not fine. This talk is going to give you some tools for how to manage the stress and anxiety that comes from not only just living your life but also working in health care. Thank you for being here today. Before we dig right in, I want to define some of the things that I'm going to be speaking to. So what is stress? Stress is anything that is going on that's going to require an output of your resources. Distress, that's the point when your resources are depleted. Triggers, these are events, sensations, images, memories, things that facilitate you experiencing any events that overwhelm your ability to cope. Coping skills, these are the tools that you use to mitigate the stressors that are going on. So those are some of the things that we're going to be going over today. I consider the work that we do in health care to be sacred. And I do really mean that. Being able to take care of people through sickness and into wellness and even, you know, during times of wellness is sacred work. I think that we're here on this planet to take care of each other. So for us to choose to go into a caring field like this is sacred. But the work that you are doing as a medical assistant, that can come with a lot of stress and a lot of anxiety. Because stress and anxiety are going to be a naturally occurring thing in your work. We want to talk about what are some things that you can do to minimize them. So some of the things that are currently causing stress and anxiety for those of us working in health care, poor job related interpersonal relationships. So when you are not getting along with people on your team, that can be a lot of stress and anxiety on you. Working with people who you can't get along with makes those days longer, it makes tasks more difficult. It's a huge cause of stress and anxiety. Being short staffed through the last several years. My clinics, I have, I manage two different subspecialties, and I have seven different sites for those clinics. And we have been short staffed most of the time since 2020, whether it be one person short or multiple. So being short staffed can cause a lot of stress and anxiety on the whole team. And often because we're working short staffed, we're working longer hours. And when we're doing this work, this sacred work, we're already, you know, giving so much. So when we're going beyond our usual shifts and working even longer hours, that's a lot of stress. Changes within our organizations. Change is constant, change is always happening. However, that doesn't mean that we don't have stress and anxiety around it. Change is hard to navigate. And it can be difficult when we don't know everything that's going on. And a lot of times in the big health care delivery systems that a lot of us work in, we who are doing, you know, the work of taking care of patients, we don't always have all the information right away on the changes that are going on. And that can be a lot of stress and anxiety. Now during COVID, we all experienced a lot of rapid change. So a lot of rapid change is also something that can be really stressful to try to navigate through. Struggling with competing demands. When everybody needs something from you, and everyone needs it, you know, yesterday, that's really stressful. Because what do I do first? What do I do second? Whose needs am I meeting first? A lack of autonomy. When we feel like we don't have the ability to make decisions and work on our own, that can cause us to have stress and anxiety. In general, I think, you know, all of us enjoy being autonomous beings. And so feeling like we don't have any of that in our workplace is stressful. Poor leadership. When I say that you might the person who was a titled leader for you that you felt like was not a good leader may have popped into your head. It is my belief that there are bosses and there are leaders. So I think that people go into titled leadership to heal the world or to rule the world. And a lot of us have had bosses who are not very connected to the work. And that can cause a lot of stress and anxiety when you feel like your titled leader doesn't know what you're doing, or doesn't have that same kind of commitment to the mission of what you're doing, and isn't a very good leader. That's hugely stressful. Not feeling like you're sufficiently rewarded. It's important to all of us, that the good work that we're doing is acknowledged. And it's also important that we are acknowledged in ways that are meaningful for us. So I'm going to give you an example from some of the clinics that I manage. So I have dozens of people on the team. And one of them received an award, it was a pretty big award in the medical group. And it happens to one person once a year, and she won this award. And so the president and the vice president and a lot of senior leadership came to the clinic to present her with this award. It was a plaque and a jacket and a gift card, it was a whole big thing. And she was so embarrassed, she did not want to have that spotlight on her. She just, you know, kept saying like, it's the team, it's the team. So she was just very, very like, Oh, my gosh. But when I mail a card to her home, and I just thank her, you know, thank you for this, this specific thing that you did this week and clinic, that was a wonderful thing. And I'm so grateful for you. When you just privately thank her, that means everything for her. So not only feeling like we're sufficiently rewarded, so we're being acknowledged, but then also in the way that is meaningful for us, right, that's the key. So we're not feeling like we're acknowledged and rewarded that that can be stressful. Trauma and violence. So trauma and violence are things that unfortunately, are happening in healthcare. And again, joining a field of care, you guys are medical assistants, because you're caregivers. Having trauma and violence be part of our work days is something that I think was unexpected and is becoming more prevalent. And that's, those are trauma and violence are huge causers of stress. My gosh, that's a lot, isn't it? So that's workplace stuff. But then our lives outside of work also has a lot of things that can be causing stress and anxiety. When we're in conflict with the people we care about with our friends, that's stressful. Going through a divorce is something that's really stressful. But also, a marriage is really stressful. If you, you know, are planning to have a wedding ceremony, that can cause a lot of stress. So it's not just a divorce, it's not just an end of a relationship. But a marriage ceremony also is something that causes stress. Pregnancy, pregnancy is joyful, and it's exciting, we're bringing new life into the world. But also, it's something that can cause stress and anxiety both. Being sick, our own sickness. So you chose to be in a field of taking care of others. But when we're sick ourselves, those are things that can cause stress and anxiety as well. Money troubles, financial stuff can really weigh on us, and can be huge causes of stress and anxiety. Moving, moving is often