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What is an Athletic Trainer?

Athletic trainers are health care professionals who collaborate with physicians and other health care professionals to provide preventative services, emergency care, clinical diagnosis, therapeutic intervention and rehabilitation of injuries and medical conditions. For more information regarding the profession of Athletic Training visit the NATA.

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March 25, 2020 BLOG

For our final installment for OATS women in history and National Athletic Training Month we have chosen to spotlight Jennifer Krug.

 

Jennifer Krug received a Bachelor’s of Science in Physical Education from Western Baptist College (now Corban University) and her Master’s of Science in Health and Fitness Promotion from Portland State University.  Jennifer is currently the Head Athletic Trainer at Dallas High School in Dallas, Oregon.  Jennifer was drawn to the profession at a very young age.  Growing up Jennifer described,

 

(When I was young) I would beg to go to the doctor’s office anytime someone needed to go so I could learn as much as possible.  When hiking on a 5 day trip on the Pacific Crest trail, my older brother rolled his ankle and I didn’t know how to help him.  It bothered me that I didn’t have a solution.  Initially, I thought my only option was to become a nurse or a doctor, but since I’m not a fan of bodily fluids it created a huge problem.  However, when in college a new health professor came on staff and told me about this sports medicine field that combines sports and medicine.  It prompted me to take a class called Athletic Training, and well, here we are a few years or more down the road! 

 

When asked to describe the most significant event in her career, Jennifer had some difficulty picking a single moment, rather she described the “many moments in a career with colleagues, coaches, administration, support staff and of course athletes”.  Jennifer mentioned the “happy moments as you see your athletes graduate, come back from an injury, persevere through difficult circumstances, become athlete trainers, marry, have kids, become teachers, coaches and role models”.  

 

Jennifer has had a number of professional mentors.  Some of those she mentioned included, Barrie Steele, Tom Koto, Russ Richardson, Jimmie Whitsel and Mark Smaha.  Jennifer also noted the influence of Jim Wallis at Portland State University, who she stated, 

 

… consistently directed, pushed, shoved and even allowed me to struggle.  He gave me the opportunity to grow while learning the why, what, how, when and where in the athletic training world.  He also encouraged me to stay involved in the field, attend conferences, and give back to my industry.  His advice to pay attention to those who are leading and learn from them because someday those leaders would be us always stuck with me.  

 

Jennifer’s advice for a new graduate was to.

 

Always do the right thing for your athletes.  Never stop learning.  Don’t be arrogant.  Get involved.   Learn how to do things without all the fancy equipment.  Know WHY you are doing something.  Have a purpose.  Laugh.  Don’t be afraid to say no.  Take care of yourself.  Repeat.  

 

 

March 20, 2020 BLOG

Compassion Fatigue and Burnout: What is it and what can you do when you are at your limit?

​Briana Orlob, MS, LAT, ATC

 

I had a hard time admitting to myself that I was/am experiencing burnout. Sure there were plenty of good days and I knew I still loved my job, but I had this growing feeling of loathing towards it at times and it honestly scared me. How could something I love so much start becoming something I hate? How could I resent my patients for needing my help when helping others is why I chose this profession? My goal in discussing the topic of burnout and compassion fatigue is not to shame our profession and just live with “that’s just how it is,” but to begin a conversation and open up more about the realities of what happens to care providers in stressful jobs. And ultimately what we can do to combat this major issue in our profession.

 

Burnout:

Burnout is described as a psychological state of mental weariness that often occurs when work stresses become too much for an individual to handle. It has three distinct dimensions:

 

Emotional Exhaustion

Depersonalization

Decreased Personal Accomplishment

You begin to fall into a state of physical and emotional depletion that leads to reduction in care for patients, which is accompanied by a negative sense of one’s worth and ability. Heavy stuff, I know, but these symptoms don’t occur over night. I often tell my distance runners that see me for chronic issues that their injuries occurred over time, with hundreds and thousands of steps in every workout they do. Burnout is also manifested in the same way over a long period of time by many stress factors such as amount of time in a career, hours worked, patient load, home stresses, lack of physical activity, the list is quite long. All of this can lead to huge long-term consequences, things that if we saw in our own patients we would do anything to help change that negative trajectory! Our ability to do our jobs well is at risk and could even lead to negligence. Worst of all is the negative impact in your own health, the mental, emotional, social, and physical aspects.

Compassion Fatigue:

The TedTalk from this link really describes this well: https://www.compassionfatigue.org/

Compassion fatigue differs from burnout in that it is associated with the work you do whereas burnout arises from where you work. Compassion fatigue is defined as an overexposure to suffering and pain that can cause personal stress and a reduced ability to be empathetic. It can be seen in four phases:

  1. Zealot Phase

    1. Overflowing enthusiasm, willing to go the extra mile, work late, ‘I can handle this,’, overcompensating stress with more work.

