What is Psychological First Aid?

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Navigating mental health discussions is challenging. However, the individual seeking to eat the nut's fruit must first crack the shell. It would be far easier to play the role of Mr. Facing Both Ways and avoid it altogether, in which the author could find reasons and excuses for avoiding it. However, the platform and canvas for conversation regarding mental health are some topics that the author of Palate and Pabulum has a strong affinity for investigating to elevate himself and others. For that matter, it is vital to write about the mental health of workplace employees. If the reader would allow the term, a professional nurse possesses an alphabet soup of skills, education, and training that influence practice. One would be challenged to disagree that most nurses and other allied health professionals have been exposed to situations and circumstances that affect their mental wellness.

When writing about mental health, one is cautioned that it is not something to be observed like an experiment but that mental health, just like physical health, is something experienced by all, and for that matter, healthcare professionals are not immune or excluded. However, there is much stigma regarding mental health, especially when screening for depression and anxiety (Joyce et al., 2015). Is this true of those who work in the healthcare sector?

The following discussion will highlight some findings in the literature. The aim is to provide insight into how leaders can help employees address their psychological well-being or, better yet, offer some psycho-intellectual first aid (Joyce et al., 2015). Definitions are helpful and thorough reviews of literary works about mental health in the workplace borrowed from European scholars who performed reviews of literature from their keyword searches of anxiety and depression, for example, in "Workplace interventions for common mental disorders: A systematic review" (Joyce et al., 2015) describe job risk factors.

Common knowledge informs the author of the Palate and Pabulum regarding job risk. For instance, as a prior service Marine, there were inherent risk factors for being in the infantry. As mentioned, one can imagine any other sector where risk factors for a particular profession are inherently risky. Although risk stratifying for any job or career is not the point of the following blog post, an argument can be made to suggest that any profession can have inherent risks.

Joyce et al. (2015) supplied the following definitions from their paper, which are inherent in many professions. Workplaces have work-related tension, require mental and cerebral demands, encompass job restraints, have relational constructs, and perform institutional remodeling. These are often accompanied by dissatisfaction at work, which can put one at risk for a deviation in one's mental well-being.

In addition, disability affecting people from anxiety-related disorders is in the top ten globally (Penninx et al., 2021). The overarching element surrounding anxiety, for instance, is baseline fear of actual or perceived threats (Craske et al., 2022). For example, children often encounter separation fears of detachment from their parents through different stages of development. Other forms of fear are phobias, dislikes, or aversions to particular objects and situations that cause anxiety in individuals.

Social anxieties or situational fears stem from the fear of being watched by others, being the recipient of derogatory remarks, or fear of being rejected (Craske et al., 2022). Probably the most common type of anxiety, as outlined in the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the most chronic and characteristic of workplaces, is the generalized type of anxiety that is a common symptom of those in professional and academic environments.

When manifested, feelings of being ramped up, easily irritable, tense muscles, and problems with sleeping (Craske et al., 2022) can be felt. The generalized type of disorder of anxiety, common in the workplace, is what scholars have outlined as needing intervention (Joyce et al., 2022). The author of this blog post bends thinking to a hypothesis that two types of manifestation of workplace fears and anxiety are social and generalized anxiety in the setting of healthcare environments.

What are some options we as leaders can try to help those we steward meet mental wellness challenges, especially when caring for others, as nurses and doctors often do? How do we help those who care for others care for themselves? That is the genie in the lamp question.

Wedging encouragement and weaving inspiration alongside science-based literature with a nuanced approach from Henri Nouwen, the reader gains understanding. In his book, The Wounded Healer (Nouwen, 2010, p. 96), a definition of hospitality plain as day is giving our attention to a guest. That is what being hospitable means, and by extension, healthcare providers and allied healthcare practitioners perform their functions well when caring for patients entering the clinic or acute care institution, maybe because it is from a sense of duty in which to earn a living, or perhaps some feel a calling. Again, how much more can we be hospitable to each other, nurses, doctors, and other healthcare workers? As Henri Nouwen put it, we can give attention to each other at work or be hospitable to one another.

European scholars give insight into the interventions or the how-to of helping employees promote mental well-being through primary, secondary, and tertiary advocacies. First and foremost, an essential preventative measure for health should include, but not be limited to, increasing employee autonomy at work, acknowledging the importance of physical activity on mental health, and improving the work environment's atmosphere (Joyce et al., 2015). Secondary preventative measures include screening for anxiety and depressive-related symptoms, resources for counseling, and managing stress initiatives, which are methods for helping those who experience difficulty living with symptoms of job-related mental health experiences (Joyce et al., 2015). Lastly, according to Joyce et al. (2015), advanced preventative measures include, in conjunction with a qualified health provider, cognitive behavior strategies with clinical therapists and psychiatric providers, and pharmacological management for mental hygiene.

