|The Best Defense May Indeed Be a Good Offense — Part 2|
|By Caterina Spinaris & Gregory Morton|
Continued from the September 2018 issue of the Correctional Oasis.
With this robust research-based evidence for the detrimental effects of burnout on physicians as support, it is not much of a leap to suggest that burnout and overall Corrections Fatigue could have adverse consequences among corrections professionals also. That it could negatively impact the quality of offender management, and increase the likelihood of errors or lapses, resulting in policy violations, and hence reduced safety—with ensuing increases in critical incidents, injuries, death and litigation risks. In other words, it does not seem to be far-fetched to conclude that countering Corrections Fatigue is in fact a mission-critical issue. So much so, that if we are going to do for the public what we say we are going to do, then pro-actively attending to the well-being of our staff is a crucial matter for corrections leadership.
Where does one start?
An easy answer is, start with what you’ve already got in place.
At Desert Waters we do not assume that an agency has not thought of these concepts before, and that no one has taken steps to address this long-standing condition. Quite the opposite. It’s very likely that you already have wellness-related training programs in your catalog, or that after-action employee support is currently written into physical force policy, or that creative scheduling has long been an issue you’ve wanted to address. Maybe now is the time to proactively enhance those programs. Maybe even do that by reassigning some resources for the purpose of giving these programs a renewed jump-start towards success. Perhaps it is as simple as just measuring the effectiveness of what you presently have in place. Or maybe it’s bigger than that. Maybe it’s a system-wide initiative to uncover and address Fatiguing conditions wherever they are found, and then strategically and intentionally target them to enhance Fulfillment for each and every employee. You know your agency better than we do.
A key point that needs to be repeatedly emphasized is that BOTH bottom-up and top-down approaches are required if employees are to stay healthy and functional in their professional and personal lives. For example, it is necessary to pair staff wellness trainings and resources with systemic work-setting improvements in the areas of workload, work hours, and leadership styles. One without the other will undermine staff well-being in the long run. Both individual staff and agencies must do their part for the workforce to be able to function well and remain well.
It is not reasonable to expect that bottom-up efforts, such as staff getting trained in resilience-promoting strategies, would be able to sustain the resilience of the workforce in the face of chronic adverse work conditions that interfere with the neurobiological foundations of well-being—such as long working hours that interfere with the ability to rest and to have sufficient and good quality sleep. An exhausted body and brain will chip away at healthy functioning and the capacity to endure and bounce back after encountering challenges.
That is, top-down strategies, even though more complex logistically and perhaps costlier, are essential, because it cannot be expected that staff be able to maintain their well-being in the face of pervasive and long-term extreme stressors that are pervasive in their agency. Whatever gains staff may make through their implementation of effective individual coping strategies could easily be lost due to the relentless grind of the adverse working conditions.
Here are some additional thoughts along these lines offered on resolving burnout issues among physicians—thoughts which seem relevant to corrections work settings: “But what can health care organizations do right now? Burnout among physicians (and other health care workers) ... cannot be fixed through individual resilience training alone. Instead, health care organizations should treat burnout like the key quality and safety issue it is. Solving basic problems like workflow and communication deficiencies may significantly improve physician well-being, and the use of scribes to support EHR (electronic health record) documentation is a particularly promising practice. Health care organizations should ensure that their governance and management systems maximize the participation of clinical staff in setting priorities and solving problems. They should also develop and track indicators of physician burnout ... and important stressors that may lead to burnout, such as excessive work hours; … the clerical burden imposed by EHR systems and workflow design; … psychological safety survey results; teamwork quality; etc.”.
In corrections work settings, work conditions that must be tackled top-down include chronic partial sleep deprivation due to frequent mandatory overtime or changing shift work schedules, and chronically high workloads. Enough and regularly predictable down time—time away from the overstimulating work environment that requires continual vigilance, so that staff can relax, rest and sleep—is a fundamental, non-negotiable human need.
Other universal issues that must be addressed top-down in corrections agencies are the quality of staff interactions, and the quality of leadership and managerial/supervisory styles. Negative staff interactions and leadership styles are toxic, yet preventable organizational stressors which sap morale and which cannot be ignored.
Yes, bottom-up interventions that promote staff well-being are crucial steps in the right direction. And they need to be matched with top-down initiatives regarding working conditions which can help staff sustain any gains they make through their application of wellness and resilience-promoting behaviors.
In conclusion, we urge you to recognize and benefit from the research: the best defense may indeed be a strategically targeted, proactive offense.
We at Desert Waters are here to discuss these mission-critical matters with you further, and to bring to the table our various approaches to complement yours.
 West, C.P.; Dyrbye, L.N.; Erwin, P.J., Shanafelt, T.D. (2016). Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. The Lancet. First published online 28 September 2016. doi: http://dx.doi.org/10.1016/S0140-6736(16)31279-X
 Panagioti, M.; Panagopoulou, E.; Bower, P.; Lewith, G.; Kontopantelis, E.; Chew-Graham, C.; Dawson, S.; van Marwijk, H; Geraghty, K. ; Esmail, A. (2016). Controlled Interventions to Reduce Burnout in Physicians: A Systematic Review and Meta-analysis. JAMA Internal Medicine. First published online December 5, 2016. doi:10.1001/jamainternmed.2016.7674
 Salyers, M.P., Bonfils, K.A., Luther, L., Firmin, R.L., White, D.A., Adams, E.L., Rollins, A.L. (2016). The Relationship Between Professional Burnout and Quality and Safety in Healthcare: A Meta-Analysis. Journal of General Internal Medicine. First published online 26 October 2016. doi:10.1007/s11606-016-3886-9
 Card, A.J. Physician Burnout: Resilience Training Is Only Part of the Solution.(2018). Annals of Family Medicine, 16, 267-270.
This article as been reprinted with permission from the September 2018 Issue of Correctional Oasis, a monthly e-publication of "Desert Waters Correctional Outreach".
Editor's note: Caterina Spinaris is the Executive Director at Desert Waters Correctional Outreach and a Licensed Professional Counselor in the State of Colorado. She continues to contribute to the field of corrections staff well-being individually and organizationally, in particularly regarding issues of traumatic stress due to exposure to violence, injury, death on the job, and also issues of organizational climate improvement.
Gregory Morton serves as an Instructor at Desert Waters Correctional Outreach. Prior to that he worked for Oregon State Corrections nearly his entire adult life—a total of more than 34 years—after graduating from Oregon State University with a Bachelor’s degree in Psychology. He started his career at the Oregon State Penitentiary (OSP) as an academic counselor in 1975, and progressed to Staff Training / Employee Development shortly thereafter. Greg served as the department’s Leadership Program Manager and as Staff Training Administrator until 2006. He was the ORDOC’s Labor Relations Administrator until he retired in 2009. His concern for the professional and life skills of the corrections workforce has been his motivation throughout his career.
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