How to save for expected expenses

Have you ever been doing a great job sticking to your budget and then your auto license renews and you need a smog check and neither of those items is on your monthly budget? It can throw all your financial progress out of wack. However, these are perfect examples of irregular, but expected expenses.

When we sit down and work out our monthly budget it’s easy to forget the things that only occur once a year or every few months. So I thought I’d share the approach I’ve been using for almost 10 years to help me keep on top of my finances and stay out of debt.

Step 1: Identify irregularly occurring/expected expenses

At least once a year I update my “expected expenses”. This spreadsheet includes:

  • Auto license(s), oil changes, expected repairs
  • Nursing License, professional organization dues, re-certification fees, scrubs, work shoes
  • Blog expenses (domain name renewals, website hosting fees, etc.)
  • Bulk meat (can I have 1/2 a pig or 1/4 cow, please?)
  • Gifts (birthday, Christmas, mothers/father’s day, weddings, etc.)
  • Propane for our RV (it’s much more expensive in the winter)
  • Household repairs
  • Travel
  • Vet/Pet expenses

So this represents both bills that I know I’ll have on a specific date AND items that I’ll typically pay for during the year but that occurs when I don’t expect them (auto repairs or deductibles).

Step 2: Calculate Annual Total and divide by # of paychecks per year

Add up the total of all these expenses and divide by how many paychecks you receive in a year (Divide by 26 if you’re paid biweekly).

Step 3: Set funds aside from every paycheck

Create a savings account that is only used for these funds. Every 2 weeks, on payday, have your funds auto transferred to this savings account. It’s really cool to see the funds add up knowing that you are prepared.

For example, our washing machine in the RV is only two years old but it is broken and the warranty won’t cover it. That represents $1,000 of unexpected expenses. But we’ve been setting aside funds for RV repairs, so we have 1/2 of that already saved for this specific type of situation.

Step 4: When you incur an expense transfer it back to your checking account.

Personally, I do this once a month, but I know that may not work for everyone. The point is that you have cash available to cover the expense.

How to track this information

I use 2 tools to help me track this information:

  1. tracks my expenses and monthly budget. I have categories that correspond to the categories I’m saving for, so it’s easy to look at Mint to see how much needs to be transferred to checking
  2. I use a google spreadsheet with two tabs
    1. Annual Expenses is where I calculate the total amount I need to set aside each year and each paycheck
    2. Account Tracker is where I track how much I’ve saved for each category. I update this after each paycheck and each time I transfer funds back into my checking so I have an accurate view of how much I have saved for each category.

My “expected expenses” savings account is at, an online bank. They recently added a new tool to their savings accounts called “buckets”. It’s possible that this tool will replace my need for the google spreadsheet.

Check out this google spreadsheet template

Here is a template for tracking annual expenses and how much you have saved for each category: Account Tracker Template. There are instructions within the google spreadsheet.

COVID-19: Are essential workers getting the best PPE?

Last week, I spent some time last week reading through PPE recommendations from the CDC, WHO, WSHA, Washington L&I, WA DOH, and UW. At that time, CDC and WA L&I both recommended airborne precautions when caring for all COVID patients regardless of what type of procedure was being performed. WHO, WSHA and UW only recommended airborne precautions when doing aerosolizing procedures. DOH recommended airborne precautions for aerosolizing procedures and “critically ill” patients.

Today, a friend asked the question, “Do you think essential workers are getting the best PPE that can be provided?”

The answer is “no.”

Normally in healthcare, we default to the safest option until other options are proven.

“Best” PPE would be us saying “there are indications that this could be airborne, let’s protect our workers/ourselves until it’s definitively proven otherwise.”

“Best” PPE would mean disposing of disposable PPE after using it with one patient one time.

It would mean laundering reusable gowns after one use and never having to reuse a gown another healthcare worker already wore in a COVID patient’s room.

It wouldn’t involve cloth masks – which have varying levels of filtration depending on the material used but most are not as safe as surgical masks.

It would not require workers to reuse the same PPE for an entire day or an entire week or an entire assignment.

“Best” PPE would not involve differentiating between aerosolizing procedures and the rest of a patient’s care.

“Best” PPE would not cause healthcare workers across the country to feel afraid to go to work because they don’t have the tools they need to protect themselves.

“Best” PPE would involve engineering controls that also keep us safe, like using negative airflow whenever the patient is suspected of COVID, not just for aerosolizing procedures.

Let’s say “good enough” PPE is the next step down from “best.”

“Good enough” PPE would involve extended N95 use (wearing one time without taking off for an extended period of time) AND discarding N95 after use in an aerosolizing procedure (per CDC recommendation). It would not involve using the same N95 for multiple aerosolizing procedures.

“Good enough” PPE would involve N95 reuse within limited circumstances AND wouldn’t involve placing it into a container (like a paper bag) that can easily contaminate the side that faces the health care worker.

Below “good enough” would be “inadequate.”

 “Inadequate” PPE is using trash bags as gowns.
Or only having access to a surgical mask that is reused for days on end, that the healthcare worker reinforces with feminine hygiene pads to prevent it from disintegrating
Or only having access to cloth masks or reusing cloth masks over N95s.

We are in a shortage, some of it happening in real-time and some of it based on projections. But we can do better.

We may not have the “best” PPE right now, but we can do better than “inadequate.”

And the organizations that outline recommendations can do better at communicating the WHY behind their changes or differences. Please, share the evidence and explain your reasoning with us. We’re trained to evaluate recommendations based on evidence, please show us the evidence.

In the future, we need to plan better.

As a nation, we need to champion for our government and our local healthcare facilities to have a reserve of equipment… because we are showing our enemies how susceptible we are to bioterrorism.

But we can do better now.

Krista, RN, CEN, TCRN

P.S. I think this idea for using rubber bands to help “seal” surgical masks to our face is pretty cool: Fix the Mask

P.P.S. I work at multiple facilities and have friends at many other facilities. These opinions are generalizations of my observations and are not about any specific facility.

P.P.P.S. It’s strange that employers are defaulting to recommendations that aren’t aligned with L&I recommendations since L&I are the people who decide whether an occupational claim is appropriate or not. I would think from a “protect the organization from liability” perspective that the L&I recommendations would be the go-to source.