also a very positive and a fun thing. But it can also be something that is just really stressful. Same as going on vacation, right? We're going away, we're going to relax, but planning it, funding it, and then even when you're on it can cause stress and anxiety. When we are changing things in our lives, so we when we're revising personal habits, that can cause stress and anxiety too, right? We talked about how change is hard and change can cause stress. So even when we're kind of, you know, leveling up or taking a new class, we're, you know, working out, we're cooking at home more, you know, whatever these things are, revising our personal habits, even though they have positive outcomes, there still can be causes of stress. And then, of course, when a person passes away, a death of people that we care about, another huge cause of stress and anxiety. So really, it's just a lot. We're dealing with a lot at work and at home, just living our life. So how does stress manifest at work? So we've talked about, okay, here are things that cause stress, but what are how does show up for us at work? Well, increased call outs. So team members or even yourself calling out more, right, that can be a manifestation of stress, medical and other errors. So there have been studies that have shown that medical professionals so truthfully, the studies that I read were of nurses and doctors, but I believe this is true of anyone who works in the medical field. So this is something very true for medical assistants as well. Medical errors are more likely to happen when we have cognitive dysfunction. And one of the things that stress causes is that cognitive dysfunction. So we're more likely to make errors when we are feeling stressed out. Low morale. Of course, you know, the morale on on the team is paramount to it being functioning to it being successful. And when we are feeling stressed, our morale is lowered. Also, our energy is infectious. So when we are feeling stressed out, our team members, our co workers can also begin to feel stressed out. And when we're all running around the clinic feeling stressed out, that can cause low morale. And then when we have low morale, then we're also more likely to be disengaged in the work. We're just not interested in giving it our all. We're not interested maybe in the real mission of our work when we're feeling stressed out. Compassion fatigue can happen. So what is compassion fatigue, that is when we who work in the field of cares, you guys working as medical assistants, it's when we take on the stress and the trauma of what our patients are going through. So we don't know how we don't get compassion fatigue is that we have really strong resilience and really strong boundaries. But when we're stressed out, and those are lowered, we're more likely to develop compassion fatigue. And that can be a real struggle for you staying engaged in this work that you're doing. High turnover, when we're not addressing stress and anxiety, and in systematically, things aren't changing for us in positive ways. You know, people are leaving, they're leaving the clinics, or they're leaving healthcare in general, to find a different, different work that is going to be less stressful. And high turnover is something that we're dealing with in general in healthcare. But it's definitely how stress manifests an inability to concentrate. A lot of times when we are feeling that stress and that anxiety, it's it's consuming. And we're not able to dig into our in baskets and epic or be looking at the schedule, which patient is ready to be room next? Do I need to call in to the pharmacy for this patient's refill, you know, the things that are going on, you're not able to concentrate, we're just going to zone out and disassociate because we are just, you know, we're at our limit, we're not engaging with coping mechanisms, we're just stressed out. And unfortunately, corrective action can happen, right? Because we have certain tasks that we're responsible for. Again, with this sacred care that we're giving, we are changing people's lives. medical assistants are absolutely active care team members for every patient that comes through that door. And when we are suffering from stress and anxiety, our behaviors can be impacted, right, we could be calling out, we could be making those errors, we could be developing compassion fatigue, we could become less invested in our co workers, we could be making errors, or just, you know, not caring, just not doing the work. And that can lead to corrective action. So this stuff is, this is hard, this is a bummer to think about. So to that point, thinking about it, tell me if any of this sounds like you, do you feel like you have a lot of fatigue? And even if you're getting what feels like enough, quote unquote, enough sleep a night, you are fatigued? If you feel irritable, and it's not your normal state of being, but you're easily irritated? Do you have a lack of concentration? Are you just really not able to focus and get things done? Have you noticed changes in your eating or your sleeping patterns? So did you used to eat breakfast every morning, and now you just are in a place where you just don't? Either you don't have an appetite or you're too busy and you just don't eat? Are you sleeping more? Are you sleeping less? Like has there been changes in those eating and sleeping patterns? Do you feel worsening mental health issues? You know, is stuff that's already going on with you, does it feel like it's getting heavier? And then also worsening chronic health issues. So do you have a chronic condition physically that feels like it's getting worse? Do you feel like you're unhappy? Do you feel like you're not content? And do you feel like you're using some substances like drugs or alcohol more? And do you feel like maybe you're using drugs and alcohol as a way to not feel the stress? So does any of that sound like you? And if it does, you might be feeling some stress and anxiety that we're going to want to figure out how can you how can you work on that? Stress and unhappiness come not from situations, but how you respond to situations. So now I want to talk about what do we do, right? We've just spent some time talking about all the things that can be or a lot of the things that can be causing us stress at work and in our lives. How does that stress show up when we're at work? But now let's talk about okay, so when I have all these stressors that are happening, how do I not take that into my workplace into my clinic or my hospital? What do I do? So here's what I'm going to invite you to do. I want you to be open minded and listen to all of these ideas and then try them out. Take the ones that work for you and leave the rest. But we're here to help you. So let's try them. So as soon as you wake up, set your your affirmation for the day and speak it aloud if you're able to. So this affirmation can be today I'm going to have a positive day. I'm going to go in with an attitude of we got this, we can do this no matter what the schedule looks