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Section 6
Track #6: Defusing 6 D's in Your Department


Table of Contents | NCCAP/NCTRC CE Booklet

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Note-Taking Exercise

Why is it important to learn to recognize the 6 D’s?

 

 

D #1. Defensiveness:  Do I feel defensive today?  How so? Is there some way in which you feel you need to be defending or protecting your point of view or your activity departmental turf?

 

If applicable, briefly describe one stressor below that may be linked to your defensiveness that  needs to have solution-focused thinking applied to it?

 

D #2.  Depression:  What two feeling are often underlying depression.?  anger or loss

On a scale of 1 to 100, write down a number indicating to what degree do you feel your depression is linked to anger _________?   a feeling of loss of control _________ or
another feeling __________________?  What percent   _________

Am I feeling depression?  Are there possible underlying feelings of anger, or the loss of control?

 

If applicable, briefly describe one stressor below that may be linked to your depression that needs to have solution-focused thinking applied to it?

 

D #3. Disorganized:  If this applies, write examples of three possible signs that you have become disorganized perhaps as a result of stress?
1.Example of  Sloppiness

2. Examples Absentmindedness

3. Examples Poor judgment

 

If applicable, briefly describe one stressor below that may be linked to your disorganization that  needs to have solution-focused thinking applied to it?

 

D #4. Defiance: Does direct or indirect defiance describe me at times?   If so, what stressor in the facility do I need to apply solution-focused thinking to in order to defuse the stress that may be causing my defiance?

 

If applicable, briefly describe one stressor below that may be linked to your defiance that  needs to have solution-focused thinking applied to it?

 

 

D #5. Dependence:  Am I so stressed that I regress and withdraw from my leadership role in some subtle way in the facility?

 

If applicable, briefly describe one stressor below that may be linked to your dependence that needs to have solution-focused thinking applied to it?

D #6. Decision-Making Difficulties

If applicable, briefly describe one stressor below that may be linked to your decision-making difficulties that needs to have solution-focused thinking applied to it?

 

Regarding the stressor you listed answer the following questions.
1.  What do I want more of or want to have happen?

2.  How can I achieve this?

3.  What resources do I have?

4.  What opportunity may the new solution create?

 

Track 6:  Defusing 6 D’s in Your Department

By this time you may be saying "Gee, solution focused thinking does make sense.  But why is it that I don’t do it all of the time?  Why do I spend so much time complaining to my assistants or significant others?”

Well the answer why you don’t use a solution-focus more often may lie in an analysis of your six D's

The first five tracks of this CD set gave you a de-stress plan for pivoting to the positive and creating a positive action, via the answering of the four questions in solution-focused thinking.  Those questions were:  What do I want?  How do I get it?  What are my resources?  And  What will happen next if I get what I want?  However, you cannot resolve all of your stressors simultaneously and some long standing situations may take time to resolve.  So what do you do in the mean time?  White knuckle it?  No, you don't have to.

Ask yourself, do I feel too overwhelmed to think in the proactive solution-focused thoughts of defining my problem or stressor in terms of what I want, how can I get it, what resources do I have , and what opportunities can this create?  If you are too overwhelmed to think creatively in the solution-focused mode, let's look at your six D's.  On the rest of this track we will help you assess if any of the 6D’s apply to you and to help you pinpoint the major stressors in your facility to which you need to be apply solution-focused thinking..  As each of the 6D’s are explained ask yourself, “What stressor is causing this that needs to have solution-focused thinking applied to it?  On the next track you will get a specific technique to start to defuse your 6 D’s.

In order to do this you may need to deal with some of your underlying feelings as you pivot to the positive and become solution rather than problem focused.  Georgia Witkins Ph.D. lists the 6 D’s of stress as: defensiveness, depression, disorganization, defiance, dependency, and decision-making difficulties. 

So, think of a situation in the facility that is stressful for you.  It can be the same one you chose previously or a different one.

Defensiveness
Let's talk about the first D, which is defensiveness, that may effect your ability to apply a solution-focused approach to this stressor in the facility.  Ask yourself, is there some way in which you feel you need to be defending or protecting your point of view or your activity departmental turf?   Defending yourself against the Dietary Supervisor, Charge Nurse, or physical therapist can be very stressful and energy draining.  Ask yourself,  "Do I really need to win here with my Dietary Supervisor?  Or am I secure enough in myself to avoid biting the bait, so to speak, and engaging in a verbal sparring match?"  I am going to ask you to turn the CD player off in a minute and ask you to contemplate the following question, “Today at work, did I get defensive, or feel like I had to defend my position regarding something?”  Of course, if you have some aggressive domineering residents this may happen on a regular basis.  If you are perceiving these resident encounters as stressful, definitely include those in this mental check list, as well as including staff and volunteer interactions.  So…did you feel defensive today, and if so, how?  MUSIC