Relevant quotes and summaries from sources as of 4/1/2020

Who needs PPE according to CDC

Screen shot from CDC website on 4/1/2020

WA L&I “ When available, an N95 respirator is preferred to ensure workers are protected from any contamination residual in the air… N95s are the minimum level of respirator filtration but provide effective protection from known COVID-19 exposure.” They also recommend that if reuse of N95 becomes necessary it should be done cautiously and according to CDC recommendations

CDC differentiates between extended use and reuse, “Extended use is favored over reuse because it is expected to involve less touching of the respirator and therefore less risk of contact transmission.”

Washington Department of Health “We acknowledge that the CDC currently recommends standard/airborne/contact precautions with eye protection for patients at highest risk and we continue to support this approach for our patients who are critically ill and those undergoing aerosol-generating procedures. These CDC guidelines also recognize that based on local and regional situational analysis of PPE supplies, facemasks are an acceptable alternative when the supply chain of respirators cannot meet the demand.”

World Health Organizations lists droplet/contact precautions and only N95 for aerosolizing procedures

Washington State Hospital Association is copying WHO and states they aren’t following CDC guidelines

Screenshot from UW COVID PPE recommendations on 4/1/2020

Screenshot from UW COVID PPE recommendations on 4/1/2020

The University of Washington Medicine is also limiting airborne precautions to aerosolizing procedures. Although they also do something I haven’t encountered in my reading: “PPE use for suspected or positive COVID cases will continue to require a trained PPE observer to assist with donning and doffing.”

Living with gastroparesis: my experience with diet, foods and medications

I have gastroparesis.

Gastroparesis is a condition that affects the normal spontaneous movement of the muscles (motility) in your stomach. Ordinarily, strong muscular contractions propel food through your digestive tract. But if you have gastroparesis, your stomach’s motility is slowed down or doesn’t work at all, preventing your stomach from emptying properly.

Mayo Clinic

For me, how it feels varies from day-to-day or even minute-to-minute. Sometimes it feels like what I eat gets stuck in the middle of my chest. I’ll develop nausea out of nowhere, nausea that ranges from annoying to debilitating. I’ve had projectile vomiting.  Or I’ll experience a severe burning sensation that feels like my insides are eating themselves. Sometimes I’m able to taste what I had for breakfast while trying to fall asleep. I’ve also had the pleasure of having my breakfast come back up my throat when I lay down to go to bed. Yuck.

BUT… I’m thankful to say that I now have many days when my symptoms are just a minor annoyance instead of debilitating. For the average person, the stomach should be empty within 3-4 hours. My nuclear stomach emptying study showed I had 76% left in my stomach 4 hours after eating scrambled eggs and toast. One doctor documented that this is a “very convincing gastric emptying study” and another said I have “one of the worst gastric emptying studies I’ve ever seen.” My favorite response from a provider is “I thought the gastric emptying time in your records was a typo.” Even so, I get the impression that my symptoms are not as severe as others. So what works for me, might not work for others.

I would like to give a shout out to my gastroenterologist for referring me to Virginia Mason’s gastroenterology group. Not only do they have one of the world experts on gastroparesis, they also have a nutritionist on staff that provides free consultations. The free part is awesome, but what’s even more awesome is that she cares for a lot of gastroparesis patients and can offer suggestions based on what has worked for others.

In this post, I’m going to talk about the medication, diet/eating approach that is working for me. I plan to follow-up with a post about lifestyle changes and how changing how you eat impacts social interactions.

UPDATE: the week after initially publishing this post my gastroparesis flared up, so I’ve updated with some additional tips.


Schedules/Daily Meds

These are the medications I use to prevent symptoms.

  • PPI to control acid. I take lansoprazole simply because that is what I bought over-the-counter when I first became symptomatic and no provider has recommended switching because this currently works for me
  • Ranitidine. I added this to my daily meds (I only need it in the AM) in the fall when the lansoprazole wasn’t cutting it on its own. I can’t tolerate the pain without both meds, which is disappointing because both can cause hair loss.
  • Miralax. My “gastric dysmotility” extends beyond my stomach to the rest of my gut. So constipation is a factor. I didn’t find much relief with magnesium supplementation (although I still use it). Instead, I use 1/8-1/2 tsp of Miralax in my morning protein shake (I was told to dilute in 12-18 oz of water for best effectiveness).
  • Multivitamin. To prevent nutritional deficiencies associated with gastroparesis.

PRN / As needed Meds

These are what I use to control symptoms. Sometimes I can’t tell if I am nauseated, having heartburn, or am hungry. So I just go through the options until I get relief.

  • my #1 lifesaver: TummyDrops!
    • I love these and try not to leave the house without them. I hate eating out and then feeling miserable and having nothing with me.
    • I use the Ginger Pear drops for mild nausea and the Double Ginger Peach for more severe nausea or if it feels like what I ate is “stuck.” If I’m having a “bad” day, I sometimes use one before I eat to get my stomach moving. I like that they are hard candy so I can pop it in my mouth and go without having chewy ginger candy stuck to my teeth.
    • Ginger water was also recommended, but I haven’t tried it
    • I tried making my own ginger candy, but it was time-consuming and it went bad before I used all of it.
    • Tip for making your own ginger-related remedies is to drop the ginger in boiling water for 10 seconds to make the skin easier to remove
  • #2 eat something that I normally tolerate
  • #3 Mylanta
    • If you want to use Mylanta, don’t do the generic brand plain flavor 🤮. The minty one is decent. I’m about to try the Vanilla Carmel and hope it doesn’t ruin those flavors for me forever.
    • Others have success with different antacids, but I respond better to magnesium and aluminum.
  • #4 Reglan. I try to avoid this until I absolutely have to take it. And I only do 1/2 tab. This is basically my “I’ve done everything and I still feel so terrible I can’t go to sleep” solution. I’m prescribed enough to use daily, but I typically use it once a week or less. But I always try to keep some on me because sometimes the need to vomit hits me out of nowhere and it responds to nothing except Reglan. And working or doing normal daily activities are really challenging when you feel like you have a stomach bug or the flu.
    • Why do I avoid it if it works so well? Reglan has some side effects that I want to avoid and I’ve been told if I develop them (EPS or extrapyramidal side effects) I have to stop using it. My understanding is that the likelihood of a reaction is related to how much/frequently I use it.
    • Note: one of the things that helped point us to a gastroparesis diagnosis was because Zofran doesn’t work AT ALL, but Reglan does. Zofran still works for nausea with other causes (i.e. gastroenteritis or influenza)

Pain meds

I’m no longer able to tolerate ibuprofen, which was my go-to options for pain management. So now I use acetaminophen and a supplement called Curamin as needed.