    2. May experience rapid heartrate, aches and pains, anxiety, due to stress.

  2. Irritability Phase

    1. Becoming easily distracted, cutting corners, making small mistakes, become cynical and begin feeling under-valued for all of the extra work you have been putting in.

    2. Symptoms shown as becoming impatient, irritable, moody, and/or angry.

Compassion Fatigue, continued

  1. Withdrawal Phase

    1. Altered sleep patterns, repeated illnesses, lack of self-care, potential for negative coping techniques

    2. Self-entitlement of negative maladaptive behaviors, seeing patients as a burden, and withdrawing and detaching from those around you.

  2. Zombie Phase

    1. Going through the motions, very disconnected, mistakes are common, apathy.

    2. Potential for self-harm/harming others and the use negative coping techniques.

 

When I decided to finally make a change for myself and learn more about burnout and compassion fatigue, I felt so relieved to have an answer for everything that I had been experiencing. You know when you finally tell an athlete his or her diagnosis, good or bad, and often hearing the disappointment but also relief of having an answer. It brings trajectory towards a goal instead of swimming in the unknown. As both Erica and Sam pointed out in their blog posts, we have to have an awareness of what we are doing with our time and be able to take action and be intentional to make change. So if any of this rings true for you, there is a way out.

 

What to do with your burnout or compassion fatigue?

  1. Evaluate your Quality of Life.

    1. A great place to start is to fill out the Professional Quality of Life scale (https://proqol.org/ProQol_Test.html; https://proqol.org/uploads/ProQOL_5_English_Self-Score.pdf). The Proqol was specifically developed for caregivers and is a validated assessment tool.

  2. Talk to Someone

    1. Vulnerability is such a strong tool. We are all human and all struggle, please reach out to someone, a friend, a co-worker, a loved-one.

    2. USE AT CARES! I have personal experience with AT Cares and it was immensely helpful when I was experiencing a moment of crisis. Lisa Kenney is our NWATA AT Cares representative (and is amazing!).

    3. Seek Counseling. Many schools, especially in the college setting offer free counseling sessions. If we are willing to refer our patients, then be willing to use the services yourself. I have also looked into online counseling such as BetterHelp, which gives you 24hr access to a counselor, even over text!

  3. Set Boundaries

    1. Turn off your notifications when you are not at work, that ‘Do Not Disturb’ button is amazing. Most of what we deal with can wait, I promise.

    2. Read our other two posts by Sam and Erica, they both gave some useful tips when it comes to setting boundaries and taking time for yourself.

In closing, please be kind to yourselves and each other. I have listed some resources below if you are interested in learning more.

 

Thanks for reading,

Briana

Useful Links:

AT Cares

 

Compassion fatigue in service industry

 

Great infographic on Compassion Fatigue

 

Personality Traits and Burnout among Athletic Trainers Employed in the Collegiate Setting

 

Perceptions of Wellness and Burnout among Certified Athletic Trainers: Sex Differences

 

BetterHelp Online Counseling

 

 

March 18, 2020 BLOG

Linda McIntosh’s career spanned over 35 years, with much of it spent as a part of Pacific University.  Linda first served as the Head Athletic Trainer at Pacific University in 1988 and then after 25 years in this role, Linda took over as the Clinical Coordinator for the education program for the next 4 years before retiring.  Linda’s journey into athletic training was actually a “second career” for her.  Linda stated the she began as “a carpenter and licensed contractor”.  However after realizing the physical demands of this position, she turned her focus on the profession of athletic training.   Linda has a Bachelor’s of Science degree in Sociology from the University of Oregon, and “needed to take some prerequisite courses before entering U of O's AT program in 1983”.  One of the most significant event’s in Linda’s career, 

 

…. was the death of one of my athletes very early in my career.  His death from a head injury shaped my career and influenced my decision-making throughout my career as a Certified Athletic Trainer.  It gave me perspective and reinforced what is truly important in life.  I had always seen myself as an advocate for my athletes' good health and well-being.  This event made this idea the bedrock of my career.  

 

Another significant event for Linda was the opportunity to be part of the medical staff for the Paralympics in Atlanta.  Linda described it as a “truly awe-inspiring to witness what humans can achieve and overcome.  It inspired me to do my best to help my athletes achieve their goals”.

 

When asked about her mentors, Linda brought up Dr. Lou Osternig who was her advisor during her graduate studies at U of O.  Linda stated that he was instrumental in helping her get started in her career and helping her find my first job.  Linda stated that “Dr. Osternig was always available to me and graciously answered all my questions.  He mentored me during my first high school internship and I continued  to use him as a resource well into my 35 year career as an AT”.

