the phraseology and the words that I use to get backwards a step is what did you hear me say because what you heard me say obviously is not what I meant to say yeah so how can we phrase I need help without saying throw me a life raft or throw me you know what how can we phrase that yeah so it's actually not an easy thing if you're used to communicating in a different communication style okay so there's various levels of listening that we know about in kind of research shows us that level one listening you kind of hear the words but yet you don't listen to what they're saying you know that happens a lot especially with kids who when they're watching TV level two listening is a little bit or you're listening to the words but you're thinking about what you're going to say next you know like you're trying to one-up them or you're trying to bring up something from the past that's actually not what you do so so having even these types of conversations saying we know that there are these different ones level three listening is actually where you start to listen to what the person is saying and really it starts so resonate you don't need to solve problems or anything but you're really there for them level four listening is really the key where you're listening to the words you're hearing their emotions you're seeing their body language and so just simply knowing that there's different levels of communication is the start is just to say you know honey I have something to speak with you about when can we speak about this because it's important because if you're just gonna show up and your spouse is in the middle of preparing dinner dealing with the kids because it's funny I'm laughing because it resonates is as OnPoint very true yeah and so it's not okay to just throw information at somebody and they're not prepared and so even your with your spouse saying this is important enough to me I would really like to have quiet time where the two of us can really focus in on oh I don't want to impose on you while you're doing Jenner in dealing with the kids and all that and so just simply establishing a safe environment you know where it's non-threatening and they're going you know these are the different levels of this and I know what I may have not done anything but level or two or three I want to better our relationship so you start with that and then you start with the with the non-violent communication but by just simply saying these are my feelings I'm owning them I also want to own my future by making it better not just for me but for us and so once you it is selfish but it's also beyond ourselves and usually our spouses are like yeah you're right okay all right well those are some great tips thanks again for being on the pharmacy leaders podcast absolutely thanks Dodie are you feeling a bit stressed at work unhappy with where you're going if you are you might want to come to the lead 360 program in Chintan DC July 14th through the 15th for more information you can go to WWF as comm slash lead 360 register find out some additional information we look forward to seeing you there support for this episode comes from the audio book memorizing pharmacology a relaxed approach with over 9,000 sales in the United States United Kingdom and Australia it's the go-to resource to ease the pharmacology challenge available on audible iTunes and amazon.com in print ebook and audiobook thank you for listening to the pharmacy leaders podcast with your host Tony Guerra be sure to share the show with a hashtag hash pharmacy leaders