Nausea is a powerful deterrent / negative reinforcement. So, I quickly learned that overeating was a recipe for feeling horrible. When I feel full I have to stop right then. Even “one more bite” is enough to ruin the rest of my day.

Irritating Foods

I’m pretty disciplined about avoiding foods that irritate and/or slow gastric emptying. With food lingering in my stomach for hours I develop gastritis pretty easily (which is inflammation of the stomach lining… it’s a painful, burning sensation that feels like my stomach is eating itself).

Here are the foods I avoid:

  • Coffee. even decaf. This makes me sad because I love the taste.
  • Acidic foods including tomato sauces. I miss spaghetti and lasagna!
  • Citrus. I still put citrus juice in recipes, but I am careful with the amount.
  • Fried and/or high-fat foods. Fat slows down gastric emptying. But I still have the occasional order of french fries
  • Soy. I found that soy makes my symptoms worse. I can tolerate small amounts but mostly avoid all but soy lecithin.
  • Chocolate 😭… but only when I have flares

I tried removing dairy, but that didn’t seem to make a difference and including dairy provides a lot of additional, easy to eat options. I was gluten-free prior to this diagnosis.


Here are PDFs of handouts that I received that are very helpful. I recommend reading them. I discovered a lot of the info in these handouts by trial and error. I wish I had access to them earlier (instead of 2 years after my initial diagnosis)

Other resources I discovered while writing this blog


I have experimented with multiple eating plans:

  • five shakes a day plus one meal
  • two shakes a day (beginning and end of day) plus two snacks and one meal
  • one shake a day, 1-2 meals and 2+ snacks depending on how hungry I am / activity level.

I vary my eating based on how I feel and what I’m doing that day. But one thing I don’t mess with is how I start my day.

On the rare occasion where I decide to start with something other than a shake, I end up regretting it. I call these “dietary indiscretions”

***Morning Shake***

I start every day with a protein shake that includes collagen and Miralax. I like to mix my shake with a milk frother, I get fewer clumps than when using a protein shake bottle and I can drink my shake in a mug (fewer pieces to wash! yay!). This provides enough sustenance for my stomach to tolerate my morning meds and supplements.

  • I supplement with vitamin D, multivitamin, biotin and collagen (also for the hair loss), magnesium, and omega/fish oil. This is based on blood lab results and recommendations from my doctors based on my health.
  • Burping fish oil is nasty. If you need fish oil, I like these burpless fish oil capsules.

The texture and taste of whey protein shakes are WAY better than pea protein. However, not all whey protein is created equal. My all-time favorite is Isagenix Peach Mango. I could drink that every day multiple times a day. Unfortunately, it’s pricey. Orgain branded protein shakes were recommended by my nutritionist and I like them (some varieties are even carried at Costco). When I’m tolerating chocolate, the shake I use the most is Chocolate Orgain Whey Protein Powder.

Here are some flavor combinations to break up the monotony:

  • Orgain Natural Unsweetened protein powder OR plain whey protein PLUS either water or almond milk PLUS
    • 1 Tablespoon Jello sugar-free pudding powder (I like banana, butterscotch, pistachio, vanilla, white chocolate. Lemon was disgusting)
    • Sometimes I like to combine the White Chocolate SF pudding powder with 1 scoop of JUCE (super fruit and veggie powder)
    • Or I’ll combine the pistachio pudding powder with a scoop of powdered green stuff
  • Orgain chocolate protein powder + Powdered Peanut Butter
    • Sometimes I add banana pudding powder to this combo (yum!!!)
    • For chocolate protein powder I have 3 varieties I use:
  • I don’t like the Orgain vanilla protein powder taste, so when I had a container I wanted to finish, II added 1/2 packet of Splenda + 1/2 tsp cinnamon and/or 1 tsp cocoa and/or 1 tsp vanilla abstract

I was inspired to mix flavorings by


Meal Timing

I eat my main meal around lunchtime. This is when my stomach seems to work the best. I feel like my stomach takes several hours to “wake up” in the morning. And then I need to finish eating 3-4 hours before going to bed (since we want gravity to help with stomach emptying), so that makes dinner challenging especially when I’m working 12-hour shifts.

Typically, I only eat 1 main meal per day, the rest of my nutrition comes from smaller (100-200 calorie) snacks spaced throughout the day

Meal proportions

1/3 cooked or pureed fruits or veggies, 1/3 protein, 1/3 starch

Gastroparesis Plate

The recommended “plate” for gastroparesis, is 1/3 protein, 1/3 starch, 1/3 cooked/pureed veggies and/or fruit.

I try to do 1/4 lean protein + 1/4 complex carbohydrates + 1/2 fruits and veggies, which is what I learned to do when losing weight with Isagenix (which is very effective for healthy weight loss, especially abdominal fat, but also very expensive).

But to be honest, my meals are often higher on the starch/carbs and lower on the fruits/veggies. I may start adding JUCE (super fruit and veggie powder) to my daily shake to increase my micronutrient intake.

I love using sweet potatoes as my complex carbohydrate. It’s easy to digest, tastes delicious and is great left over.

It never occurred to me to look for gastroparesis recipes or cookbooks, but my nutritionist recommended The Gastroparesis Cookbook by Karen Frazier. (update: After seeing this post my Mom bought me this cookbook. I LOVE it. It clearly indicates which recipes are GERD-friendly, SIBO-friendly, gluten-free, etc. Plus it has great information and tips for managing gastroparesis. I HIGHLY recommend it!)


