Ahead of GIANT STEPS 2019 we caught up with one of our speakers, Dr Shahina Braganza, to find out what’s in store for her session and why finding joy at work is so important.
Shahina is a senior staff specialist in emergency medicine at Gold Coast Health and founder of the oneED staff wellness program, an initiative that embeds practices of wellbeing into daily activities.
We hear a lot about ‘joy at work’. What does ‘joy at work’ mean to you?
I have just worked a run of shifts in our ED. It was busy with sick patients and a heavy workload, with limited space and resources as the whole hospital was full so movement though our ED was affected by this. It would have been easy to feel overwhelmed during my shifts, and exhausted after them.
However, I was working with a spectacular team. In particular, nursing team leader Brett heavily influenced my emotional experience of my work. He leads from the frontline - as comfortable and willing to defibrillate a young man in cardiac arrest as he is to clean an elderly lady who has soiled herself. As he conducts his work, he is energetic and cheerful, and we share many laughs along the way.
I carried this sense of levity into the interactions I had with other staff and with patients. Rather than feeling overwhelmed and exhausted, I in fact felt enthused and capable (and safe). To me, this is how joy at work translates into better performance, and ultimately to better patient care.
You are particularly interested in the ‘non-technical’ skills in medicine. What do you think these skills offer that technical skills don’t?
I remember seeking a recommendation for a surgeon to look after a family member. I was given a list of options, one being described as "She doesn’t have a great bedside manner, but she’s a good cutter".
Imagine a surgeon who is excellent with a scalpel but less adept at communication or perhaps with empathy. A patient will likely be in safe hands during their care, but they would also like to be confident that the surgeon’s junior assistant felt comfortable asking for help or that the scrub nurse felt empowered to query an approach. They would also really like to know that the surgeon understood what was important to them and had the capacity to properly care.
There is no competition or conflict between the two sets of skills - a good clinician embodies both. We are yet to find an effective term for what we call ‘non-technical skill’ - one that captures professional and humanistic approaches that extend the impact of delivering good technical care. Yet an increasing body of work in this area demonstrates that it clearly takes these global skills to provide safe and quality patient care.
What led you to establish the oneED program?
I have worked in my ED for 17 years. In my first year there, I experienced an episode of burnout and my boss rescued me, mainly with the words “I’ve been there”.
I feel that in healthcare our challenges are compounded by the perception that if we struggle, then we struggle alone - because we believe we are the only ones having difficulty and everyone else seems to be just fine. Of course, this is not true. We are all capable, well-prepared and well-intentioned and it is a normal part of our human experience that we will have an emotional response to what we witness each day.
oneED was built in 2016 simply to start the conversation around wellness and struggle - to make the statement that “We get what it’s like to be who we are, and to do what we do - and we are here to support and look after each other”.
What positive changes have you seen since it first rolled out?
You know, it would be difficult to present figures on what has changed or improved. One of my colleagues said it best when he said:
“Whether or not weekly mindfulness practice helps staff is really hard to measure – there are so many other factors that can affect how someone feels. I’m uncomfortable with trying to measure things like this, but I would say that certainly these activities make people feel appreciated and that they are not alone. [The program] definitely has positive benefits on a subconscious level that are intangible or cultural, and reminds people of what is important.”
The program is fluid and organic, and we leverage its 'brand' to promote other activities. For example, we've done a clothing donation drive, had a team compete at the Gold Coast marathon and now we plan to do the push-up challenge to raise money for Headspace.
You recently wrote about having ‘imposter syndrome’. Do you think this is something commonly experienced by women in medicine?
Yes! Without a doubt. And, actually, by men also. We likely just manifest it differently.
Pauline Clance, one of the psychologists who first coined the term back in 1978, said "If I could do it all over again, I would call it the impostor experience, because it's not a syndrome or a complex or a mental illness, it's something almost everyone experiences.”
I think this is important because reframing the description shifts one's perspective to help them understand they are not isolated in this experience - and, again, not feeling alone is key.
Why do you think people question their own success?
That’s a great question, and I won’t pretend to have an answer that applies to everyone (#imposter!)
I’ll speak from my personal experience: We grow up working hard to learn and acquire knowledge and skills. We learn that there is always more to learn, and we learn about how things can go wrong - this induces anxiety that perhaps we won’t know enough, or do enough, or indeed be enough.
It is really important to remain humble and acknowledge that we may in fact lack capability at times. Where we run into trouble is when we place unrealistic expectations upon ourselves, or when we perceive others’ expectations to be at a certain level. The gap between what we think our capability is versus where we think it should be can make us feel like imposters, and this feeling can be crippling. For me, it has helped to learn to embrace my own vulnerability and imperfection - to learn that I am enough. (It’s a work in progress…)
What can we expect from your GIANT STEPS session?
Andy [Tagg] has assured me he won’t be dancing. He doesn’t know that I just might.
I would love for attendees to leave our session understanding at a cognitive level why Joy at Work is something that we should invest in at individual and organisational level. So that they can return to their workplaces and conduct dialogues with decision-makers about how this can be enhanced in their own contexts.
I would like to share the lessons that we have learned from our own program - the vital ingredients, what has worked well, what failed miserably, and what we have modified. Mostly, I would love for them to leave having experienced at an emotional level what joy at work can actually feel like.
Catch Shahina presenting ‘Joy at work: Not just the kind thing to do, but the smart thing to do’ alongside Andy Tagg at GIANT STEPS, 21–22 November 2019 in Melbourne. Limited tickets available, book your place now