Although the writers in which Joyce et al. (2015) acknowledge limitations in the literature review, for example, the multidimensional work environments and careers in which people are employed and, ultimately, that is undiscovered the utilization of such tools and resources to perform workplace mental health intercession for employees, strategies for improving the overall health of a workplace can be initiatives, can be constructive and can be advantageous for the overall health of employees.

References:

Craske, M. G., Manicavasagar, V., Schultz, S. K., Zbozinek, T. D., Wolitzky-Taylor, K., Ollendick, T. H., Muris, P., Mesri, B., LeBeau, R., Brown, L. A., Bogels, S., & Baum, K. B. (2022). Anxiety Disorders. In American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (5th ed., Ser. Text Revision, pp. 215–262). essay, American Psychiatric Association.

Joyce, S., Modini, M., Christensen, H., Mykletun, A., Bryant, R., Mitchell, P. B., & Harvey, S. B. (2015). Workplace interventions for common mental disorders: A systematic meta-review. Psychological Medicine, 46(4), 683–697. https://doi.org/10.1017/s0033291715002408

Nouwen, H. J. M. (2010). The wounded healer: Ministry in contemporary society. Image Doubleday.

Penninx, B. W., Pine, D. S., Holmes, E. A., & Reif, A. (2021). Anxiety disorders. The Lancet, 397(10277), 914–927.

Does Culture Really Matter?

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The author of "Palate and Pabulum" derives leadership traits from a diverse background, including high school football, the U.S. Marines, and professional nursing education. Authentic relationships are crucial for transformational influence, as noted by Cialdini (2021), while positional titles do not guarantee authority. Effective organizational teamwork is essential for optimal patient outcomes (Wei et al., 2024).

Values such as discipline, integrity, and compassion have been a priority for the author, cultivated through unwavering parental support and various life challenges that serve as learning opportunities. These experiences refine character and enhance leadership, especially amid societal changes that demand our attention.

In the context of leadership, particularly in addressing staff engagement, Gallup surveys indicate that only 15% of employees feel engaged in their jobs (Gallup Inc., 2024). Nursing scholarship defines staff engagement as a positive and committed outlook (Wei et al., 2024). Leadership plays a critical role in improving engagement, with effective leaders fostering collaboration and supporting team strengths, as Clifton & Harter (2019) outlined.

References:

Cialdini, R. B. (2021). Influence: The psychology of persuasion. Harper Business.

Clifton, J., & Harter, J. K. (2019). It's the manager: Gallup finds that the quality of managers and team leaders is the biggest factor in your organization's long-term success. Gallup Press.

Gallup, Inc. (2024). Gallup - Workplace Consulting & Global Research. Gallup.com. https://www.gallup.com/home.aspx

Wei, H., Cao, Y., Carroll, Q., Wei, A., Richardson, S., Nwokocha, T., Mcintosh, J., & Hardin, S. R. (2024). Nursing work engagement, professional quality of life, and intent to leave: A structural equation modeling pathway analysis. Journal of Nursing Research, 32(5). https://doi.org/10.1097/jnr.0000000000000632

C-3PO the counselor?

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Luke, the hidden heir of the Skywalker legacy, learned about the force through training interactions, one-on-one time with his masters, and often voices heard within from Jedi who passed from the material world to the afterlife, in particular Obi-Wan and Yoda. As a student or rather disciple of the master Jedi, Luke was taught the ways of the force. Luke also had an assistant, a shiny, intelligent, sheepish database of knowledge and galactic resources known for speaking out of turn often before being asked to do so. Although C-3PO was a helpmate to Luke, the droid was not a competent tutor in place of Yoda for the young apprentice as a learner of the Jedi way.

Motifs from the Star Wars saga apply to Christianity. For example, the young padawan relationships portrayed are reminiscent of Jesus's relationships with the twelve. We can learn about the ways of God by reading scripture and being taught by others. As such, sometimes, you must read and keep reading until the Word sinks past your thoughts and distractions, and it takes practice, like warming up the body before training or, like Luke, learning how to focus the force for lifting his fighter plane out of a murky swamp which he failed on many attempts to the disappointment of Yoda.

For scripture to sink into a man's thoughts, for instance, to infiltrate past the want of his phone, listening to the news, or being distracted by others who vie for his attention, the practice of reading the Word takes time before it seeps into his conscience; imagine what the sages of old went without: no television, no phone but a minimal interference. Only then can we appreciate how much God loves man and pursues him. Reading the Word, we navigate who God is and our relationship with him; being with other disciples, we learn at least observationally and experientially how to act as he did, and we see the example of his son lived out before us through others' example to us as revealed in scripture although never perfectly.