I work 12 hour days, so I pack a lot of snacks. Here are my main go-to options.

  • string cheese and/or low-fat baby bell cheese (fat decreases gastric emptying, so low-fat options work best. I think low-fat string cheese has a weird texture)
  • Chobani fat-free Greek yogurt + honey (sometimes I use real maple syrup instead and/or add berries and/or granola)
  • Citterio Genoa + Provolone (Costco or Trader Joe’s)
  • 1/2 protein bar (protein bars may be too dense for your stomach, so be careful)
    • I occasionally use Isagenix bars. I like the chocolate peanut crunch (favorite because it keeps me satiated), chocolate decadence, chocolate crisp.
    • Rx bars was another recommendation but I haven’t tried them since developing gastroparesis.
  • Homemade almond butter on GF bread. I put 1.5 cups of raw almonds and 1 tablespoon of extra virgin olive oil or almond oil into my Blendec twister jar. It takes less than 1 minute.

When my stomach cooperates, I like to include raw nuts and raw fruits/veggies. When my gastroparesis flairs, I don’t eat these.

  • peanut butter and apple
  • hummus + celery (I avoid spicy hummus because spicy foods increase gastritis and acid reflux.)
  • Epic bison bars (I get them at Trader Joe’s)
  • a small handful of almonds (only if your stomach tolerates them. I buy the mini packs at Trader Joe’s when I can)
  • For more ideas check out Balanced snacks by VM, however, not everything on this list is gastroparesis-friendly


Thankfully my team has provided me with options should my symptoms increase/become unmanageable.

Supplements & Medications

  • FDguard. I’m ordering some now and will see how it goes. (update: Unfortunately, I noticed no difference when using this)
  • Domperidone. I plan to get some next time I’m in Canada (update: turns out my MD is no longer allowed to prescribe medications not approved for use by the FDA)
  • Erythromycin. We haven’t tried this as my symptoms are controlled and its efficacy can wane with long term use. We want to keep this option available if my symptoms become worse / result in a hospitalization
  • Wheat Dextrin. It’s gluten-free despite the name. This is on my list of options if Miralax doesn’t “do the trick.” What’s cool about it (unlike Miralax which can only take you from constipated –> soft –> WAY TOO SOFT) is it can be used for both constipation and diarrhea. For constipation, it is added to water and for diarrhea, it can be sprinkled on food.

Surgical options

If we get to the point where my symptoms are unmanageable, I’ve been told I have these options:

Unfortunately, not every gastroparesis patient is the right fit for these options.

In my research, I discovered some other options for gastroparesis associated with GERD: nissen fundoplication and Stretta.


If you take nothing else away from this blog:

  1. Try TummyDrops. Serious, these candies keep me living the life I want to live.
  2. Avoid overeating
  3. Figure out what foods work for you
  4. Stay AWAY from what foods that irritate your stomach. Just don’t do it. I know it’s tempting… but that bite is not worth it.
  5. Start your day with liquid foods
  6. Eat your main meal in the middle of the day
  7. Work with your care team to find a medication combination that works for you


I hope this was helpful. And I’d love to hear tips that others with gastroparesis have discovered. Please comment or message me!

This post is not meant to replace medical consultation and advise. I am simply sharing my experiences with managing the day-to-day pain and discomfort of gastroparesis in the hope of encouraging others and providing access to the information/resources I wish I had encountered sooner.

This post contains NO affiliate links. I’m only including links to products because I want to make it easy for others to find options that work for them. If you’re interested in using any of the Isagenix products, I know a great coach (who is not me!).

Preventing Burnout: a literature survey research series

This slideshow requires JavaScript.

The series

Or read it like a paper

Key Points from How a Leader Maintains High Productivity Without Team Burnout

This is part of a series publishing portions of a research paper on How a Leader Maintains High Productivity Without Team Burnout. I have decided not to publish the conclusion from my paper, instead I am supplying a bulleted list of key points. Each of these key points could be a book or blog post in and of itself. So, think of this as a list of ideas to explore if you want to prevent burnout for yourself or individuals in your team.

All in all, I’d say the most important take-away is this:

Early intervention can prevent burnout

 How a Leader Maintains High Productivity Without Team Burnout

Key Points for Leaders:

Listening and caring for employees is the most important thing to learn to do as a leader.

  • Learn to interact well with others by listening, communicating and using self-control.
  • Develop the attributes you want from your employees; people learn by seeing others model the behavior
  • Develop coaching skills; Make feedback a natural part of interactions with employees
  • Empower employees and provide clarity via effective communication
  • Provide employees with control wherever possible; employees with decision-making power have lower burnout rates
  • Intervene when employees provide subtle clues that they are being pushed to their limits. Learn more about symptoms in Appendix A (An overview of burnout) and Appendix B (The seven aspects of burnout).
  • Provide goals and hope especially in difficult situations
  • Keep your eyes open for indications that an individual is experiencing distress.

Signs of emotional distress include anxiety, rigidity, poor listening skills, lack of empathy, impatience, and being critical. Early intervention can prevent burnout. Watch for these signs: anxiety, rigidity, poor listening skills, lack of empathy, impatience, and being critical.

More than any other factor, the improvement of communication and the dissemination of information has the greatest impact in creating a culture of engagement

Key Points for Individuals

  • Learn to identify when you’re tipping from (good) stress to distress; Don’t ignore early warning signs that you’re distressed.
  • Identify when you’ve been stressed for too long or too intensely and ask for help.
  • Develop coping mechanisms, skills, and behaviors that help you meet the challenges of your profession
  • Examine the beliefs you have about whether stress is beneficial or harmful.
  • Examine the beliefs you may have that contribute to burnout. For example:

seeing everything as an emergency, overdependence on self, failure to effectively delegate, not seeing self-care as integral to performance, and failing to make lifestyle choices that increase healthiness (Cora, 2010, pp. 21-4).

  • Develop habits that allow you to effectively manage your energy. This requires you to be connected to your needs, values, strengths, and weaknesses
  • Burnout is a process that is often overlooked for a long period of time. Learn to recognize the phases: emotional exhaustion, depersonalization, and reduced personal accomplishment.  (Maslach, 1982). Learn more in Appendix A and Appendix B.