like. Affirmations do actually work. And it's because you're rewiring your brain. You are kind of speaking it into existence. You are replacing that negative thought like this day is going to be terrible because we're overbooked with a positive thought. I'm going to have a positive day. So if you can actually speak it out loud, you're even giving it more power. And you can repeat that affirmation, you know, throughout the day to doesn't have to be just when you wake up. But if right when you start your day, you're setting that tone with your affirmation. Take some time before work. It can even be just a few minutes. It doesn't have to be you know, a full hour, a full half hour, even 15 minutes, you can just it can just be a few minutes for joy. So in the clinics that I manage the subspecialty clinics, you know, the work is very hard, we have really high expectations, our medical assistants do so much care for patients, and they're very active members of the care team. And we so we have really high expectations. Also, we have really high expectations that people are experiencing joy. It can't only be hard, it can't only be work, right. So we also want to experience joy. And that's true, just in our lives. We're not meant only to work and to care for our families or our community. We're also wired for joy. So you could be thinking, Oh, my gosh, I do not have time for joy in the morning, I have to get my kids up, I have to get myself ready for school, I've got to feed the kids breakfast, I've got to walk the dog, I have this list of things I got to do and try to get to the clinic by eight, like no way, there's no joy happening. But let be creative. Can you put your headphones on and play your favorite song to dance to and just maybe you're dancing while you're brushing your teeth, right for two and a half minutes. But just infusing joy, before you go into your work day, you've already experienced joy, that is going to change how you are able to manage stress at work. Think of something that you're grateful for. This again, is that idea of we're wiring our brains, we're rewiring our brains. So you know, very easily, I think we can all come up with a dozen things that are terrible, right? We can pretty easily say this is something that's awful, I don't like this, this thing is bad, we can come up with a list pretty quickly. But the challenge here is, let's come up with a list of something that we're grateful for. Gratitude is one of my personal core values. And I can tell you from my personal experience that it has changed my life. I instead of looking for what is wrong and what is bad and focusing on it, I'm instead focusing on the things that I'm grateful for. So if you can spend a moment every day thinking of something that you're grateful for, you're going to be then, watch this will happen. Things that you're grateful for are going to more easily just come into your life. Let me give you an example. So we in one of my clinics, we were moving. So we were moving our physical space into a different medical office building on the same campus, but moving is a big deal. And we were also expanding our staff. So we were adding more team members. So those are two big things that cause stress, right? When we think back to our other slides, moving and team dynamics. Those are things that can cause stress and those are positive things. Our team is growing, we're getting bigger, we have more capacity to take care of patients in a bigger clinic, but that can be stressful. So I was hearing as the title leader, I was hearing a lot from the team about these are things that could go wrong or that I'm worried about or that are bad. So I got each of the team a little notebook and I said, every day I would like for you to write down something that you are grateful for. You don't have to share it with me or with anyone, but I just, I'm challenging you for one week to just write this down. And that was in 2016. And some of these team members are still doing that gratitude journal. They still have it. I still have mine too. I have a specific one at work that I keep and just writing down one thing. And so what I started noticing when I challenged the team, just to find one thing they're grateful for is they were doing it. And how do I know they were doing it? Because they would then say in the moment, Oh, this is the thing that I'm going to put in my gratitude journal. So now, instead of looking for, here's the things that are stressing me out, here's the things that are terrible. And these are the bad things. Instead, they're looking for the things that they're grateful for. Gratitude can change your whole life. And that sounds dramatic, but it's absolutely true. So if you can spend time thinking of something that you're grateful for, you'll notice you're going to more easily every day, find things you're grateful for. Giving compliments, giving compliments to people, genuine compliments absolutely makes their day, right? And I feel like it also makes my day when I give someone a compliment. There is a coffee chain that has a drive-through. It's here on the West coast. It was created in Oregon. It's called Dutch Brothers. And there's one near my home. And so I will drive through on my way to work and get coffee. And over going through this drive-through so many times, I've gotten to know the team members because I'm interacting with them. And they will say like, Oh, we always get so excited when we see you because you're just so fun to interact with, or, Oh, I really like the color of your eye makeup. And so giving me these compliments is, you know, energizing to my day, just as much as getting that caffeine infusion from that coffee that I just ordered. And so I know how I feel when I get a compliment. And so if I think something nice or kind about someone, I'm absolutely going to give them that compliment. More points if it's not related to how they look, but sometimes if it's someone, you know, that you don't know, you only have the looks to go on like, Oh, that scarf is so pretty. That looks really good on your, that your hair color is fun. You know, whatever, giving compliments helps you feel good. And it just kind of spreads kindness into the world. So before you even enter into your building, your clinic, your hospital, recenter yourself, right? You've already kind of lived a life before you've even gotten to work with all of the other tasks of getting yourself out the door and ready for work, your kids, if you have them, the dog, getting the dog fed, all the things. So you've already done a lot of stuff before you've even gotten to your work site. So taking a little bit of time to recenter. So some of the things that we can do for that is taking deep breaths, right? Really inhaling and focusing on that breath, holding it, and then exhaling, you know, doing three or four or five of those. Why not? I'm a very visual person. So when I'm breathing in, I like to think I'm inhaling love. And when I'm exhaling, I like to think, and I am exhaling peace. This recenters you try a one