An extension of knowing God comes through following his son's example, which, as mentioned, is what discipleship means. To highlight the Star Wars theme, it is admittedly a crude example of a relationship like that of a padawan and master. This is no different from the fictional science fiction relationship that Luke and Yoda lived in that has been introduced. Discipleship is the practice of teacher-follower relationships and is common in faith-based organizations or communities of spiritual/religious persuasion. These interpersonal, community-centered human relationships are meant to teach the ways of Jesus again, like the force in the Star Wars series.

For context, the faith practiced by this blog's author is part of a community of Christians that try to practice discipleship by first being a student or follower of Jesus and, by extension, helping others do the same. It should be known that this blog's author does this imperfectly, falls short, and often fails to carry out the Great Commission (The Holy Bible, New International Version, 1999, Mark 16: 15-18) but perseveringly.

Although there is no substitute for human interaction and relationships for the practice of discipleship and being in a community of others who share the same beliefs, attitudes, and ways of life, which at this time of the blog does not allow room to discuss faith-based organizational citizenship, adjuncts for discipleship exist for the student of scripture.

For example, as an analogy, AI platforms are to disciples as C-3PO is to Luke. Allow the sentence to follow for elaboration. For starters, the author takes great pains in voicing AI's inferiority to the authority of scripture. In addition to the insights and inspired Word, the reader is reminded that God inspired all scripture and is beneficial for teaching, training, rebuking, and correcting in righteousness (The Holy Bible, New International Version, 1999, 2 Timothy 3:16-17). Again, as disciples, we are all workman-approved (The Holy Bible, New International Version, 1999, 2 Timothy 2:15); to be teachers of the Word, as followers, we are competent to handle the scriptures.

Suppose one can tolerate the idea that AI is an adjunct, like a personal C-3PO, a tool for helping and building one's faith. The author here will argue that this connection with artificial intelligence will be helpful for others who are students of scripture or are seeking God through these technologies. By highlighting this point and recognizing more than a few advantages of artificial technologies, the author will demonstrate how AI can be supportive, supplemental, and significant.

Through intervention, one can awaken the stupor and stigma surrounding artificial intelligence. The author of Palate and Pabulum aims to convey that the platforms of large language models are helpful in three ways. First, they can access information from sources instantly, not just as knowledge banks but also by providing additional resources in the responses. Second, the information provided can help the user formulate additional questions from the prompts provided in the inquiry response. Lastly, artificial intelligence models are tools like personal C-3POs when another person is unavailable. They can respond to requests and be resourceful when in-person assistance is unavailable through analytical and informational avenues (Claude AI, 2024). This blog's author tries to ignite the argument that the large language models are also our teachers, educators, and discipleship helpers.

Let's explore an example based on a question posed to Poe.com, a prominent language model platform. The inquiry stemmed from insights gained while reading a chapter in the book of Romans, specifically regarding how disciples can present themselves pleasing to God. This understanding was further enriched by consulting commentary on Romans 12 (Plummer, 1979; The Holy Bible, New International Version, 1999, Romans 12:1). The commentary suggests that one way disciples can be pleasing to God is by maintaining a sense of their unworthiness, which reflects humility and contrition. Reflecting on recognizing our need for God and our unworthiness about His holiness could be an enriching discussion with a spiritual advisor, mentor, or pastor. This blog's author decided to reach out to Poe for insights on this philosophical question. Poe was asked to describe the qualities one might possess if one is penitent and aware of one's unworthiness. Here is the response that followed.

Description of the Penitent Man

Physical Appearance:

He is of average build, with a modest demeanor that reflects his humility. His clothing is simple, perhaps slightly worn, signifying a lack of concern for material wealth. His eyes, however, are expressive—deep and contemplative, revealing an inner life marked by reflection and sincerity.

Emotional State:

This man carries an air of quiet introspection. There's a softness in his gaze, indicating that he has grappled with his shortcomings. He acknowledges his flaws without self-pity, understanding that imperfection is part of the human experience. His posture is slightly slouched, not from defeat but from a grounded awareness of his place in the world.

Character Traits:

He possesses genuine humility, recognizing that while he has made mistakes, these do not define him entirely. He is penitent, not in a way that paralyzes him with guilt, but as a motivating force for personal growth. His awareness of his unworthiness fuels a desire for improvement and a compassionate approach toward others who struggle.

Interactions with Others:

He listens more than he speaks in conversations, demonstrating empathy and understanding. He freely admits his faults and often reflects on lessons learned from his past actions, which fosters a sense of connection with those around him. He supports others, inspired by his journey through remorse and redemption.