 

Linda’s advice to new graduates was,

 

….find a life-work balance in your career that works for you.  You will be better able to serve your patients as they deserve if you are able to take care of yourself, as well.  Be true to yourself and remember what is important in life.  Advocate for your patients and remember who you are there to help.  

March 13, 2020 BLOG

Athletic trainers are master multitaskers and notorious for working 40+ hour work weeks regularly. Working so many hours leaves little time for ourselves and can leave many of us feeling conflicted when having to weigh competing professional and personal demands. We find ourselves looking for work-life balance, a concept that involves the effective management of one’s paid occupation with various personal roles and responsibilities. It’s important to note that these roles and responsibilities can vary from person to person as well as the priority assigned them at any given time. Lack of work-life balance has consequences like burnout, job dissatisfaction, organizational commitment, and turnover. In an effort to promote retention and decrease burnout in the profession, the NATA published a position statement in 2018 titled Facilitating Work-Life Balance in Athletic Training Practice Settings. Have you seen it? If not, we’ve shared a link below! So how can you organize your work day to maximize your time, increase productivity and fully disengage from work when the time comes? I’ve outlined some tips, tricks, and strategies I’ve found helpful along my professional journey below:

1. Know where your time is going

How much time do you truly have in a day or week? How long do you spend doing patient care? How much can you reasonably accomplish in a day or week’s time? How long do you get caught up checking social media or other time suck activities? When do you have the most energy to get things done? For me, I’m much more productive in the morning during the offseason before my patients begin to arrive and there’s less chance of getting distracted and my work flow being interrupted. During season I’ll scope out a quiet spot at the airport or on the team bus to get a few things done with minimal distraction. To minimize outside distractions, I often turn off the notification features on big group texts and social media apps.

 

2. Make a list

Once I’m home for the evening, I often find that I can’t get my mind off all of the things that I need to get done. Making a list serves before bed serves as a brain dump and preparation for the next day AND helps me clear my head so that I can get to sleep faster. This list is split into two parts, work and home. I then quickly prioritize this list by running it through 2 mental filters of what’s urgent and what’s important.

 

3. Prioritize effectively & strategically get going

The next day, I’m tackling the few work related items that are urgent and important FIRST! So often we hold off on completing the harder and more impactful task until it can’t wait any longer. So go ahead and send that email, make that phone call, finish that assignment and enjoy the feeling of relief when you’ve tackled that task! After slaying those giant to-do’s, focus on your important tasks that aren’t time sensitive and group like items together. Those items that are not important and not urgent I’m looking to delegate, outsource, or remove from my time all together when possible.

 

4. Strive to leave your work at work

I still struggle with this on occasion, but I consciously make an effort to leave my laptop at the office and avoid checking my email outside of work. Implementing boundaries (like Sam mentioned in last week’s blog) for non- emergent communication with coaches and student-athletes allows me to be fully present when I’m home for the day.

 

5. Know that it’s OK if you don’t get it all done 

There are only so many hours in the day. If you’ve checked off those big items but still have a few items left on your list, determine if they can wait until tomorrow. If you’re consistently not completing your to-do list, do you have co-workers that you can ask for help or an admin you can campaign to for more staff? No- body deserves to be on an island and you should never feel guilty for needing time off to tend to a person- al emergency, attend a wedding, or take a personal day. Having a support team in place you can bounce ideas off may help you further prioritize your to-do list as well. 

Working such a demanding job coupled with the seemingly endless tasks to be done can lead to burnout and decreased satisfaction with work and home life. When all is said and done, what are you doing for YOU? If you need more ideas for self-care, be sure to check out last week’s post. You can’t pour from an cup. Coming up next week, Bri will go into detail on compassion fatigue.

 

 

Useful Links: NATA Work-Life Balance Position Statement: HERE

 

 

March 6, 2020 BLOG

Implementing Self-Care Strategies: Ideas for setting boundaries, preventing burnout, and genuinely loving what you do

 

Sam Drewes, OATS YPC Member

 

When it comes to the field of Athletic Training, we rely heavily on our ‘innate’ skills as healthcare professionals; compassion and providing patient-centered care.  We stretch ourselves thin to work around team practices, events, games, provider meetings, clinical hours, and at times, even athlete requests. This can make it very difficult for us to schedule our own downtime and when (or IF) we do- the ‘guilt’ for allotting time to ourselves (AKA putting ourselves first) begins to set in.  I personally have felt myself combat this. Not to mention burnout. And what the heck is ‘Work-Life balance? Is it ever actually possible to achieve this? You may have asked yourself the same question.