or two minute meditation. There's a lot of guided meditations kind of all over the internet. So maybe trying a meditation and then having a couple of sips of water, right? We're all chronically dehydrated. So getting that hydration going, lubricating up the old organs and your brain, and that's all before you're even at work, right? So now once you're in that clinic, once you're in the hospital, now, what do I do? Well, working on establishing and maintaining boundaries. So what even are boundaries? So those are limits that we're setting for ourselves about how we're going to be in a relationship, right? This, think of boundaries, not as a way to keep people out, but really it's a way to keep you safe. So when we establish and maintain the boundaries, yes, coworker, I am willing to change my lunch break with you on this day, but my boundary is that I'm committed to my lunch break at this time, but I am going to do it for you this one time, but the boundary is not all the time. Establishing and maintaining your boundaries is going to keep you safe and less stressed. Talking to your titled leadership, I hope that you have been able to develop a relationship built on trust and respect with your titled leaders, your lead, your supervisor, your manager. I hope that that is something that you have because talking to your titled leadership about how you're feeling is going to help you with stress. Here's what's going on. Here's what I'm struggling with, what my challenge is, and here's what my ask is of you, manager. Can we work together to help solve this? Not engaging in gossip. Gossip is divisive. It's destructive. It's a team killer, and I have team members who will say, well, I don't engage in the gossip. People will just come up to me and tell me this thing that's happening, and I say, okay, so then what do you say when someone is telling you this gossip, and they say nothing. I just say, wow. I'm like, okay, well, then that's a tacit approval of that gossip by not saying, hey, sounds like you have a problem with your coworker. You should go to the coworker to discuss it and not me. Not engaging in gossip is a really big way for you to lower your own stress levels. Taking your breaks. Breaks are so important. It can't only be go, go, go, go, go. Even when the clinic is really busy and we're really short-staffed, it's still so important to take those rest breaks. Your mind and your body needs time to rest. Take your breaks. Resisting perfection. Perfection doesn't exist. It doesn't exist, and so when we're chasing it or we're trying to maintain it, that's going to increase our stress, not lower it. Now, this is not the same as, you know, don't make any medical errors. Don't worry about that. You want to be very careful and very diligent in the work that you're doing, but everything is not going to be perfect all of the time. If things get messy, the clinic schedule goes off schedule. Either the patient or the provider takes longer in the room than we were expecting, the day, you know, gets thrown off. That's going to happen. It's not always going to be perfect, and when we can just flow, when we flow, we're going to be less stressed. Tap into your employee assistance program. If you have one at your workplace, I highly, highly recommend that you check it out. A lot of them offer counseling, and that would be free for you, and it, you know, it doesn't have to be necessarily an ongoing counseling where you go every week, but maybe it's something that you're dealing with acutely. You know, I have this conflict with a co-worker, and I want to talk to a trained professional on how I can navigate this conflict, or I'm feeling stressed. I'm feeling anxiety at work. I am nervous about these changes that are happening. How do I manage that? See if your workplace has an employee assistance program, and then tap into it. A lot of these programs also have, like, online. They have, like, webinars, like what you're doing now, quizzes you can take, just kind of worksheets, articles to read with tips in them, so employee assistance programs I have found over my years to be hugely, hugely helpful, so highly recommend checking those out if you have one available to you. Okay, so how do we manage the competing demands of work and life? It's a lot, right? It's a lot. Living a life, there's a lot going on kind of all the time, so what do I do? I have everyone wants a piece of me, and I also want a piece of me, so, you know, where do I fit in all this? So what are some things that we can do to manage all those demands? Well, first, we want to know what our objectives are. So at work, what is my objective for today? And maybe those are going to change day to day based on what's going on in the clinic in this moment, but knowing what your objective actually is, that's going to help us first and foremost, right? So we want to prioritize that. That's another way that we are going to manage. What do we need to do? What's the objective, objectives, what are my tasks, and then how am I going to prioritize that, right? Then something else that's really important, though, is being flexible, right? So when we think, okay, so our clinic is going to be over at noon today, a surgeon is going into the operating room at one, so we'll be done at noon. Great. Oh, no, we had three add-on patients. Things are, we're going to have to call the operating room, push back the surgery start time. We've got to be flexible. Things are always going to come up. You're probably thinking in your own work that you're doing how many times this happens, right? Where what we expect to happen isn't what's happening. And when we're flexible, that's going to really help us manage that daily stress and anxiety. So set and manage expectations. So if I'm expecting this to happen, okay, great. This is what I want to do. I want to be out of clinic. We want to be done with clinic by noon today, but then we have to manage that expectation. Oh, but we had these add-on patients, clinic is now going to be late. So now I got to reset that expectation. And this can also be set and managing expectations for our team members too, for our coworkers, you know, for our providers and for our patients. But when we're thinking about them and when we're talking about them, when we're setting them and managing them, that's going to help lower our stress and then giving ourselves time. You know, I'm going over like a lot of these ideas, but you want to give yourself time for everything. So you're not going to wake up tomorrow and speak an affirmation and think of something you're grateful for, take a sip of water and then go into work. And now you don't have any more stress. Everything takes time and make sure you're giving yourself time too. Knowing there's not really a thing called multitasking. I see this on resumes a lot. People say they're great at multitasking. That's actually not possible, is it? We really can only do one thing at one time. Now, of course we're responsible for a lot of things, right? The medical assistance, you're