Transcript Self-Care for the Professional Helper

“SO YOU ARE THINKING OF QUITTING?”
(Compassion Fatigue Presentation)
JCMVAMC & Community Service Council
Muskogee, OK
January 7, 2014
Jim Lyall, MPA, CIRS
Lanny Endicott, D.Min., LCSW, LMFT
Erv Janssen, MD
Objectives for Our Time Together
1.
Share our growing collaboration:
JCMVAMC & CSC
2. Discuss dimensions of Compassion
Satisfaction – Compassion Fatigue –
Burnout
3. Explore complexities of Compassion
Fatigue
Community Collaboration
• The Veterans' Initiative of the CSC
(2009)
• The Initiative's relationship with VA
administration & various departments
• CSC sponsorship of "Silent Wounds of
War"
• Assistance with VA Resource Fair
• Coffee Bunker: veteran drop-in center
(Tulsa – 41st & Sheridan)
• Wounded Warrior Project
• Cognitive Processing Therapy
• Training in Military Culture
• Question Persuade Refer Suicide
prevention
• Moral Injury/Soul Injury Training
Continuing Collaboration
• Veteran's Treatment Court
• Preventing/Ending Homelessness
• Moral/Soul Injury
• Annual Veteran's Stand Down
Future Considerations
• Community Based One-Stop-Shop
Center
• Continuing Communication between VA
& Community-based Organizations
Dimensions of “Compassion”
Satisfaction
Fatigue
(Secondary Trauma)
Burnout
Compassion Satisfaction
Encouragers
Experiences pleasure from helping
Perceives agency as supportive
Personally enjoys the work
Able to do the work
Sees work as fulfilling (“work may be
viewed as a calling”)
Adapted from Beth Stamm
Compassion Fatigue
Discouragers
Missing pleasure from helping
Agency not perceived as supportive
Doesn't enjoy the work
Questions the ability to do the work
Unfulfilled, disillusioned in the work
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Fatigue
Frequent illness
Sleep problems
Disillusionment with
work
Helplessness
Sense of Hopelessness
Being harsh with other
staff
Cynicism
• Powerless to change
events
• Anger toward the
organization and/or
“clientele”
• Depression and isolation
• Staying away from coworkers
• Reduced commitment to
work
• Being absent
• Use of Chemicals
For more see: http://www.compassionfatigue.org
Burnout
Worn out
Helpless
Exhausted
Loss in Productivity Loss of Self (Soul)
• Takes time to develop
• Person is often not aware
• Key sign is looking to quit and/or change jobs
Additional Fatigue Factors
Working with the traumatized
Absorbing trauma of others
Personal exposure to trauma
Accompanying sense of:
powerlessness, hopelessness,
"wearing out"
http://www.proqol.org
Model for Burnout
Primary Trauma(s)
Compassion Fatigue (ST)
Stress of Life
Burnout
Personal Strategies for Prevention
Recovery
Exercise
Diet
Journaling
Meditation
Spiritual
Photography
Sports
Family
Reading
Music
“Breathing”
Gardening
Sleep
Hobbies
Some Strategies at Work
In the Unit, Team, Group
Creating opportunities to share
Nurturing an encouraging atmosphere
Keeping information confidential
Spending social time together
Maintaining an atmosphere of safety
Self-Care is Balance
Care for Me
My Responsibilities
Professional "Impairment"
Complexities of Compassion
Fatigue
Patient/Family
Me/Team
Hospital/System
Complexity of Compassion Fatigue
(from the perspective of a clinician)
The role of compassion: The VA motto
March 4, 1865: President Abraham Lincoln
“To care for him who shall have borne the battle and for his
widow, and his orphan.”
• Thus the framework is set………
COMPASSION is foundational for our work in a
system with the mission of caring
• Compassion engages
• The quality of compassion puts us at risk
AND, not only for those who have direct contact with
patients, clients or families……but for all who are a part of
the VA!!
U. S. Department of Veterans Affairs; Celebrating America’s Freedoms; The Origin of the VA Motto:
Lincoln’s Second Inaugural Address
Compassion Fatigue
Related to relationships:
• Clinician-patient/client
Within groups:
• In families of those suffering from PTSD: “like a
virus, the stress spreads”
• In “systems” such as teams, or a hospital
➢ NOT JUST LIMITED TO “CLINICAL STAFF”
Figley, Charles R.: What is Compassion Fatigue-Prevention & Treatment; Gift From WithinPTSD, Resources for Survivors and Caregivers (web page) © Green Cross Foundation
http://www.giftfromwithin.org/html/What-is-Compassion-Fatigue-Dr-Charles-Figley.html
A Concern for the VA
In VA publication: Organizational Health (Vol. 18;
Spring 2013)
• “Healing the healers”, Linda Belton, p. 4
• “Burnout in the VA: How are we doing?”, Katerin Osatuke, p. 5
• “All Things Connected….”, Linda Belton, p. 10.
And from a “sister” VA: Puget Sound VA pushing to
hire, grow, retain staff:
• “Low job satisfaction and morale may be one factor driving
turnover”
• “Demands of job take a big toll”
• “I loved every job I ever had, but I just burned out at the VA”
(supervising physician)
The Seattle Times, December 20,
2014[http://seattletimes.com/html/localnews/2025279563_vastaffingsxml.html]
PERSONAL REFLECTIONS: TAKING STOCK
1. Introspective (honest, in-depth) effort
2. Review with others: ENCOURAGING CONTINUING
CONVERSATION
• Family
• Friends
• Work colleagues
• Supervisor?
• Professional consultation
3. Structured assessment: PROFESSIONAL QUALITY OF
LIFE SCALE
30 question “self test” for self scoring
Beth Stamm
What Can Be Done?
1. Creative possibilities by continuing the conversation
• Not just complaining
• Together generating ideas, exploring possibilities
• Minimize “It will never work”
2. The Mayo experience: “Peer Support Trumps
Time Off in Preventing MD Burnout”
• 90 minutes every 2nd week (9 month trial period)
• 6-8 physicians with trained facilitators/colleagues
vs. unsupervised time off
3. CREW “Being locally creative”!
A randomized controlled trial evaluating the effect of facilitated small group sessions on
physician well‐being and job satisfaction (C. West, L. Dyrbye, J. Sloan, T. Shanafelt); Research
Presentation 26 Oct 2012
Peer Support Trumps Time Off in Preventing MD Burnout. Medscape. Nov 06, 2012
COMMENTS
QUESTIONS
"Keeping the conversation going"
Jim Lyall
[email protected]
Lanny Endicott [email protected]
Erv Janssen
[email protected]