It is manifested by symptoms of severe exhaustion and distress at being overwhelmed and over-extended, feelings of ineffectiveness and inadequacy, reduced motivation and commitment, and ‘dysfunctional attitudes and behaviors at work’.

  • Develop very specific routines that ensure you are regularly renewed; block off time to rest
  • Learn to pace yourself
  • Keep an eye on your sleeping and eating habits; these are good indications of how you’re doing
  • Know your risk factors for burnout: under age 20, being an “over achiever” (very high level of motivation to succeed in your careers and high expectations and goals about your own accomplishments), feeling stuck in a job-person mismatch.

This slideshow requires JavaScript.


The series

Build engagement through company culture

This is part of a series publishing portions of a research paper on How a Leader Maintains High Productivity Without Team Burnout.

  • The premise for principle one is this: there are no quick-fix solutions. All attempts to prevent burnout need to come from a long-term plan that helps employees become passionate about their work.
  • A key to burnout prevention is employee engagement which can be improved through effective communication and the dissemination of information.

 How a Leader Maintains High Productivity Without Team Burnout

Sustaining high-performance without burnout is a complex issue with far-reaching implications. There are no easy, quick solutions. The term burnout, according to Casserley & Megginson, has become colloquial; a faddish term that people use flippantly. This “stimulates the articulation of quick and simple solutions, dubious methods, and inferior inventions by those who want to make fast money in the booming burnout business.” (Casserley & Megginson, 2009, pp. 14) A leader needs to recognize this and realize that burnout prevention is long-term and involves radical changes to a company’s culture. As Smith states, “If you want exceptional performance for your company, you must focus on its culture.” (Smith, 2011, pp. 1) This culture must promote employee engagement. According to Cooper, employee engagement (as contrasted with burnout) isEngagement vs. burnout

a state of high energy (rather than exhaustion), strong involvement (rather than cynicism), and a sense of efficacy (rather than a reduced sense of accomplishment)…Strategies to promote engagement may be just as important for burnout prevention as strategies to reduce the risk of burnout. (1998, pp. 73-4)

This concept is further supported by Maslach & Leiter who say,

Reducing the possibility of burnout is only part of a preventative approach. Even more important is increasing the chances that people engage with their work. Focusing on engagement means focusing on the energy, involvement, and effectiveness that employees bring to a job and develop through their work. (1997, pp. 102)

Cooper suggests increasing engagement by improving the person-job fit. There are six areas that he describes as person-job misfits. They are workload, control, reward, community, fairness, and values. These areas are discussed in detail in Appendix C.

 “All attempts to prevent burnout need to come from a long-term plan that helps employees become passionate about their work.”Maslach & Leiter coach that “the outcome is a process.” (1997, pp. 125) This suggests that there is no sure fire, guaranteed way to prevent burnout. “Prevention emphasizes long-term, disciplined efforts in self-reliant and responsible behavior as opposed to the faddish quick fixes that some people appear to seek.” (Quick, et al., 1997, pp. xviiI)

More than any other factor, the improvement of communication and the dissemination of information has the greatest impact in creating a culture of engagement. The basic idea is this: communication empowers employees. Stephen Covey states “Empowerment is the creation of conditions within organizations which results in the ability of individual people to contribute their maximum potential energy…to achieving the mission and strategy of the organization.” (Smith, 2011, pp. 89)

A leader that wants to create a company culture that cultivates engagement needs to realize that they “have a key role in pursuing individual and organizational well-being” (Quick, et al., 1997, pp. 151) and to learn how to teach their employees by example that they are “responsible for their health as individuals and for the health of the organization.” (Quick, et al., 1997, pp. 151) Additional tactics for the leader include building their coaching skills, improving their ability to facilitate team interaction, creating trust within the team so members do not fear sharing their real opinions, removing barriers, communicating clear expectations, developing systems and watching for the signs of burnout. The signs of burnout can include exhaustion and distress, reduction in performance and productivity, disillusionment and reduced commitment, dysfunctional attitudes, and addictive behaviors (Casserley & Megginson, 2009, pp. 25-32).

Finally, the leader can offer the one thing that no one else on the team can: adjusting “their style to provide what the group cannot provide” (Blanchard, Carew & Parisi-Carew, 200, pp. 68) By adjusting their style and filling in the gaps in the team a leader can help improve each team member’s experience of their job. As Maslach & Leiter put it, the idea is to “enhance the relationships of people with their jobs. The ultimate goal is to build something positive, not simply eliminate a negative.” (1997, pp. 103)

Part 5 of this series also includes a few other culture shift ideas such as getting rid of the “survival of the fittest mentality and creating shared energy-generating principles.


The series

The six areas of job-person mismatch

This is part of a series publishing portions of a research paper on How a Leader Maintains High Productivity Without Team Burnout.

 How a Leader Maintains High Productivity Without Team Burnout

Appendix C: The six areas of job-person mismatch

A conceptual framework for the crises that disrupt the relationships people develop with their work.

“Each area of mismatch has a distinct relationship with burnout and engagement.” (Cooper, 1998, pp. 75) Cooper provides a concise, useful overview of these six areas of mismatch in his book:

    • Work overload occurs when job demands exceed human limits. People have to do too much in too little time with too few resources. When overload is a chronic job condition, not an occasional emergency, there is little opportunity to rest, recover, and restore balance.
    • Lack of control occurs when people have little control over the work they do, either because of rigid policies and tight monitoring or because of chaotic job conditions. Such lack of control prevents people from being able to solve problems, make choices, and have some input into the achievement of the outcomes for which they will be held accountable.
    •  6 Critical Areas: work overload, lack of control, insufficient reward, breakdown of communication, absence of fairness, value conflict.Insufficient reward involves a lack of appropriate rewards for the work people do. This lack of recognition devalues both the work and the workers. Prominent among these rewards are external ones such as salary and benefits, but the loss of internal rewards (such as pride in doing something of importance and doing it well) can also be a critical part of this mismatch.
    • Breakdown of community occurs when people lose a sense of positive connection with others in the workplace. Some jobs isolate people from each other, or make social contact impersonal. However, what is most destructive of community is chronic and unresolved conflict with others on the job. Such conflict produces constant negative feelings of frustration and hostility, and reduces the likelihood of social support.
    • Absence of fairness occurs when there is a lack of a system of justice and fair procedures, which maintain mutual respect in the workplace. Unfairness can occur when there is inequity of workload or pay, or when there is cheating, or when evaluations and promotions are handled inappropriately. If procedures for grievance or dispute resolution do not allow for both parties to have voice, then those will be judged as unfair.