rooming the patients, you're doing report out for your provider, you're managing your in baskets and your call pools, you're handling referrals. A lot of times you're doing in my clinic, surgery scheduling, you are handling medication refills. Like there's a lot of things you're responsible for, but you shouldn't be doing any of those tasks at the same time because that's more room for error. And we're just not, it's not physically or brain power possible for us to even do that. So knowing that, right? Knowing I can only do one thing at one time. That's where my prioritizing is coming into setting and managing that expectation to, Hey patient, I know that you want this refill. Um, I'm in clinic today until 4.00 PM. My goal is to get that called in for you before five, but it's going to be after four. So setting and managing expectations, prioritizing, right? Not trying to multitask. You're not an octopus with eight arms with one to do each different task. You're just one person, one important person. And so the less we try to multitask, the more we're able to actually get stuff done and giving yourself grace, giving yourself grace. We're, we're going to make mistakes, friends. We're going to make mistakes. We're going to make errors. We're going to screw up. It's going to happen. We're not going to be perfect because there is no such thing. We're going to say the wrong thing. We're going to put our foot in our mouth, give yourself grace. And what does that mean to give myself grace? It means allow myself forgiveness. Okay. So, um, I, I am not the worst thing I've done. I am not the error that I made. I am not perfect. So giving yourself that grace when you can also give grace to other people, it's even more beautiful. Okay. Let's dig into some coping skills. So these are some truths about you and coping skills. So there's no such thing as a wrong response, only adaptive ones. So several slides back, I talked about, you know, do you feel like you are using drugs and alcohol to deal with stress? So that is a coping skill and I'm not judging it as a good or bad coping skill. It is an adaptive one, but what we want to be thoughtful about is, is it really serving me? Right? And so adaptive coping skills are what's happening. We want to constantly be thinking though, is it actually helping me? Is it getting me where I want to be? What you have survived has wired your body to proceed with extreme conscious on an unconscious, unconscious level at all times. So that's kind of a big deal. Your body is always looking, your body and your mind is always looking for keeping to keep you safe. So you're not choosing to shut down. So when it, um, when you're feeling triggered by a trauma, you're not choosing to just shut it down. That's your body saying, Oh no, nope, nope, nope. We are, we're, we're shutting it down. This is a scary thing that could potentially harm us. So we're going to shut it down. Um, it's not a mental illness. It's a cycle, physiological state of your human body. And that's just your brain trying to keep you safe. You're not crazy. I cannot stand that term. You're not crazy. You've just adapted to the environment that is around you with the only information that you had at that time. Right? So the goal is how are we looking for new coping skills is deep breathing and managing my sleep schedule a little bit different. Is that going to actually lower my stress more than misuse of drugs and alcohol, right? Try it. But your coping skills, no right or wrong. They're adaptive. So what are some things that we can do to cope finding and refinding our center? So I say finding and refinding our center, because it's like a compass. We're going to go, it's going to, that dial is going to spin around. Our center is going to get knocked off and we're going to have to refind it. So this is not something that we do one time and then it's done. We have to find it. And then we refined it. And that involves us being connected with our minds, bodies, and spirits. So I talked about breathing, a big proponent of the breathing, right? Really mindfully breathing. So that's really, again, I told you I'm a visual person. So really like imagining, really focusing on that breath, imagining your lungs filling up, imagining your lungs deflating as you're exhaling, really leaning into breathing. This is a mindfulness practice too. When we're focusing on our breath, that can be relationship savers. So again, that's dramatic, but it's true. When I can really focus on my breath and nothing else, I'm shutting the world out. I'm just focusing on my breathing. That's going to recenter me. I have actually seen in the work area where my medical assistants, team members are, I've seen people standing at their desks, you know, doing that mindful breathing, which I absolutely invite. The thing about breathing is it's free and it's available to you all day, every day, absolutely focusing on breath work. You can look up videos, there's TikToks, YouTubes, you know, everywhere on the internet, there are different types of breathing. There's like people who can guide you through the different types and find the one that works for you, you know, cause there's so many of them, but really focusing on breathing. Nature, being out in nature. So there is a practice called Shinrin-yoku in Japan and Shinrin-yoku means forest bathing. And so the idea is that you are going out into nature. So it could be a public park. It could be, you know, maybe you're, you live close to mountains or the beach, whatever kind of nature is accessible to you going there and experiencing it. So listening to the way the wind is moving through the trees. Do you smell petrichor? Petrichor is that smell after the rain, the smell of earth after the rain. What does that smell like? What does the bumps on the raspberry, what does that feel like in my fingers? You know, really digging into nature with all of your senses. Use caution with your sense of taste, but you're here. What am I hearing? What am I seeing? What does this feel like? Right? Shinrin-yoku. So, and studies have shown that exposure to nature, being out in nature, it leads to better cognitive function and it decreases stress and it boosts happiness. So everybody wins when we're out in nature. So if you can get away on your lunch break, if you happen to work near a nature area, a park or something, try it. One of the hospital campuses I work at isn't near a park, but there's beautiful trees. And as I'm recording this, it's autumn and the trees are changing color. And so I will just kind of walk around the campus and experience, you know, the beauty of what it looks like when those trees are changing. And it absolutely, I'm telling you every time it recenters me. Moving your body. I like to think of joyful movement. What is fun for you? Do you, you know, I have a team member and she said, you know, so she had a baby and she said, I just am not happy with my physical body. I don't feel connected to my body since I had my son and I wanted to go work out. And so I went to a