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Approaching Wellness in the ED: A Conversation with Wellness Expert Dr. Shahina Braganza

2018-07-22T21:17:15+00:00

The Wellness Think Tank created a podcast with wellness expert Dr. Shahina Braganza from the Gold Coast in Australia. Facilitated by Dr. Annahieta “AK” Kalantari and joined by EM residents Dr. Alecia Gende and Dr. Adrienne Taren, the conversation covers a broad range of topics including the concepts behind Emotional Contagion, Dr. Braganza’s published “oneED” program1, and the challenges of adopting wellness initiatives in the ED. We present the podcast and highlights below.

Podcast with Wellness Expert Dr. Shahina Braganza

We Can Influence Our Shift

We all have leadership potential and can impact the mindset of our team, the patient room, and the shift. Dr. Braganza discusses how we can be both overt and subtle leaders. She recommends strategies for bringing a positive attitude and outlook to a shift, even if you are having a significant challenge in your personal life. Act happy. It isn’t easy, but your mood and smile will positively affect others, and in return, this will be reflected back at you. Eventually you will feel better and the mood will be genuine. She recommends Mindset: the New Psychology of Success (Carol S. Dweck) and The Upside of Stress: Why  Stress Is Good for You, and How to Get Good at It (Kelly McGonigal) to learn more about mindset interventions.

oneED Program

Dr. Braganza observes several daily situations for us to step up and serve as leaders of our team. Despite our affects as an emotional contagion, we have potential to help achieve some of her goals for EM wellness. We can help normalize the conversation and embrace our vulnerability. Those are some of the goals of her oneED project, which she created for Australian EM physicians in 2016.

The oneED project embedded mindfulness activities into the clinical areas of the ED at her institution. For example, each week at change of shift the ED team participates in a mindfulness exercise, 4 minutes to “just stop and reflect” on their potential emotional burden and compassion fatigue. This is followed by a 90-second guided sit or meditation. The oneED project also encourages staff to focus on the present, rather than the past and future, which is where Dr. Braganza states we spend 95% of our time. Signs were posted near their blood gas machine that encouraged a brief mindfulness exercise while waiting for the specimen to process. The oneED program also offers other activities, lectures, and video stories during a weekly lunch session for those interested and able to attend.

Adopting Wellness Initiatives

Dr. Braganza recommends finding the right time to make a department-wide change, which may be now in today’s blossoming wellness culture. Securing buy-in from department leadership and creating a cohesive spirit in your department may be the hardest part. She recommends focusing on normalizing and prioritizing wellness as a way to enhance performance rather than fix a problem. Emerging research related to wellness, work culture, and patient outcomes may serve as a useful tool to achieve buy-in.

At the individual level, we can serve as a positive emotional contagion, creating a wellness mindset for our team and our patients. We can engage in the conversation about EM physician wellness, our vulnerability, and our responsibility to address some of the challenges inherent in our work. Dr. Braganza states we are striving for more of a lifestyle change rather than a fad diet; we are part of a wellness evolution rather than a revolution.

Closing Thoughts

Next time you’re trudging through the ED with a negative or exhausted attitude, remember that you are a leader, you are an emotional contagion, and you have the potential to affect the mindset of everyone on the team. As the saying goes, “smiles are contagious.”

1.
Braganza S, Young J, Sweeny A, Brazil V. oneED: Embedding a mindfulness-based wellness programme into an emergency department. Emerg Med Australas. March 2018. [PubMed]
Alecia Gende, DO

Alecia Gende, DO

ALiEM Wellness Think Tank Wellness Champion
EM Resident
Department of Emergency Medicine
University of Iowa Hospital & Clinics