Spiritual Outlook:

Spiritually, he embraces the idea of grace, understanding that while he may fall short, a greater purpose and forgiveness are available. His faith is not rooted in self-righteousness but in a profound appreciation for the complexities of life and the human condition.

Conclusion:

This man exemplifies a healthy form of penitence, characterized by an honest acknowledgment of his unworthiness without being consumed by it. His journey is one of continuous growth, compassion, and a deep understanding of the interconnectedness of all human experiences (Poa AI, 2024).

If, in summary, as proposed and if the analogy holds, AI could become, to a certain degree, our personal C-3PO, it opens up the possibility that AI can help us explore profound questions and guide us toward illuminating solutions and concepts that address the most challenging aspects of our philosophical and psychological journeys.

References:

Claude AI. (2024). Response to: How can you engage in meaningful discussions about faith, spirituality, and personal growth? OpenAI. https://claude.ai

Plummer, W. S. (1979). Romans 12. In Commentary on Romans (p. 561). Kregel Publications.

Poe AI. (2024). Response to: Can you describe a man who is penitent and has a healthy, just sense of his own unworthiness? OpenAI. https://poe.com

The Holy Bible: New International Version. (1999). Cornerstone Bible Publishers. (original work published 1973)

Can AI help us in the hospital?

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In mid-2023, the author of the Palate and Pabulum blog began implementing recommendations from technology experts regarding the functionality of AI platforms. The usability and accessibility of AI language learning apps are increasingly gaining traction. As a healthcare provider, the author became aware of these applications through a website called Recomendo, created by the original editors of the well-known magazine Wired. Recomendo distills technology-related information and shares it for free.

Now more than ever, the AI revolution is upon us, leading to a distinction between early and late adopters. The academic community actively explores artificial intelligence applications across various disciplines, and the healthcare service industry is no exception. The following essay and dialogues aim to draw on academic literature as source material for the following blog post. A keyword search in CINAHL using "AI" and "nurse*" was conducted to surface relevant articles. The selected articles were chosen randomly based on titles that included "AI," "artificial intelligence," and "nurse."

Scholars have identified that advances in computer technologies, such as artificial intelligence modalities, can affect patient care by enhancing services and offering best practices (Wangpitipanit et al., 2024). One of the diverse ways that AI has been able to differentiate itself, for example, from a general online Google search, is that some of the platforms' methods do not just offer up random facts of knowledge; instead, these applications can first and foremost analyze questions when submitted, integrate, and organize prototypal insights for the user.

Additionally, others have reported that AI can be used as an adjunct to trusted research databases. For example, Epstein (2024), a healthcare informationist, has discussed that nurses often need information from trusted academic sources such as CINAHL, a standard library index of evidence-based literature for allied healthcare professionals and registered nurses, and the upcoming surge of significant language computational programs can assist those seeking knowledge to help them distill queries when searching for evidence-based literature to inform best practices when delivering care to patients.

Without question, more scholars have added to the knowledge available for artificial intelligence capabilities in healthcare. Ronquillo et al. (2021) have noted that the applications for AI's reach will address tasks and activities requiring little to no reasoning or contemplation, such as resupplying medications when electronic dispensers need refilling or using robot-assisted notifications when rooms need cleaning after a patient has been discharged automatically freeing up time for nurses. What is more, the scholars pointedly acknowledge, as to be expected, that the use of AI platforms can help nurses strategically gather information regarding their patients and that education on these technologies is paramount to continuing education as they evolve and become visible in healthcare delivery (Ronquillo et al., 2021).

References:

Epstein, Helen-Ann B. (2024). Suggestions from experience and AI tools to teach evidence-based practice to nurses. Medical Reference Services Quarterly, 43(1), 59-71. https://doi.org/10.1080/02763869.2024.2289335

Ronquillo, C. E., Peltonen, L., Pruinelli, L., Chu, C. H., Bakken, S., Beduschi, A., Cato, K., Hardiker, N., Junger, A., Michalowski, M., Nyrup, R., Rahimi, S., Reed, D. N., Salakoski, T., Salanterä, S., Walton, N., Weber, P., Wiegand, T., & Topaz, M. (2021). Artificial Intelligence in Nursing: Priorities and Opportunities from an international invitational think‐tank of the Nursing and Artificial Intelligence Leadership Collaborative. Journal of Advanced Nursing, 77(9), 3707–3717. https://doi.org/10.1111/jan.14855

Wangpitipanit, S., Lininger, J., & Anderson, N. (2024). Exploring the deep learning of Artificial Intelligence in nursing: A concept analysis with Walker and Avant's approach. BMC Nursing, 23(1). https://doi.org/10.1186/s12912-024-02170-x