gym, I, you know, went home and I changed, I got my headphones and I went to the gym parking lot and I sat in the car and I cried and I did not go into the gym and work out. And she said that she just felt bad. And so she didn't even want to go in at the potential of people looking at her and her, she felt like she wasn't strong. And so she instead cried. So I said to her, you know what? I know that you love, I know that you love singing and I know that you love dancing. So what if your joyful movement is you have your son on your hip and what if you're building out some song that you love and you're just dancing around the living room, that's joyful movement. What if you tried something like that? Do you have to go to a gym? No. Right. Um, I like roller skating. So roller skating is way more fun to me than like, quote unquote exercising, but it is actually right. I'm moving my body. Moving our body is a great way for us to find our center. Just do something that's joyful. Stretching is a wonderful one. Um, stretching our bodies, especially if you can do it. Um, when you wake up, I actually do stretching just even in my bed before I even get up. Um, there's again, a lot of tutorials. There's, um, tick talks and YouTube videos on, um, stretches that you can do, but actually stretching. If you can actually do it at night also great or any even time during the day. Um, but stretching is a really wonderful way to find our center laughing. Oh my gosh. Laughing boosts our serotonin. It puts us in a better mood. Laughing is huge. Um, in March of 2020, I, you know, when we were going into the quote unquote lockdown of COVID for a couple of weeks. So all the restaurants were closed. Everything was closed. Remember everyone was staying home. Um, of course our hospitals, we were open, but a lot of my friends were staying home. Um, and this was going to be for a couple of weeks, right at the beginning of COVID. So I thought, you know, what is something that I can do to kind of boost people's spirits during this, this couple week lockdown that we're going to have in March of 2020. So I started on my personal Instagram on the stories I started telling a joke every day. And it's just like a, you know, like just a terrible joke like what did one wall say to the other wall. Meet me at the corner, you know jokes like that. So I would tell one of those jokes every day and I thought, Oh, I'm just going to tell this joke, you know, every day for a couple weeks while we're in lockdown. So, friends, I'm still telling these jokes. Now we're, you know, over three years later and I'm still telling these daily jokes and what's funny is that I've actually started telling these daily jokes in my daily leadership huddle. So I have a director and then I have manager peers, and we meet every morning. There's like 10 of us and we meet over Microsoft Teams. And if for daily huddle. And it's where we go over you know issues that have come up any kind of problems that is happening, announcements, whatever's going on. So I started adding kudos for people, but then I started adding that daily joke that's how we end the huddle my director says okay Jen and what's today's joke, and it's just laughing, right, it's just like a fun little thing. Our work can only be hard, it can only be serious. Right, so finding that time to laugh, it helps center and recenter us. Engaging in positive self talk. We have what 60 70 80,000 thoughts every day. And I just heard a statistic that said that 80% of those are negative self talk. So, the biggest voice is us right in our head. And so when we can turn those 80% of negative self talk into positive self talk, your life is going to change. You are the only you that we have right you're a gift to this world, you deserve safety you deserve kindness, and it starts with you. Right, and so being able to say, you know, I am really funny, I am a good friend, I am a very strong medical assistant I have awesome skills, engaging in that positive self talk, not the like here's what's terrible. I did this in an awful way but really engaging in positive self talk, it's going to build your confidence. Also the way that you, you know, the everything starts with the self and it flows out from there so your most important work is taking safe and excellent care of yourself. And part of that is by speaking to yourself with love and kindness. Speaking with people that you love. We have limited time. So spend that time that you're choosing of who you're going to be with, with people that lift you with people that you know when you leave them you just think, Oh man, I feel really good about that. I had one of my friends over for breakfast on Saturday. And after she left, I texted her and I said, Oh, thank you I that visit with you was just what I needed for my spirit. And she said yeah me too you know like thank you so much like that talk that we had really helped me see this thing in a different way so thank you for that. You deserve to be with people who are going to feed your spirit. Right. So be very thoughtful about the people that you have in your life and the relationships and share your time with people that you love. I talked about how I do expect that my team members experience joy at work, and I have things that I do as their titled leader to try to facilitate that joy like I will do crafter noons where we bring in stuff for crafting. I asked a daily question on our team's channel. You know we just have fun interactions with each other I've coloring books in all the break rooms, just laughing and sharing with each other right so there's certain things we're definitely doing to cultivate joy at work. But what are some other things that you could be doing in your life, maybe it's at work and outside, but cultivating joy. So volunteer for something that's meaningful for you. We don't all have unlimited funds to give money to causes that are important to us. But do you have any time or capacity that you could volunteer for something that's meaningful for you. I get a lot of joy out of volunteer work that I do. When I took a roller skating class that was painful when I fell but also really joyful. I took a cross stitch and an embroidery class those were also something that was really fun really joyful, learning new things is something that absolutely cultivates joy, noticing the good things. So, again, we can all come up with a bunch of stuff that is not awesome, and that is bad, we could do that right. I think that our brains are wired for that because that's how we keep existing by looking for danger. But when we're noticing good things, more good things appear it's like like that the same concept of the positive affirmations and expressing gratitude. But when I'm noticing when things are going right when I'm noticing good things that's going to cultivate joy. Start a joy journal. So you've probably heard of gratitude journals where you write down something you're grateful for I told you I gave those to my team What about a joy journal, something that is joyful for you. Sometimes