  • Value conflict occurs when there is a mismatch between the requirements of the job and people’s personal principles. In some cases, people might feel constrained by the job to do things that are unethical or not in accord with their own values. For example, they might have to tell a lie or be otherwise deceptive or not forthcoming with the truth. In other instances, people may be caught between conflicting values of the organization, as when there is a discrepancy between the lofty mission statement and actual practice, or when the organization undergoes major changes.

These six types of mismatches are not totally independent, but can be interrelated… The mismatches in these six critical areas of organizational life are not simply a list summarizing research findings from burnout studies. Rather they provide a conceptual framework for the crises that disrupt the relationships people develop with their work. This approach emphasizes the social quality of burnout – it has more to do with the organizational context of the job than simply with the unique characteristics of an individual. (Cooper, 1998, pp. 75-76)


The series

Not all stress is bad stress

This is part of a series publishing portions of a research paper on How a Leader Maintains High Productivity Without Team Burnout.

Stress is a beneficial component of personal development; this is “good” stress. However, too much stress can also lead to distress, which leads to burn out. Signs of distress can be subtle, but early intervention can prevent burnout.

 How a Leader Maintains High Productivity Without Team Burnout

Learn to guard against distress and utilize stress as a tool to grow. (Literature Survey Principle #2)

“An organization cannot anticipate and avoid every situation in which employees may feel overworked, frustrated, or unappreciated.” (Maslach & Leiter, 1997, pp. 103) Any leader who is working with a high-performance team knows that this statement represents business reality. To quote Quick, et al., “stress is inevitable; distress is not…We contend, as we have over the last 20 years, that stress is an essential agent in an individual’s and an organization’s growth, development, performance and success.” (1997, xvii-xviii) They go on using a bell curve to illustrate that

Stress Bell Curve

performance increases with increasing stress loads up to an optimum point, and then the stress load becomes too great, resulting in depressed performance. The optimum stress load that maximizes performance varies by individual and by tasks, on the basis of several considerations. Individual considerations include susceptibility to stress, fatigue, psychological and cognitive skills, and physical capacity. Task considerations include complexity, difficulty, duration, and intensity. (Quick, et al., 1997, pp. 4)

Loehr & Schwarts agree saying, “Stress is not the enemy in [life]… it is the key to growth… Any form of stress that prompts discomfort has the potential to expand our capacity…so long as it is followed by adequate recovery.” (Loehr & Schwartz, 2003, pp. 11) Similarly, Cora says, “Stress is not new, nor is stress always negative…Acute stress in small doses can be exhilarating.” (Cora, 2010, pp. 11)

This does not mean that all stress is beneficial. There is a difference between beneficial eustress (using the “eu,” Greek root for good) and distress (using “dis,” the Greek root for bad).

Stress becomes a threat to a person’s health and well-being when (a) the stress response is elicited too intensely, for too long a period of time, or too frequently; (b) early warning signs of problems, disorders, and distress are ignored; or (c) the person does not have the skills and repertoire of behaviors to meet the challenges and demands an organization presents…Stress in an opportunity when it challenges people to be all they can be. Stress is an opportunity when it enables people to display the talents, skills, knowledge, and gifts with which they are endowed. Stress is an opportunity when one grows, learns, changes, and develops through the experience. It is a challenge when it leads people to transform themselves, adapting to changing circumstances, and live well. (Quick, et al., 1997, pp. 307)

Cora suggests that whether stress becomes beneficial or threatening is the result of an individual’s beliefs. The beliefs that can lead to burnout include: seeing everything as an emergency, overdependence on self, failure to effectively delegate, not seeing self-care as integral to performance, and failing to make lifestyle choices that increase healthiness (Cora, 2010, pp. 21-4).

 “Stress is inevitable; distress is not.” - Preventative Stress Management in Organizations by Quick, Quick, Nelson & HurrellWhile stress is inevitable, leaders need to prevent stress whenever possible, especially stress that extends over a long period of time. Five formal organization areas that can be adjusted as part of preventive stress management are: job redesign, participative management, flexible work schedules, career development, and the design of physical settings (Quick, et al., 1997, pp. 164).

Another key part of stress management focuses on “improving relationships at work” (Quick, et al., 1997, pp. 187). The topic of conflict and relational conflict was a recurring theme throughout many resources. Another recurring topic was that of intra-personal conflict; conflict within the individual worker. Casserley & Megginson suggest keeping an eye out for four behaviors that are signs that an individual is not in touch with what he or she is thinking or feeling: dysfunctional anger, desensitization, beating up oneself, and using humor to avoid discussions related to burnout (2009, pp. 92-5). They also show two personality traits that often lead to burnout: over identification with work and a desire for recognition. When these behaviors or traits become apparent this is an opportunity for a leader to intervene because these are signs that stress is leading to distress instead of growth. Burnout develops in stages and intervention is possible at several points along the way.

