Activity 1 A Pair work What are the people below doing? Do they have healthy lifestyles? Describe them using these words and your own ideas. active fit lazy stressed busy healthy relaxed unhealthy “He’s eating junk food and watching TV. He looks lazy and .” B Pair work Look at these suggestions for having a healthier lifestyle. Add two more. Then check () the ones you think you can do. get up early and go for a run go for a bike ride go to gym take a long walk ride a bike to class go swimming walk instead of taking the bus go dancing with friends eat a good breakfast avoid all junk food _______________________ ________________ C Join another pair Compare your answers from part B. Why can’t your partners do some things? “Why can’t you go to a gym?” “ I’m too busy, and it’s expensive!” Activity 2 A Pair work Look at these people. What do you think each person’s problem is? “I think Kris wants to lose weight.” B Listen The people are now calling a radio show called “ How Can I Help?” Check () the advice each caller receives. Advice Agree? Kris Have fruit, not candy. Eat a good breakfast Yes / No Avoid all snacks Exercise more Yes / No Tim Don’t work late on Fridays Take a vacation Yes / No Sleep late on weekends Work on weekends a little Yes / No Jill Take long walks Quit your job Yes / No Get a hobby Learn to relax Yes / No C Listen again Do you callers agree with the advice? Circle Yes or no. Activity 3 A Pair work Take this survey. Ask your partner the questions, and check () the answers. Then go to page 92 to score the survey. 1. How much fruit do you eat? none some a lot 2. How much junk food do you eat? none some a lot 3. What do you usually drink? coffee tea soda water 4. How often do you exercise? never sometimes often all the time 5. How often do you get sick? never hardly ever often all the time 6. What do you usually do to reduce stress? sleep eat exercise nothing B Pair work Do you agree with the analysis? Who has a healthier lifestyle? Activity 1 Pair work Look at these pictures. Then discuss the questions below Do you ever sleep in class? at work? on the bus or train? Can you sleep anywhere, or do you need a comfortable bed? Is it ever difficult for you to get to sleep? Why? I never sleep during class “Yes, You do?” Activity 2 A Pair work What do you know about sleeping and dreaming? Check () True or False. Sleeping and dreaming True False 1. Women sleep more than men 2. A sound sleeper moves less than a light sleeper. 3. Most people need nine hours of sleep a night. 4. Reading in bed helps you sleep. 5. Some people don’t dream at all. 6. The average person has about four dreams a night. 7. Not everyone can remember his or her dreams. 8. Eating before bed can give you nightmares. B Listen You will hear an expert talk about sleeping and dreaming. Were your guesses correct? C Listen again Correct the false statements. D Group work Discuss these questions How much sleep do you get during the week? On weekends? Do you ever take naps during the day? How do you feel afterward? Do you usually remember your dreams? Do you ever dream in English? “I sleep about six hours a night during the week, but on weekends I sleep .” [...]...Activity 3 A Pair work Take this survey Ask your partner the questions, and check the answers Then go to page 92 to score the survey B Pair work Do you agree with the analysis? C Join another pair Discuss these questions What’s the longest you’ve ever stayed awake? What’s the longest you’ve ever slept? How do you feel if you sleep too much? What do you do if you can’t sleep? Are you an “early... you feel if you sleep too much? What do you do if you can’t sleep? Are you Practice a healthy humility Practice a healthy humility Bởi: Joe Tye “To understand man’s significance, I saw, you must first accept his insignificance Only then could you focus him into importance against this stupendous, unshruggable background [of the Grand Canyon] And now, accepting this vision utterly, accepting it without fear and with joy, I had, for the time being at least, found all I needed.” Collin Fletcher: The Man Who Walked Through Time The first time I ever hiked in the Grand Canyon I had recently been terminated from my job as a hospital chief operating officer, had no idea what to next, and was frankly terrified A week in this vast, natural cathedral did not bring any answers, but it did help me start to ask better questions The humbling experience of feeling totally insignificant in a canyon millions of years in the making, sleeping under the light of billions of stars – light which had traveled billions of years before reaching my eyes – was, I think, an essential factor in being able to give up the ego-driven dream of being a highly-paid big shot executive and beginning the quest to find my real purpose here It might be the ultimate paradox: when your world has been turned upside down it is easier to accept your insignificance on the cosmic scale but, as Fletcher says, that is often the essential first step to truly grasping your significance on the human scale 1/1 1 Promoting a ‘Healthy City’ for Elderly People in Tseung Kwan O Dr Lam Ching Choi, Medical Director, Haven of Hope Christian Service Introduction Tseung Kwan O (TKO) is designated as one of the few strategic growth areas in Hong Kong SAR. Around 300,000 people have now moved into this district. The population is projected to be 520,000 upon full development. Of the 300,000 people residing in TKO, 9.9% are 60 years and over, making TKO the fourth youngest district in Hong Kong. Like other developing new towns in Hong Kong, TKO faces common urbanization problems such as insufficient local employment opportunities and the consequent need to travel to work sites outside the district, time lag in provision of various services and facilities, nuclear families detached from support network, etc. All these, adding up, constitute threats detrimental to the health of people residing in TKO. Thus, whilst the Government was actively building the hard infrastructure of TKO, Haven of Hope Christian Service, with her 30 different service units started the ‘TKO - Healthy City’ project in 1998 to work on the soft aspects of the budding district. Today, the ‘TKO - Healthy City’ project is adopted by the Steering Committee of the project and is recognized as a regular committee under the Home Affairs Department. This paper aims to present the experience of Haven of Hope Christian Service and the Steering Committee in promoting ‘Healthy City’ for elderly people in the local district. The premise is that in promoting ‘Healthy City’, healthy aging is promoted. Definition of Health ‘Health’ was once defined as ‘the absence of illness or infirmity’. The progressive definition of health adopted by the World Health Organisation (WHO) is ‘a state of physical, social and psychological well-being, having harmonious family and inter-personal relationships, and a stable social support network, besides being able to enjoy life and attain one’s fullest potential’. With such a definition, there are implications. The determinants of good health are not just good personal health habits, but inter-relatedness to wider issues is implied. Everyone and everything is inter-dependent for good health. The physical, economic and social environments have their direct and inter-related impacts on personal health. HEALTH IS NOT JUST THE RESPONSIBILITY OF THE HEALTH CARE SECTOR. For all of us who have experience in services for our elderly people, we know for sure that this is so true. 2 Healthy Cities Project The Healthy Cities Project was first promoted by the European Office of the World Health Organisation in 1985 and since has been adopted by WHO world-wide to work toward ‘Health For All’. There are now more than 1,200 cities participating in this movement. Our Seven principles have been laid down to guide the implementation of ‘Healthy Cities’. The principles include : 1. Inter-sectoral collaboration : Working partnership relationships are promoted and cultivated amongst local government and non-government service providers and organizations. This is to facilitate a concerted approach in meeting the total needs of the community. 2. Community participation : People are well aware of their needs and hence should be encouraged to voice out their opinions and empowered to take part in all activities affecting their health. 3. Equity in health : It is considered that every individual should have a fair opportunity to attain their full health potential. 4. Health promotion : Every individual has a role to play Cooking for Tw o A HEALTHY EXCHANGES ® COOKBOOK JoAnna M. Lund with Barbara Alpert A Perigee Book Cooking for Tw o Also by JoAnna M. Lund The Healthy Exchanges Cookbook HELP: The Healthy Exchanges Lifetime Plan Cooking Healthy with a Man in Mind Cooking Healthy with the Kids in Mind Diabetic Desserts Make a Joyful Table Cooking Healthy Across America A Potful of Recipes Another Potful of Recipes The Open Road Cookbook Sensational Smoothies Hot Off the Grill: The Healthy Exchanges Electric Grilling Cookbook Cooking Healthy with Splenda Cooking Healthy with a Microwave The Diabetic’s Healthy Exchanges Cookbook The Strong Bones Healthy Exchanges Cookbook The