THRIVING AMIDST CHAOS:
The V.A.A.R. Mantra Solution
Presented by:
Carol Shelby and Dr. Vineeth John
University of Texas Medical School
Houston, Texas
A Typical Monday Morning
• Delinquent ACLS cards and the site rotation
threatening immediate suspension
• Resident forget to notify the RT ofc about absence
• Delinquent patient logs
• Delinquent evaluations (residents/faculty)
• Residents not meeting mandatory survey deadlines
• Faculty wanting to fire the resident mid rotation
• Residents taking off early and site supervisor livid
• Lectures cancelled last minute, poor attendance
• Residents not paying much attention to critical
important emails
The Life of a Residency Coordinator
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Busy
Chaotic
Cyclical
Constant evaluations
Being evaluated
Multiple interface systems
Multiple stakeholders
Balancing service, education, and budget
Who are we though really?
How Do We Survive?
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Personal qualities
Motivation
Time management skills
Organizational support
CHAOS AFTERMATH
Balancing Tasks
Toxic Work Place
CHAOS
Mistaken Intentions
Misinterpretations
Daily Hassles
Constant Interruptions
Multiple Interfaces
Frequent Rejections
CHAOS AFTERMATH
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We lose our values?
We forget who we are?
We stop being generous?
We give up too soon?
Need blueprint to help guide us
V.A.A.R. Mantra
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We lose our values?
We forget who we are?
We stop being generous?
We give up too soon?
Virtuousness
Authenticity
Altruism
Resilience
Whitehall study
 Imbalance in effort and reward
 Low levels of control in one’s job
Whitehall study
Virtuousness
Authenticity
Altruism
Resilience
 Aspiring to be at one’s best
 Doing the right thing; all the time
 Meaningful purpose
Source: Lipman-Blumen & Leavitt, Becker, Eisenberg
 Better Decision making
 Increased Creativity
 Enhancing social capital
Virtuous Action 1
AMPLIFY
Virtuous Action 2
Traumatic Events
Organizational
Virtuousness
BUFFER
Negative Outcomes
- Kim Cameron
www.kamat.com
Knowing others is wisdom
Knowing oneself is enlightenment
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- Lao Tzu
• Know your story
 Manifest your values
 Find your own voice
 Shame
 Guilt
 Perfectionism
“We cultivate love when we allow our most vulnerable
and powerful selves to be deeply seen and known, and
when we honor the spiritual connection that grows from
that offering with trust, respect, kindness and affection.”
“ Shame, blame, disrespect and betrayal and the
withholding of affection damage the roots from which
love grows. Love can only survive these injuries if they
are acknowledged, healed and rare.
-Brene Brown, PhD
 Practice courage and reach out:
 Talk to self with self-compassion:
 Own the story:
Photo - Gregory Heisler
 Selflessness
 Practice or principle which keeps other’s wellbeing a
priority
 Increases the fitness of others while decreasing the
fitness of others (Evolutionary approach)
Givers vs. Takers
Givers –
Injected Energy
Created opportunities
Respected others
TakersSucked energy
“Black holes”
Energy Vampires
- Craft your job so that you can give more
- Practice five minute favors
- Seek help more often
Adam Grant
www.giveandtake.com
 Strength in the midst of change and stressful
life events.
Physical
Social
Resilience
Psychological
Spiritual
 We shape our network
 Our network shapes us
 Our friends affect us
 Our friends’ friends affect us
 Network has a life of his own
HAPPINESS AND SOCIAL NETWORKS appin in the Framingham social network.
Fowler J H , Christakis N A BMJ 2008;337:bmj.a2338
©2008 by British Medical Journal Publishing Group
Scatterplots showing increase in fitness (VO2 peak) is related
to increase in hippocampal volume cm3
Correlations significant for both left and right
(even after including age, sex, years of education as covariates)
Erikson Ki et al. Hippocampus. 2009;19:1030-1039.
Reduction in opioid receptor
availability after exercise (red
is P<0.05)
Boecker H et al. Cereb Cortex. 2008;18(11):2523-2531.
Physical
Social
Resilience
Psychological
Spiritual
Jeff Widener/ Associated Press
“ The common experience …..of being carried away by an
outside force, of moving effortlessly with a current of
energy at moments of highest enjoyment”
- Mihaly Csikzentmihalyi
HIGH
ANXIETY
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L
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N
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FLOW
BOREDOM
LOW
SKILLS
HIGH
 Goals are clear
 Feedback is immediate
 A balance between opportunity and capacity
 Concentration deepens
 The present is what matters most
 Control is no problem
 The sense of time is altered
 The loss of ego
-Mihaly Csikzentmihalyi
“ Flow is a state of self forgetfulness, the opposite
of rumination and worry… In this sense moments
of flow are egoless. Paradoxically, people in flow
exhibit a masterly control of what they are doing..
And although people perform at their peak while
in flow, they are unconcerned with how they are
doing, with thoughts of failure or success- the
sheer pleasure of the act itself is what motivates
them”
-Daniel Goleman