'Choosing Joy' at Work Can Help Cancer Care Team Increase Resilience and Reduce Burnout

Oncology is a high-stress field. Regulatory complexity continues to grow, while medical developments require staff to constantly learn about new treatments and changes in protocols. With limits on staffing and increased workloads, the healthcare team often feels overwhelmed. Not to mention the emotional toll of daily contact with patients coping with illness. How can oncology teams become more resilient in the face of these challenges?

At the Association of Community Cancer Centers 35th National Oncology Conference (NOC) in Phoenix, Arizona, featured speaker Vicki Hess, RN, MS, shared her answers to that question, kicking off the conference with a presentation focused on the year’s key theme: creating a resilient, results-driven oncology team.

The goal, Hess said, is to consider what brings one joy at work and then incorporate that into daily practice. Each individual should assess what makes them feel satisfied, energized, and productive at work. In that way, they can become "chief paradise officer" of their own jobs no matter what is happening around them, and in turn, they become more engaged.

The elements that make someone satisfied, energized, and productive differ from person to person. For an oncology nurse working in an infusion center, it could be the relationships they build with people over time. For a manager, it could be watching their staff grow and develop. For a nurse practitioner, it could be finding a treatment plan that makes a real difference in someone's quality of life.

In many organizations, the culture contains the belief that it is the leader of the organization's job to create optimal workplace culture. In Hess’ paradigm, it is a tripod: the organization, the leader, and the individual all need to take responsibility for employee engagement, effectiveness, and results.

According to Hess’ "professional paradise" paradigm, “your beliefs drive your mindset, which drives your actions, and ultimately your outcomes,” she said.

To change beliefs, employees must change the way they respond to stimuli, and internalize a process that increases joy. One cannot always control the stimuli, but they can train themselves to choose how to react to them, Hess explained.

A poll of the audience at the presentation revealed that difficult people at work were the leading stressor encountered by attendees. Though one cannot control others’ actions, one can use mindfulness practices to control their own reactions to them, Hess said, adding that when a person is better able to control their reactions, they feel more powerful and more empowered.

According to Hess, three ways to shrink the effect of negative external stimuli at work are to:

• Lose the attitude. When someone has an attitude at work, it is because they want to be right, or they feel entitled. But if one can shake off negative responses, they free themselves from the feelings that cause a cloud of negativity that follows.
• Let it go. Often at work, employees rehash something that has happened in the past, and keep talking about it and complaining about it.
• Step up and get involved. If one connects to what makes them feel satisfied, energized, and productive, they will feel empowered to effect change. These coping skills can enable them to take ownership of their problems and solve them.

“It's not what happens to you, it's how you deal with what happens to you (that matters),” Hess said in an interview with Oncology Nursing News. “I might not be able to change whether the copier is broken, but I can change how I am responding.”

In addition to controlling one’s reactions, Hess added, one must actively pursue things that make them feel satisfied, energized, and productive. In other words, “choose joy.”

One way to pursue joy is by spreading appreciation. “You feel good when you are the appreciator, and you feel good when you are the appreciate(d),” she said.

Another way is to develop an attitude of gratitude, actively creating triggers in one’s mind. Choose something that is that is already happening, that can trigger an emotion of gratitude. Hess’ triggers are food, and when she is washing her hair. At those times of the day, she takes a moment to be grateful in the moment.

“It’s simple things. Maybe when you’re pulling into the parking lot at work,” she said. “Maybe it’s when you get your team together in a huddle…Working in oncology, we know, there are a lot of things to be grateful for. You want to put it into the fabric of the day. You want to embody it so people can own their own gratitude.”

“There have been a tremendous amount of studies in the field of positive psychology that show that gratitude really does change the physiology of your body,” she added. “It definitely benefits you from a health perspective. It doesn’t cost anything. Doesn’t require advanced skills. It doesn’t even require a lot of time. It just requires attention. What are the triggers?”

A third strategy for increasing joy, Hess noted, is to “keep discussing what matters most.” Put things in perspective and consider what is really important.

Hess recommended a 5-step process to effecting these changes—the SHIFT process, an acronym for:

• Stop and breathe
• Harness harmful knee-jerk reactions
• Identify and manage negative emotions
• Find new options
• Take one positive action

“If you get really good at the first step, you might not even need the other four,” she said.

Incorporating mindfulness into one’s personal practices—Hess suggests thinking of it as “breathing in what you want to attract and breathing out what you want to let go,”—can make a significant difference for the individual and ultimately, for the entire care team.