Compassion Stress The Cost of Caring

1. Compassion StressThe Cost of Caring Evelyn Sikorski, CSW, CEAP Manager, Employee and Family Assistance

2. Brainstorm #1 What do you want for yourself as a healthcare giver?

3. The American Nurses Association’s Code of Ethics underscores the importance of self-care and meaningful work • “The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence and to continue personal growth and professional development.”

4. Empathy, compassion & vigilance • Major skills of helping professionals • Provides emotional awareness and accurate perceptions • Enables identification with others • Maximal physiological and psychological readiness • Ability to detect and reach on behalf of the patient and family • Enables understanding of other’s feelings and motives Makes us more vulnerable

5. Following an Adverse Event…Taking care of yourself first • Traumatic symptoms are not caused by the event itself. They arise when the activation, mobilized to meet an extreme or life threating event, is not fully discharged and integrated. • The energy remains trapped in the nervous system where it can wreak havoc on our bodies and minds.

6. Recapture your sense of purpose, hope and joy • Feelings become intense and sometimes are unpredictable • Thoughts and behavior patterns are affected by trauma • Reoccurring emotional responses are common • Interpersonal relationships often become strained • Physical symptoms may accompany the extreme stress

7. Definition of Compassion Fatigue • Compassion Fatigue occurs when you focus on the needs of others without sustaining healthy self-care practices to balance our giving and receiving • An extreme state of tension and preoccupation with the suffering of those being helped to the degree that it is traumatizing for the helper. • A deep physical, emotional and spiritual exhaustion accompanied by acute emotional pain. • Compassion Fatigue originates from an internal place of depletion.

8. Role of exposure in health care • Exposed to patient’s trauma • Exposed to physical and emotional pain • Absorbing the suffering day after day • We are left with nothing to fortify and strengthen our resolve to be of service to others

9. Brainstorm #2 Complete the following statements in your group Things that take the job and fulfillment out of my job… Things that bring energy and fulfillment into the job…

10. Signs of Compassion Stress “I’ve got the stress; I just don’t have the compassion right now.” • Preoccupation with work. You just can’t stop thinking or talking about it. • Sleep difficulties/over or under eating. • Over reactive, unprofessional. • A sense of helplessness about your work. “It doesn’t really matter.” • A feeling of weariness about what you do. • Argumentative with coworkers; angry feelings; isolation • Asking yourself “Why am I sad all the time? What is wrong with me?”

11. How compassion fatigue affects the workplace • Higher turnover rate • Low morale • Coworker conflict • Lower productivity that can lead to patient errors • Higher rates of physical illness and injury • Use of alcohol and substance abuse • Poor self care

12. Harsh reality • How it is, when several people are exposed to the same stressor, that some will break down while others remain healthy and even thrive?

13. Resilience defined George Varliant (1993) defined resilience as the “self righting tendency” of the person, “both the capacity to be bent without breaking and the capacity, once bent, to spring back.” The Road to Resilience (p. 248) Goldstein, 1997 American Psychological Association

14. Hardiness Three Components: • Commitment: valuing one’s life, self, relationships • Control: the belief that life events are are in part a result of ones own actions and attitudes, and amenable to change. • Challenge: the belief that change, rather than stability is the normative mode of life.

15. Impact on employee health • Fatigue • Injury • Illness • Depression/anxiety • Substance abuse • Job dissatisfaction • Lower performance • Poor self care

16. Factors contributing to resilience & resourcefulness • The capacity to make realistic plans and to take steps to carry them out • A positive view of yourself and confidence in your strength and abilities • Skills in communication and problem-solving • The capacity to manage strong feelings, emotions and impulses • Take care of yourself • Find a mentor or professional help if further assistance is necessary

17. Characteristics needed for resilience • Positive • Focused • Flexible • Organized • Proactive

18. Ideas to manage compassion fatigue • Create a self-care plan that you can effectively put into action • Communicate necessary boundaries • Commit to being positive • Rebalance your work • Have a transition plan from work to home • Take time for physical activity and proper nutrition How do you manage stress?

19. Making one small change in your daily routine can have tremendous results in the long term for a healthy nursing career. Thanks for coming!

20. Community and Emergency Resources • Medically Induced Trauma Support Services www.mitsstools.org Clinical section of resources and clinical support programs 24/7 resources • Suicide Prevention Lifeline 1-800-273-TALK 24/7 • Fletcher Allen Employee and Family Assistance Program efap@vtmednet.org Counseling, resources and referrals • Evelyn A. Sikorski, CSW CEAP Manager, Employee and Family Assistance Program Consultation and Training Evelyn.sikorski@vtmednet.org / 802-847-6540