When it comes to utilizing stress to help an employee grow it is incredibly important to be aware of the individuality of each team member. After all, “it is not the situation that is the primary cause of burnout, but the way in which people interpret and handle that situation.” (Casserley & Megginson, 2009, pp. 36)

Job stress is triggered by a wide variety of job demands, including task-specific demands, role demands, interpersonal demands, and physical demands (Quick & Quick, 1984a). These demands may or may not be inherently or necessarily harmful. In line with Lazarus’s perspective, the degree of stress they elicit in a person depends in part on the individual’s cognitive appraisal of that demand. (Quick, et al., 1997, pp. 11)

 “Empowered employees—employees who have a sense of control over their job tasks—are resistant to burnout.” - Overcoming Job Burnout by B. PotterA third repeating concept in utilizing stress for growth and development involved an employee’s experience of control. In a chapter dedicated to how managers can prevent burnout, Potters refers to a Harvard Business Research project and a U.N. Labor report, both of which support the fact that with stress levels being equal, those with decision-making power reported “less frustration, more satisfaction and fewer illness.” (Potter, 1998, pp. 266) Potter emphatically states that “Empowered employee–employees who have a sense of control over their job tasks–are resistant to burnout…Employees who feel they can impact their work and can ‘win’ by doing a good job retain their enthusiasm and are more motivated.” (1998, pp. 268) In other words, they are engaged. When employees have some level of control over the stressors in their work, those stressors are more likely to be a catalyst to growth instead of a sentence to burnout.


The series

Prevent burnout by managing energy

This is part of a series publishing portions of a research paper on How a Leader Maintains High Productivity Without Team Burnout. 

This post contains the portion of my research that focuses on what a leader can do to manage energy, but it barely scratches the surface on what I think is the key to burnout prevention: our personal management of energy. Energy management is holistic; it encompasses spiritual, mental, emotional, and physical health. It is not about being self-centered but about caring for ourselves so we have the energy to be others-centered. In the future I plan to delve into what I think are the three main aspects of energy management:

  • our day-to-day habits
  • whether we’re investing our time/energy into things that energize us (i.e. things that align with our personal, intrinsic values) or drain us.
  • our beliefs about stress (more on this in part 6)

But that is a topic for another day.

How a Leader Maintains High Productivity Without Team Burnout

Learn how to manage energy (Literature Survey Principle #3)

Leaders are stewards of organizational energy… They inspire or demoralize others first by how effectively they manage their own energy and next by how well they mobilize, focus, invest and renew the collective energy of those they lead.  The skillful management of energy, individually and organizationally, makes possible something that we call full engagement. To be fully engaged, we must be physically energized, emotionally connected, mentally focused and spiritually aligned with a purpose beyond our immediate self-interest. (Loehr & Schwartz, 2003, pp. 5)

First, Learn to manage your own energy

Managing energy and increasing engagement involve daily habits and the health of the whole person (physical, mental, emotional, and spiritual health). Managing energy requires a person to be connected to their needs, their values, and their strengths and weaknesses.

It is difficult, even impossible (or unethical), for a leader to manage the habits and beliefs that are most influential in an individual’s use of energy. What a leader can do, however, is lead by example: develop good self-awareness, set healthy boundaries around time and energy investment, get adequate sleep, eat regularly, take time to be with their family, create routines that renew, and invest in becoming healthy physically, emotionally and mentally.

The purpose of self-care through preventive stress management is to become more competent in managing stress, to become healthier, and as a result of that competence and health, to be a stronger asset for the groups and organizations in which one participates. (Quick, et al., 1997, pp. 301-2)

“The magazine Fast Company asked… successful professionals to talk about how they avoided burnout in the face of highly demanding jobs. Nearly everyone described very specific routines they had instituted to ensure they regularly renewed themselves” (Loehr & Schwartz, 2003, pp. 33-4) One of these interviewees said specifically that it’s important to pace oneself and “allow time for plenty of breaks” (Loehr & Schwartz, 2003, pp. 34) Another said that she never works on airplanes, instead she uses that time to do something that helps her recover. Another takes a four-day-weekend once a month with his family and makes sure his calendar is blocked off for those days. Another refuses to use a cell phone or voicemail.

Then, Watch for signs that employees are not managing their energy well (and say something to them)

Watch for signs of emotional health and then choose to coach employees to systematically expand their capacity. Signs of emotional distress include anxiety, rigidity, poor listening skills, lack of empathy, impatience, and being critical.

A person’s sleeping and eating habits are good indications of how an individual is doing. A leader can ensure that employees take breaks, get adequate time between shifts to sleep, and have access to healthy food during their breaks (or champion for wages that allow employees to afford healthy food).

These can be difficult topics to approach with an employee. Check out part 4 for an interview with a leader that practices the art of giving effective feedback (hint: it’s about the trust a leader has developed over time with their employee and the way the feedback is approached).

Identify conditions in the organization that are energy-sucks and champion change.

For example, Morgan McCall says that

believ[ing] that the fittest will survive without much nurturing, organizations not only overlook people [with] the potential to develop but also frequently and unintentionally derail the talented people they have identified as high flyers by rewarding them for the flaws, teaching them to behave in ineffective ways, reinforcing narrow perspectives and skills and inflating their egos. (Casserley & Megginson, 1998, pp. 64-5)

Companies can also help employees manage and regenerate energy by creating “energy generating principles and values [that] are stated clearly, understood and shared by every employee” (Smith, 2011, pp. 3).

“Tackling burnout means changing the way organizations are structured and led. Implicitly it means reducing workloads and helping employees find greater work/life balance.” (Casserley & Megginson, 2009, pp. 63-4)

This looks different in every organization. This may represent removing needless bureaucracy, creating stronger lines of communication between departments, or even allowing employees to feel like they have more control over their schedule. Other ideas can be found in this interview. The possibilities are endless.

" Energy, not time is the fundamental currency of high performance.” - Loehr & Schwartz


The series

Preventing burnout: Insights from an experienced leader

A requirement for my capstone research project on How a Leader Maintains High Productivity Without Team Burnout required an interview. The interview focused on how this specific leader increases employee engagement, manages the stress load of his team and models healthy behaviors and attitudes.

 How a Leader Maintains High Productivity Without Team Burnout

In the interview, it quickly became apparent that the leader had developed a division with a culture that built employee engagement. This leader’s work area was within hearing distance of his direct reports and he had intentionally created a department with very little hierarchy so that he could keep a pulse on how individuals in his group were doing. He continually returned to the point that listening was the best thing he does to know how his employees are doing. Whether it’s listening when they come to him for help, intervening when a potential issue comes across his desk, or listening to his employees interacting with the clients they serve. He is attuned to their normal ways of interacting and to subtle clues that the employee has been pushed to their limit. He said that his technique would probably not be scalable with a large group, but that if he had a larger team to manage he would focus on teaching his direct reports how to listen to their employees. He believes that organic listening is a skill that can be taught.