Depending on who you ask, you could get an array of answers on achieving this so-called ‘work-life balance’. The bottom line is, I don’t believe it’s ever really in equilibrium as much as it is fluid- teetering back and forth from ‘busy’ to ‘less-busy with more free time’. It also requires us to differentiate what we believe to be ‘work’ and the enjoyment and fulfillment we get out of it. We love what we do, right? Isn’t that why we all became Athletic Trainers or allied healthcare providers?  Ask any healthcare professional why they do what they do and most often you will find a similar answer; “I enjoyed helping others.”  But this can come at a cost when ‘helping others’ turns into putting others’ needs above your own- and doing so consistently.  I find this comes in waves. As a high school athletic trainer I can attest to this burnout feeling during fall athletics season, especially as teams continue (successfully) through playoffs. I have experienced this in the collegiate setting as well- where off-season training can be just as demanding to our schedules as the competitive season is. This burnout can come in three forms: Overload, lack of professional development, and motivational burnout (https://www.dynatronics.com/blog/overworked-athletic-trainers). Recognizing WHY you might be feeling this way is the first step to effectively problem solving.

Boundaries are also an important factor in self-care. We talk about them all the time with our patients, yet how often do we set them for ourselves? How often do you consider your needs and *gasp* put them first? And this doesn’t always mean just in the workplace. This could be at home, with friends, with your family, you name it! Setting professional boundaries may look different than other boundaries in our lives, however they are just as important and stem from the same thing: your values.

While schedules may be hectic, there ARE ways recharge and avoid burnout. The following is a list compiled by a Women in Athletic Training survey and various healthcare professionals, asking what types of self-care strategies individuals use to maintain a healthy ‘work-life’ balance. Feel free to take what you need 😊 And we’d love to hear from YOU as well.

  • Exercise; join a gym that offers group fitness classes to hold you accountable

  • Walking their dog

  • Step outside for a minute, in-between patients

  • Surround yourself with non-work friends on occasion (co-workers tend to discuss work together, and this could lead to even more frustration, resentment, etc)

  • Meditation (try a guided meditation app such as Headspace)

  • Sleep

  • Focus on nutrition

  • Get a massage

  • Listen to a TED talk

  • Journal

  • Schedule a vacation

  • Breathing practice

  • Planning a mini ‘day-cation’ on their day off

  • If you have a work phone, turning it off once you get home

  • Be present with friends and family when you are not working (most things can wait)

  • DON’T check your email on your day off

  • Take a bath

  • Read a book (or check out Audible for more of a book on tape vibe)

  • Go for a run outside

  • Swap stretching services with another AT! (personally I love this idea) We work on patients and athletes daily- how often have you said to yourself ‘man, I wish someone would take care of me!’

  • Therapy (yes to this!)

  • Yoga

  • Meditating outdoors

  • Listen to a podcast (there are a TON of athletic training podcasts out there… )

  • Find a workout partner, running buddy, someone to hold you accountable.

 

Additionally, I urge everyone to take a look at the most recently published National Athletic Trainers' Association Position Statement: Facilitating Work-Life Balance in Athletic Training Practice Settings. It can be found in the Journal of Athletic Training (August 2018 publication) or at the following website:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188079/

A wise mentor once told me: You cannot pour into someone else’s cup if yours is empty. So please, I urge you- fill your own cup first. We cannot do our best work and care for others if we’re consistently feeling drained, unhappy or underappreciated at work. If this is you, I urge you to sit down with your boss, mentor, advisor, coach, and have a real, honest discussion with them about what is and isn’t working for you. Be prepared to offer up strategies for balance, healthy boundaries and scheduling. Besides, more often than not, we’re making ourselves available to last-minute schedule changes because we assume we’re at the mercy of everyone else… when realistically, we may not be.  Again, this comes back to boundaries. It is okay to re-visit expectations and make sure they align with your colleagues, coaches, and contracts!

So, if you have taken a moment out of your busy day to read this and consider your own self-care strategies, I commend you. You did it! You took a few minutes to yourself today. Give yourself a pat on the back… and if you’re reading this and thinking ‘I really need to try one of these things. I’m feeling burnt out’ then it might be time to schedule a morning (or day) off.

Thanks for reading!

Sam

 

Useful links:

9 ways to avoid burnout: https://www.dynatronics.com/blog/overworked-athletic-trainers

 

How to set professional and personal boundaries: https://positivepsychology.com/great-self-care-setting-healthy-boundaries/

 

National Athletic Trainers' Association Position Statement: Facilitating Work-Life Balance in Athletic Training Practice Settings: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188079/

 
 
 
 
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