I'll make a tick tock and I'll say like these are the things that are bringing me joy today. You know, when I am driving to work and I see a dog hanging out of a car window, they just, it makes that makes me so happy to see that is such a joyful moment, you may hear lately in pop culture they're called glimmers. Record it, because then when you're, you know, by writing it down. When you're not having a good day. You can go back into your joy journal and be like oh my gosh I remember that dog that big fluffy white dog with his head out the window. He looks so happy and that brought me joy. Right. And so you can maybe relive that joy if you have a joy journal. Also the act of writing it down makes it more real for you. Being kind to others is something that brings joy into your life. So I told you guys earlier about the coffee shop that I drive through to get coffee. So, one time I made a focaccia bread for my team in the morning before I went to work, and I you know cut cut it up into pieces and I had it on this tray and it was in my car and the seat next to me on my way to clinic. And I was in the drive through with people and they're handing me my drink and I was like, and they're like, Oh, how's your morning going I said oh I just baked a focaccia and they're like what. So I pulled the focaccia over to the drive through window, and I'm like, Oh, do you want a piece of this focaccia bread and so the people that were working like they each grabbed a piece of bread and they're like oh my gosh and so the next time I came through was so good I'm like oh I'm glad you liked it. So then later, I made them their own entire focaccia bread and you know slice it up and then brought it same thing in the drive through I'm like here I made you guys this one you know so you guys have more than one piece. And they were so stoked to get that focaccia bread, and it was so joyful for me that something that honestly is low effort I make a lot of cautious so it doesn't take it takes five cups of flour and a few hours right. So being kind is something that will bring you joy, and it doesn't have to be a focaccia could be anything could be holding the door for someone it could be telling someone what a positive impact they have had on your life, it could be that you're writing a letter and putting it in the mail. There's just so many ways that you can be kind to people and bring joy into your own life. Forming strong personal connections. So, you don't have to have a ton of connections you don't have to have a ton of friends. You can have a few that are really strong so what's a strong personal connection versus a personal connection. When you have a strong personal connection, you have someone in your life that you are able to help to reach out when you need help that they can help carry things that are hard for you. Hey friend, I'm not doing good. Do you have capacity for me to share this thing that's really weighing on me and can you help me come up with a plan. And, like, this awesome thing is happening to me and I want to share it with someone like can we, you know, go out to dinner and talk about that, having that strong personal connection is going to cultivate joy in your life because you have that person in your life that you're able to share that with. And so, you know, we made, you know snacks for everybody and we just caught up with each other and then we drew numbers and everyone got a little boo basket. But, you know, as I looked around that room. These women are strong personal connections for me and these women are who helps bring so much joy into my life right and you don't have to have a ton, a ton of them there's you know there was there for me there that night so you just need a few people in your life that you're creating those strong personal connections with upping your self care. So, what does that mean like what is self care self care, you know, I think, unfortunately bubble bath bubble baths get a bad rap right they say oh self care is taking a bubble bath I mean it can be for sure. So self care is whatever that is supporting your wellness and managing your stress. So maybe your self care is that you like to play Animal Crossing on Nintendo. Maybe your self care is that you, you do you build little miniature houses. Maybe you put together puzzles. Maybe your self care is that you take really long walks with your dog, maybe it's photography, maybe it is a bubble bath bubble bath is definitely part of my self care so is making focaccia. What are the things that you're doing that are supporting your wellness. Right. Do more of that. The most important work that you do is taking safe and excellent care of yourself. And when you have lots of self care going on, that's cultivating joy in your life, releasing worry, worry is never going to serve you. It's never going to serve you it's a wasted emotion. Worrying robs peace from this moment. It robs the opportunity for joy to be happening now. If you're worrying. So I know that's easier said than done, but just try to practice it. When you feel a worry coming on. Just change that out with, okay, I can't control the outcome of whatever this is going to be, whatever this thing is that I'm worried about. It's me stressing out about it right now is not going to change it so what can I, what can I do in this moment, I feel like a lot of times when we have worry we're feeling powerless. But what can I do in this moment, that is going to calm me and potentially, you know, where could I find joy. Right, so releasing worry it's a huge part of creating a joyful life. So, what's the big deal about a joyful life right. What does it do to our minds and our bodies. So, when we can live in joy. It's going to boost our immune system, we're going to get sick less like legit we're going to actually be sick, less we're going to be more physically well when our lives are joyful. Smiling actually calms our nervous system so you can actually look up their studies on all the stuff that I'm talking about right now. Smiling actually calms our nervous system, laughing that releases endorphins and it lowers your blood pressure, you probably know this from when you do laugh. I mean everyone who hears my daily joke, they know that too. And that helps you live longer. So, joyful people are healthier, they're happier, and they live longer, and the world needs you. So we need the you that's joyful. So working on things that are going to bring us joy, hugely important. So, optimism, also hugely important optimism is the belief that things are going to turn out well. Right. This quote I love my friends, love is better than anger, hope is better than fear, optimism is better than despair. So let us be loving hopeful and optimistic, and we'll change the world. That's powerful. So what is an optimistic person, what does that look like? Well, they work on their resilience. So what is resilience? Resilience is our ability to move through things, right? I think that some people think the idea of resilience is bouncing back, but I don't believe