Organic listening is a skill that can be taught.

It also was apparent that he takes coaching his employees very seriously. By seriously I mean that he sees it as intrinsically part of leadership. However, he doesn’t coach his employees in a serious way. He is intentional about building comradery and a team spirit and keeping laughter part of the team interactions. He said that when he suggests a behavioral change to an employee it is normally handled in a light-hearted way. He also makes it clear that he is not above criticism and is open to feedback from his employees.

When he hires he spends a lot of time considering applicants before hiring them looking not only for competence, but more importantly the ability to relate well with others. He watches for clues about their temperament preferring to hire people who are open to feedback and who are somewhat introspective. He looks for people that may need coaching but who will grow as a result of the investment.

Hire people who are open to feedback and who are somewhat introspective

As far as how he manages the pressure his employees’ experience, he stated multiple times that he works alongside his employees when he asks for extraordinary performance. That means being accessible even in the middle of the night or putting aside his to do items for the day if a situation needs his help. He wants his team to know that they (both the leader and the employee) are a part of the team.

“Stress and anxiety are often caused by lack of clarity”He says that stress and anxiety are often caused by lack of clarity, so he comes alongside his employees and helps them break large projects down into doable segments. This helps employees feel more in control of what they are doing. He has also set up his department so that his employees have some level of control over what they are doing. This doesn’t mean he is removed, but simply that he allows them to handle things and watches for signs that he needs to get involved. He keeps a close eye on areas that will take a toll and that have to be managed. He says that only a leader can mediate push back and he takes that role seriously. He takes the role of team leader seriously because it’s important. He says that there are things that only the leader can do and one of the biggest things is taking care of the team.

Give employees some level of control over what they are doing.

He talks to his employees about the end goal, both for the individual employee’s development and for projects that will bring high-stress levels. He helps his employees see what is beyond the stressful situation. He sees hope as something that is key in keeping people from burnout. He said that he explains that there is a light at the end of a tunnel when employees are under extraordinary projects.

There is a light at the end of a tunnel

I asked him how he developed these perspectives and he said that when he first started managing he read books on leadership, communication, and negotiation. Over time these concepts have become an intrinsic part of who he is and how he responds. From my observations, it seems that his ability to understand what makes people tick and how to effectively work with others is probably part of his strengths/gifting make-up. But he has worked to hone those skills and takes pleasure in teaching others to do the same. He values people. He says that “people are everything, especially in small organizations.” That is why he takes hiring as seriously as he does and why he coaches employees in the way they interact with others. He tells his employees that learning to interact well with others by listening, communicating and using self-control are what will set them apart and allow them to grow into leaders themselves. He encourages them to interact face-to-face if possible instead of allowing emails to get out-of-hand. He sees email communication as something that can waste time and create issues where there weren’t any. By encouraging his team to communicate face-to-face this lowers the amount of time wasted on what can become a stressful activity.

Having seen this leader in action, I found this interview to be incredibly encouraging and inspiring. Hearing his insights on this subject supported my previous observations about his tremendous skills as a leader. It was encouraging to see that it’s been something that he worked to learn and then implement with the people on his team. He cares about people and encourages them when he sees something good. And it seems that he is always watching for people to do something good.

Before the interview, I felt overwhelmed by what I had found in the research. It seemed that preventing burnout was an impossible task for any individual. However, this leader showed that listening and caring for employees is the most important thing to learn to do as a leader. The fact that he does this shows up in the level of respect and trust his employees have for him. He models good interpersonal skills and coaches his employees to do the same. He recommends books for them to read. He doesn’t expect perfection. He knows that people will make mistakes and he has grace for that.

This leader doesn’t necessarily see himself as an example to others in the area of leadership – probably because he has a humble attitude about his skills and abilities. But he is most definitely a model to me of what I want to be as a leader.

Background and Preparation

History and Background

The person interviewed holds an executive-level position in a San Diego company. This person manages multiple departments that have significant budgetary constraints and are tasked with multiple, high-stakes projects. This person has successfully led high-productivity teams without team member burnout. It is this experience and expertise that makes this person the ideal interviewee for this research study. The researcher has had the opportunity to interact with this person’s employees and they are each committed to their work and respect the leadership of this person. The researcher admires this leader and has been impressed with stories of how this person has empowered employees, helped work through interpersonal or interdepartmental conflict, and how this person has successfully implemented new ways of handling projects to increase speed and effectiveness.

Questions to be asked

Objective One: Identify how this leader builds engagement and impacts company culture.
  • How do you help your employees contribute their maximum energy/potential?
  • How do you ensure you communicate clearly with your employees?
  • Your employees seem to be informed on what is going on in the organization. How do you disseminate organizational information?
  • How do you keep a pulse on how your employees are doing?
  • How do you identify potential issues? What do you do when you identify impending problems?
  • Are there any specific things you do to help prevent your team members from burnout?
Objective Two: Determine how this leader guards against team member distress and uses stress as a tool to help employees grow.
  • How do you monitor the level of stress each of your employees is experiencing?
  • Do you evaluate the level of stress your employees are experiencing with their individual abilities to handle it?
  • Your team seems to be heavily involved in multiple, stressful projects at any given time. How do you make sure this stress doesn’t cause distress?
  • You seem to get involved when one of your employees (or when a project) gets stuck, but you empower your employees to work relatively independently. How do you determine where the control boundaries are set?
  • Based on your experiences and observations, what makes the difference between a person or situation that causes growth verses one that burns out?
Objective Three: Ascertain how the leader helps employees manage energy.
  • How do you manage your team’s combinations of strengths and weaknesses?
  • How do you manage and communicate about your own personal weaknesses and strengths?
  • If your employee is demonstrating self-destructive habits, like overworking or not taking care of self, what do you do/say?
  • Your employees work a lot of hours and their work hours vary from week-to-week. How do you manage this?
  • Do you intentionally model specific behaviors or attitudes for your staff?

The series