The second D, after defensiveness, is depression.  Depression may effect your ability to apply a solution-focused approach to stress at the facility.  Underlying the feeling of depression, according the Dr. Watkins, are usually feelings of anger or loss.  Under stress do you feel angry that you can not control all aspects of your life, or feel a loss of your sense of control in certain areas?  If you are so depressed about something that happened in the facility that you cannot apply the solution-focused thinking presented in the preceding tracks, ask yourself, “On a scale of 1 to 100, to what degree do you feel your depression is linked to anger, a feeling of loss of control, or another feeling?  One is low and 100 is high.  The exercise on the next track may help to elevate some of these feelings.  Of course, if you feel depressed to an extreme, professional counseling might be considered.  When you hear the musical tone turn the CD player off and reflect upon any depression you may be feeling and possible underlying feeling of anger, loss of control, or another underlying feeling.  If you are experiencing depression the remaining tracks in this set will provide concrete solutions.  MUSIC

The third D, in addition to defensiveness and depression, that is a sign or a result of stress is disorganization.  Disorganization, of course, may effect your ability to apply a solution-focused approach to stress at the facility.    Would you agree that stress preoccupies and diminishes your ability to concentrate.  The resulting disorganization from stress can show up as sloppiness, absentmindedness, and/or poor judgment to mention a few.  When you hear the musical tone turn your CD player off and reflect upon the following question: “Do I feel so stressed about something that happened in the facility that I have become sloppy, absent minded, or exhibited poor judgment in some area?  If so you will be especially interested in the next and remaining tracks in this set to find some concrete solutions.  MUSIC

The fourth D, in addition to defensiveness, depression, and disorganization,  is defiance.  Defiance may affect your ability to apply a solution-focused approach to stressors in your the facility.  Ask yourself.  Do you fight back either directly or indirectly when you feel stressed?  Do you challenge authority figures, like the administrator or corporate consultant or Director of Nursing by becoming defiant perhaps indirectly by sabotaging their idea behind their back, bad mouthing them to others, foot dragging, or withholding helpful information from them?  In other words, are you being defiant indirectly not to the person’s face.  When you hear the musical tone turn the CD play off and think about the following questions, “Does direct or indirect defiance describe me at times?   If so, what stressor in the facility do I need to apply solution-focused thinking in order to defuse the stress that may be causing my defiance?

The fifth D in addition to defensiveness, depression, disorganization,  and defiance is dependence.  Dependence is pretty self explanatory.  In short you depend on others in areas that, if you stretch yourself, you could function independently.  Over Dependency on other both in and out of the activity department may effect your ability to apply solution-focused thinking to stressful situations in the facility.  When the musical tone sounds ask yourself, “Am I so stressed that I regress and withdraw from my leadership role in some subtle way in the facility?”  MUSIC

The last or sixth D in addition to defensiveness, depression, disorganization, defiance, and dependence is decision-making difficulties. Feeling stressed often times stems from feeling a lack of control, a lack of choices, and/or lack of preparation to handle a situation.  Making decisions, even minor decisions, under such conditions becomes very difficult.  Agree?   It is this last “D” that I feel is probably the main reason why you may be not be as solution-focused as you would like. Your stress level impairs you decision making ability.

Sound familiar?   Think about it.  As you hear the musical tone turn the CD player and think about  the four steps in solution-focused thinking and decision you have to make.  Here’s an example  To be solution-focused, you have to decide what you want more of, not complain about what's wrong. When you hear the tone, “Do you want more resident’s transported?  Or CNA’s doing activities with residents?  MUSIC

 Then you have to decide how to achieve your Culture Change solution. Do you talk to the Administrator first?  The Director of Nursing? MUSIC

You then have to decide what resource you have?  Use e-mail to request a meeting with your Administrator?  Ask your corporate consultant for a copy of CMS Culture Change Guidelines?  MUSIC

The last step in solution focused thinking is to decide what opportunity may the new solution create.  If one CNA will do an activity with one resident you need to decide how you can recognize this so others will start to think about following this example?  If several CNA’s are already transporting maybe the next step is giving residents the simple activities that you have left in the resident rooms.  MUSIC

In case you are becoming stressed thinking what activities can I leave in residents’ room, our Alzheimer Series provides you with over 100 no or low cost activities to leave in residents’ room.   The next track, Track 7, provides you with a strategy to create present mindedness and stop the overwhelm.


NCCAP/NCTRC CE Booklet
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