Arthritis Healthy Exchanges Cookbook The Heart Smart Healthy Exchanges Cookbook The Cancer Recovery Healthy Exchanges Cookbook String of Pearls Family and Friends Cookbook JoAnna’s Kitchen Miracles When Life Hands You Lemons, Make Lemon Meringue Pie Cooking Healthy with Soy Baking with Splenda Cooking for Tw o A HEALTHY EXCHANGES ® COOKBOOK JoAnna M. Lund with Barbara Alpert A Perigee Book THE BERKLEY PUBLISHING GROUP Published by the Penguin Group Penguin Group (USA) Inc. 375 Hudson Street, New York, New York 10014, USA Penguin Group (Canada), 90 Eglinton Avenue East, Suite 700, Toronto, Ontario M4P 2Y3, Canada (a division of Pearson Penguin Canada Inc.) Penguin Books Ltd., 80 Strand, London WC2R 0RL, England Penguin Group Ireland, 25 St. Stephen’s Green, Dublin 2, Ireland (a division of Penguin Books Ltd.) Penguin Group (Australia), 250 Camberwell Road, Camberwell, Victoria 3124, Australia (a division of Pearson Australia Group Pty. Ltd.) Penguin Books India Pvt. Ltd., 11 Community Centre, Panchsheel Park, New Delhi—110 017, India Penguin Group (NZ), Cnr. Airborne and Rosedale Roads, Albany, Auckland 1310, New Zealand (a division of Pearson New Zealand Ltd.) Penguin Books (South Africa) (Pty.) Ltd., 24 Sturdee Avenue, Rosebank, Johannesburg 2196, South Africa Penguin Books Ltd., Registered Offices: 80 Strand, London WC2R 0RL, England Copyright © 2006 by Healthy Exchanges, Inc. Diabetic Exchanges calculated by Rose Hoenig, R.D., L.D. Before using the recipes and advice in this book, consult your physician or health-care provider to be sure they are appropriate for you. The information in this book is not intended to take the place of any medical advice. It reflects the author’s experiences, studies, research, and opinions regarding a healthy lifestyle. All material included in this publication is believed to be accurate. The publisher assumes no responsibility for any health, welfare, or subsequent damage that might be incurred from use of these materials. All rights reserved. No part of this book may be reproduced, scanned, or distributed in any printed or electronic form without permission. Please do not participate in or encourage piracy of copyrighted materials in violation of the author’s rights. Purchase only authorized editions. For more information about Healthy Exchanges products, contact: Healthy Exchanges, Inc. P.O. Box 80 DeWitt, Iowa 52742-0080 (563) 659-8234 www.HealthyExchanges.com PERIGEE is a registered trademark of Penguin Group (USA) Inc. The “P” design is a trademark belonging to Penguin Group (USA) Inc. This book has been cataloged by the Library of Congress ISBN: 1-4406-0382-0 Dedication This cookbook is dedicated in loving memory to my parents, Jerome and Agnes McAndrews. They were married for over forty years; in those years Mom cooked wonderful meals that served only the two of them and she prepared enough to serve our entire family when we gathered together to break bread. Whatever the Overcoming Secondary Stress in Medical and Nursing Practice: A Guide to Professional Resilience and Personal Well-Being ROBERT J. WICKS OXFORD UNIVERSITY PRESS Overcoming Secondary Stress in Medical and Nursing Practice This page intentionally left blank Overcoming Secondary Stress in medical and nursing practice A Guide to Professional Resilience and Personal Well-Being robert j. wicks 3 2006 3 Oxford University Press, Inc., publishes works that further Oxford University’s objective of excellence in research, scholarship, and education. Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offi ces in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam Copyright © 2006 by Oxford University Press, Inc. Published by Oxford University Press, Inc. 198 Madison Avenue, New York, New York 10016 www.oup.com Oxford is a registered trademark of Oxford University Press All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Oxford University Press. Library of Congress Cataloging-in-Publication Data Wicks, Robert J. Overcoming secondary stress in medical and nursing practice : a guide to professional resilience and personal well-being / Robert J. Wicks. p. cm. Includes bibliographical references and index. ISBN-13 978-0-19-517223-2 ISBN 0-19-517223-X 1. Physicians—Job stress. 2. Nurses—Job stress. 3. Medical personnel—Job stress. 4. Physicians—Mental health. 5. Nurses —Mental health. 6. Medical personnel—Mental health. 7. Burn out (Psychology)—Prevention. 8. Resilience (Personality trait). 9. Self-care, Health. 10. Stress management. I. Title. [DNLM: 1. Burnout, Professional—prevention & control. 2. Allied Health Personnel— psychology. 3. Nurses—psychology. 