in bouncing back, because everything that happens to us impacts us. We are the sum of all of our experiences, so we're carrying it with us, we're not bouncing back anywhere. But when we have strong resiliency, we can move through with more ease, more grace, more joy. Right, so optimistic people, they have worked on that resilience. They express gratitude. That's just true. People who are optimistic are people who express gratitude. Showing compassion. What is compassion? Compassion is empathy driven to action. This is my favorite story about compassion. My friend Rhonda was walking her dog, and we live in Portland, Oregon. It was snowing, and it was obviously cold. So her and her dog, Sebastian, are walking, and she comes upon a man who was sitting, he was outside, and with a dog. And this dog was wearing the man's jacket. So the man did not have a jacket on, the dog was wearing it. And Rhonda said, oh, why is the dog wearing your jacket? You look cold. And he said, well, he's cold. And so I had to give him my coat. And so Rhonda said, oh, you know what, are you willing to walk with me down the block and go into this store, so that I can get a coat for your dog, so you could get your coat back. And so they went down to the store and Rhonda bought a coat for that dog, so that the man could get his back. And on the walk, she had said that he said, you know, he was just waiting on his check in a couple days, but until then, he didn't have any funds to buy the coat. And so Rhonda happily did that. So Rhonda is a huge dog lover, and so she's empathetic, right? So empathy, something inside of me is connecting with something inside of you. And then compassion is, and that's driven to action. So I'm buying this coat for your dog, so that he can be warm. Now, I'm not saying go out and buy all the dog's coats, but where can you show up with compassion? Where can you connect with someone innately, and then be driven to action? There's so many ways at work as a caregiver that you could be doing this. And I also want to gently remind you that your compassion starts with yourself. Positioning things in a positive light. This is what people who are optimistic do. And that is to say, you know, okay, this is going to be a tough, this is tough, right? This thing that we're experiencing is tough. However, it's bringing us an opportunity. So let's look at this opportunity. Again, we can find lots of things that are bad and terrible, but how can we position things in a positive light? Optimistic people recognize their faults, their mistakes, and they take responsibility. Listen, if I mess up, I'm going to say that I did, and I'm going to take accountability with an apology and with changed behavior, right? That's what a true apology is, is changed behavior. If I make an error, I want to learn from it. I'm not going to try to hide it, my faults. I tell people, there's this quote that I like that says, I'm made entirely of flaws, stitched together with good intentions. So again, that whole idea of perfection, it's not real. But when I'm optimistic, I'm like, hey, you know what I did? I messed that up. I messed that up, but I'm going to do better. So that is what an optimistic person looks like. Also, I'm telling you, they have joy in their life. What we're not going to do, though, is have toxic positivity. So toxic positivity is where we're ignoring how we're really feeling. We're just kind of plastering that smile on our face. If we have that good vibes only mindset, like that doesn't exist. Good vibes only is not real. It's not because life is messy. Life can be difficult, right? It's not always good. So good vibes only is absolute toxic positivity. Shaming people for expressing their frustrations or their struggles. That is toxic positivity. Again, that's going back to hiding or ignoring it like, oh, my gosh, I can't believe you're bringing up this struggle. I really am trying to move far, far away from doing at leasting. Well, at least this. You know, it could be worse that. It's not helpful. And, you know, I was talking to a person on the IS help desk. I am a Luddite and I always have computer stuff going on. So I call the help desk a lot. So, you know, we the chit chat when you first get on the phone, oh, how's your day going? And he said something like that. He was stressed out about something. And honestly, I can't remember what the thing was, but it was something minor. And then he's like, yeah, but it could be worse. You know, like there's, you know, whatever. These other things going on in the world. And I'm like, well, even though there's other things that are going on in the world, that doesn't mean that your thing that you have isn't worthy of, you know, you not feeling good over. So, you know, there's no helpful thing that's going to come out of us, at least, or it could be worse. That's toxic positivity right there. So let me give you some examples. So if you say something like, don't be negative, it's not going to help you. A genuine optimistic person is going to say, hey, let it out. And how can I help you with that? Right? When we feel our feelings, that's going to help them move through us. If we have a good vibes only, you know, people are going to come to us less with their issues, with their need of help. So instead of a good vibe only, what if we say, hey, I love you or I care about you through all of your emotional states. So I know that sometimes we all go through it. How can I help you through it? Don't worry, you'll get over it. I know that you're going to get through this thing because you're strong and you're resilient. I'm here to support you. Stop complaining. Other people have it a lot worse. You're not alone and there is support for you. Smile. Crying is not going to help. Hey, it's okay to cry. Let it out. You want a tissue? Do you want a hug? Do you want me just to sit beside you? What's going to help you in this moment? Just be positive. Things are tough right now. You want to talk about it? Do you want to talk about something else? Do you want to hear one of my jokes? Right? Just being positive ignores how hard and how stressful things can be. So when we have that toxic positivity, it's fake. And honestly, it's going to lead to more stress and anxiety. By taking care of yourself and encouraging that same care by the individuals on your team, you're going to create a space for connection and engagement in the work. It's not easy to do, but once we get there and once these ideas that I've presented to you today, once those become routine, it is going to be easier because then it's just going to be part of who you are. That joyful, optimistic person who manages that day-to-day stress and anxiety that comes up. You cannot calm the storm, so stop trying. What you can do is calm yourself. The storm's going to pass. Thank you so much for your time and attention today, and I hope that there has been some helpful tools presented to you today that you will carry forward in your life. Thanks again!

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