Transcript Clinical Review

Clinical Review for the
Generalist Hospice and
Palliative Nurse
Self Care for the Hospice and
Palliative Care Professional
1
Objectives
©
1. Define your goals for career development
2. Assess self-care skills and areas for change
3. Develop a plan for professional self-care
2
Self Care for the Professional

A lifelong process of integrating multiple
dimensions of



Wellness
Self care
Professional growth
3
Barriers
To Professional Self Care




History of altruism
Self-empowerment
Multiple roles
Time constraints
©
4
Self Development Model
Mind
Body Spirit
Work Life
Balance
Career
Planning
Grief
and Loss
5
Set Goals




Set some time aside for you!
Individually developed
Dynamic
Develop a plan to make the goals a reality
6
Skills and Insights
 Self empowerment
 Awareness of possibilities
 Change agency
 Openness
 Advocacy
 Accountability to self
 Communication
 Reflection
 Organization
 Proactive
 Flexibility
 Commitment to self growth
7
Actions






Start with doing something!
Start a journal
Consult with others
Start a new habit
Read an inspiring book
See a counselor!
©
8
Self Assessment
 Your future
 Your health
 Family and employer
 Constant grief and loss
©
9
Having a Plan is Important
 The order/steps you follow will make a big
difference in the outcome
10
©
Goals For Professional
Self-care






Goals for a career not just a job
Set reasonable and flexible goals
Think outside the box
Talk to others
Be generous to yourself
Interrelated goals and interventions
11
Mind/body/spirit
Interrelated and Indivisible
12
Physical Development



Exercise
Healthy diet
Maintain optimal
weight
©
13
Mind

Healing the healer – try something new




Rieki (Horrigan, 2003)
Massage
Music therapy
Humor
14
Mental/Emotional/Spiritual
Support For Yourself




Avoid negative self-talk
Stay in touch with all of your feelings
Create a library of positive memories
Reframing
©
15
Burnout
 > 260% increase of hospice and palliative patients
served over last ten years, continues to grow
 Nurses report more stress from lack of
organizational support, social support, lack off
decision making rather than the involvement in the
dying trajectory of many patients
 Stress and burnout less common in hospice and
palliative care than other specialties
 Cumulative effects of stress may effect nurses’
coping abilities
16
Burnout and
Compassion Fatigue
Burnout

physical, emotional, and mental exhaustion caused by
long-term exposure to emotionally demanding
situations
 Compassion Fatigue (CF)
 similar symptoms, however more sudden and acute
 Challenges the caregiver’s ability to provide services
and maintain personal/professional relationships
17
Avoiding Stress and Burnout





Take care of self continuously
Recognize burnout symptoms
Balance home and work life
Network of friends/coworkers
Develop coping skills

LET OTHERS HELP YOU!
18
Coping with the Burnout Effect




Burned out caregivers are ineffective caregivers
Burned our caregivers need relief
Accept help from others
Participate in programs to deal with burnout
19
Maintain a Sacred Place
 Simplify / De-Clutter
 Are you relaxed?
 Do you have more than what you need?
20
Connection To Something
Bigger Than Ourselves

Religious practices



Find and participate in a faith community
Participate in meaningful rituals
Create some of your own rituals
21
Sacred Self


Hope skills
Sacred self – Spiritual lifestyle


Rituals
Forgiveness
©
22
Immediate Environment


Creating “remind” spaces
Clipboard, car visor, inside manuals and
reference material

Include photos, poems, and inspirational material
23
Spiritual Self Care Actions




Create reflective – inner space
Meditative states
Journaling
Plan career breaks
24
©
Self Care Actions

Perspective taking skills



Don’t take life too seriously
Positive attitude
Problem solving
25
©
Simple Changes
 Health lifestyle
 Life skills
©
26
Maintaining
Healthy Boundaries




Framework
Make the relationship professional and safe
Professional boundaries
Line between self and client
27
Signs of Ineffective Boundaries






Socialization outside the plan of care and work
hours
Patient is treated as “special”
Self-disclosure of personal information
Exchanging of gifts
Changing a professional relationship into a
friendship
Providing unsolicited advice
28
Setting Healthy Boundaries




Examine your personal mission and philosophy
Assess your lifestyle and overall health
Strategies to maintain your current pace
Consider need for change in relationships
29
Your Plan For Promoting
Healthy Boundaries



Teach people how to treat us
Role model honoring the boundaries of others
Boundaries reflect your own priorities
30
Managing Grief and Loss
 Be proactive
 Care for yourself
 Signs and symptoms of stress
 Grief assessment
31
Career Planning –
Educational Development
 Lifelong learning
 Advanced Degrees
 Continuing education
 Clinical specialties
 Technical skills
©
32
Contract with Self - Product of Action
 Take a couple of minutes and focus on one area we’ve
discussed today
 Complete the professional development contract
 This is a draft, perfect it later
 This is the day you decide to plan a new part of your career
33
Conclusion
 Keep yourself healthy
 Maintain professional boundaries
 Plan your career
 Cope with grief and loss
 Commit to self-growth
34
References
1.
2.
3.
Horrigan B, Miles P. Reiki vibrational healing.
Alternative therapies: In health and illness.
July/August 2003;9(4):75-83.
Abendroth M, Flannery J. Predicting the Risk of
Compassion Fatigue: A Study of Hospice Nurses.
Journal of Hospice & Palliative Nursing:
November/December 2006;8(6):346-356
Källström Karlsson I, Ehnfors M, Ternestedt B, Five
Nurses' Experiences of Hospice Care in a Long-Term
Perspective: Journal of Hospice & Palliative Nursing.
July/August 2008;10(4):224-232
35
Additional References
 Benner P. Novice to expert: Excellence and Power in





Clinical Nursing Practice, Commemorative Edition. New
York, NY: Prentice Hall; 2001.
Buresh B, Gordon S. From Silence to Voice: What nurses
know and must communicate to the public. Ottawa, Canada:
Canadian Nurses Association; 2000.
Funk J. Burnout among healers. American Journal of
Hospice and Palliative Care. May/June 1995.
Ellis L. Have you and your staff signed a self care contract?
Nursing Management. 2000;31(3):47-48.
O’Connor M. Nurse Leader: Heal thyself. Nursing
Administration Quarterly. 2002;26(2):69-79.
Pert C. Molecules of emotions: The science behind mindbody medicine. New York, NY: Simon and Schuster; 1999.
36
Additional References
 Simon RI. Therapist-Patient Sex. Forensic Psychiatry.
1999;22(1):31-47.
 Sullivan E. Becoming Influential: A Guide for Nurses.
Upper Saddle River, NJ: Prentice Hall; 2004.
 Wilsterman, D. None of us is very good at this hospice
stuff: American Journal of Hospice and Palliative
Care. May/June 1997.
37
Additional References
 American Association of Holistic Nurses,
www.ahna.org
 Hospice and Palliative Nurses Association:
www.hpna.org
 Sigma ThetaTau:
http://www.nursingsociety.org/default.aspx
 Art Work on the slides done and copyrighted by
Andy Nortnik, www.andynortnik.com. Used
with permission. All rights reserved.
38