4. Patient Care—psychology. 5. Physicians—psychology. WM 172 W 637o 2005] R707.W535 2005 610.69'01'9—dc 2004026508 9 8 7 6 5 4 3 2 1 Printed in the United States of America on acid-free paper For the students, staff, and faculty of Stritch School of Medicine and Wright State School of Medicine and the nurses in my family and close circle of friends— My wife Michaele Barry Wicks My sisters-in-law Deborah Kibble and Margaret Wicks My cousins Ruthanne Croal, Annemarie Belanger, Helen Sue McNamara, Mary Kate O’Brien, and Nancy Keating My nieces Christine Candio and Chemin Malone and My close friends, who were also classmates of my wife at St. John’s School of Nursing—Susan Ferraro and Dorothy Sicinski This page intentionally left blank Foreword D enial is one of the best-developed coping refl exes in health care workers, particularly in physicians and nurses. It exists on several levels, and it is provoked by a number of different but related dynamics. Most of us in health care—in the profession of caring for patients— have thought of denial as a self-protective reaction, a shield against the emotional and psychic turmoil of the environment in which we work. And for physicians and nurses, where they work is essentially where they live. It is a well-worked and commonly described dynamic. It is also oversimplifi ed in its construct and terribly underestimated for its impact on Top Ten Tips for a Healthy, Glowing Skin Many of us are skin conscious. We often want our skin to look young and healthy and we really do something just to protect our skin from whatever possible harms there may be in our environment. Well, our skin is our largest organ performing several functions. It primarily protects us against the invasion of foreign substances and it serves as the transfer point for the release of toxins from our bodies, thus our skin is just worthy of protection and care. Now, if you found yourself coveting the gorgeous skin of fashion models and celebrities in most of today’s magazines, here are some tips that will help you on for a beautiful skin. Tip #1: Drink Water It is often said that the simplest way to clear and supple skin that is no longer dry is to drink plenty of water. Water has long been considered as the most effective natural treatment or an almost free treatment for any skin condition because of its being alkaline, with pH 7.3. It prevents dehydration which is capable of producing sebum or oil from the sebaceous glands. Your skin needs water in order for it to function best, thus doctors and nutritionists recommend that a daily intake of between 6 to 8 glasses of water per day is highly needed. Tip #2: Watch Your Diet Nutrition plays a vital role in skin health too. Specific foods such as those acidic foods and dairy products are said to be potent in causing an allergic reaction in some people. Also, one of the widely debated topics in the area of nutrition today is chocolates. Some say that chocolate does affect the condition of the skin, while others say it doesn’t. Whatever the result may be, the best recommendation is just to follow a nutritious diet that has a number of fresh fruits and green-leafy veggies, as well as fiber. Tip #3: Consider Exfoliants Many experts say that exfoliating your skin is another great way to attain a beautiful skin. So, try to invest in a good body exfoliant or “loofah”, as it is commonly called, as it is capable of eliminating the dead skin cells from your body. Accordingly, this should be done once or twice a week so to free the skin to breathe. What’s more, exfoliants help to prevent ingrown hair from developing. However, it is necessary to avoid using any body exfoliant on the skin on the face. The main reason for this precaution is that the facial tissue is more sensitive and finer than those tissues of the body. Today, there is a myriad of exfoliating sponges in the market, as well as a number of really good exfoliant gels that are especially formulated for the skin on the face. Nevertheless, one of the necessary things to note is that those people with skin affected by acne should not apply exfoliating gels or sponges, as these may aggravate the acne infection. Try to consider those exfoliating products for acne prone skin in the form of a skin peeling treatment instead. These products are now commonly offered my most salons anywhere in the world. And, perhaps what is best to consider is to consult a skin specialist before undertaking any form of skin peel. Tip #4: Consider a Healthy Routine for Facial Care When it comes to facial skin care, getting into a healthy beauty routine is not bad. Most of