The Margin Prescription:
Restoring Emotional, Physical, Financial
& Time Reserves to Busy Lives
Session II
Northeast Association of Occupational Health Nurses Conference
September 23, 2010, Meredith NH
Richard A. Swenson, M.D.
Margin: Infrastructure
1. Own the problem
2. Be intentional
3. Accept, respect limits
4. Adjust expectations
5. Take personal responsibility
Margin: Infrastructure
6. Re-establish control
7. Prioritize values, commitments
8. Be cautious of multitasking as solution
9. Keep it objective
10. Perform accurate Dx; Have 50,000
mile check-ups
MARGIN IN EMOTIONAL
ENERGY
¾Social Supports
¾ Pets
MARGIN IN EMOTIONAL
ENERGY
¾Social Supports
¾ Pets
MARGIN IN EMOTIONAL
ENERGY
¾Reconciliation
¾Service
¾Rest
MARGIN IN EMOTIONAL
ENERGY
¾ The Free Three
Laughter
™ Music
™ Nature
¾ Boundaries
™
MARGIN IN EMOTIONAL
ENERGY
¾ The Free Three
Laughter
™ Music
™ Nature
¾ Boundaries
™
MARGIN IN EMOTIONAL
ENERGY
¾ The Free Three
Laughter
™ Music
™ Nature
¾ Boundaries
™
MARGIN IN EMOTIONAL
ENERGY
¾ Vision
¾ Goodwill, Gratitude, Grace
¾ Faith
Restoring Margin in Physical
Health
MARGIN IN PHYSICAL
ENERGY
Sleep
¾ Nutrition
¾ Exercise
¾
PHYSICAL ENERGY
Sleep
¾
¾
Value sleep
Develop healthy sleep patterns
DEVELOP HEALTHY SLEEP PATTERNS
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Retire and arise at a similar time each day
Have a quiet room and a good mattress
If you suffer from cold feet, prewarm the sheets
Don't engage in disturbing conversations before
bedtime
Give yourself time to unwind from the day
If you are a clock watcher, turn the clock toward the
wall
Keep a notebook or tape recorder at bedside
Limit the intake of caffeine in the evening, and if
necessary, in the afternoon as well
PHYSICAL ENERGY
Sleep
¾
Don’t catastrophize insomnia
Don’t Catastrophize Insomnia
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Don't stay in bed awake
Get up, sit in a comfortable chair or lie on the couch
Read
Write a letter
Have a light snack; Drink some milk
Take a walk
Soak in the bathtub
Play relaxing music
Watch television
DON'T worry
PHYSICAL ENERGY
¾ Take a nap
PHYSICAL ENERGY
Nutrition
¾ Decrease intake of calories
¾ Replace processed snacks with fruit
¾ Garden or buy direct
¾ Drink more water
¾ McStay at home
PHYSICAL ENERGY
Exercise
¾ Exercise for the heart
¾ Exercise for the muscles
¾ Exercise for flexibility
¾ Exercise for the mind and spirit
¾ Bike or walk
Restoring Margin in Time
The Prediction that Got It Wrong
¾ Recent poll
¾ Time urgency
™Rush, hurry, routine panic
™Multitasking
™Decreased sleep
™Short-changed relationships
™Continuous partial attention
™Exhaustion, burnout
RESTORING MARGIN IN
TIME
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Expect the unexpected
Learn to say “No” to non-priorities
and discretionary burdens
MARGIN IN TIME
¾
Turn off the television
MARGIN IN TIME
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Prune activity branches
Practice simplicity & contentment
Separate time from technology
MARGIN IN TIME
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Control interruptions
Periodically disconnect
MARGIN IN TIME
¾ For Type A’s Only: Stand in Line
For Type A’s Only
• Stand in line
• Practice smiling
• Purposely speak more slowly, stop in the middle of some
sentences, hesitate for three seconds, then continue
• Purposely say "I'm wrong" at least twice today, even if you're
not sure you're wrong
• Listen to at least two persons today without interrupting even once
• Seek out the longest line at the bank
• Verbalize your affection to your spouse and children
• Trash the extraneous
• Cut out some of the committees, perhaps all
• Give yourself a lunch break--out of the office
• Browse in a bookstore, sit in a deserted church
Dr. Meyer Friedman
MARGIN IN TIME
¾ Be available
Restoring Margin in Finances
Hagar’s Two Rules for Happiness
1. Be content with what you have
Hagar’s Two Rules for Happiness
1. Be content with what you have
2. Always be sure you have plenty
MARGIN IN FINANCES
¾
Avoid future debt
¾
Make a budget
¾
Discard credit cards
¾
“Live within your harvest”
™
Simplicity, Contentment
Simplicity
¾ Everything
we own owns us
¾ Clutter
¾ Einstein’s suits
¾ Quaker neighbor
¾ A walk to Dairy Queen
¾ Orthopedist: Garden shed
¾ Ophthalmologist :
I tried to simplify for six years
¾ Distinguished MD on the simplicity of dying
Contentment
¾ Seattle surgeon: What do you mean by
contentment?
¾ Not a natural state
¾ John Kenneth Galbraith
¾ Immanuel Kant
¾ Take everything and move it back 50 yrs
MARGIN IN FINANCES
¾ Examine motives for spending
Recreational?
Therapeutic?
Addictive?
¾ Make spending need-based
Pleasure-based?
Interest-based?
Cash flow-based?
MARGIN IN FINANCES
¾ Resist impulses
¾ Decide possession endpoint
¾ Fast
¾ Examine your value system
RESTORING BALANCE
¾ Place
life in stable orbit around priorities
¾ Counter escalation of the norm
¾ Compare opportunity costs
¾ Do the math
¾ Maintain work-life balance
¾ Seek periodic tech. solitude
¾ Meet decent minimums
¾ Make space for deep consecutive thoughts
War and Peace