Work Sustainability. Social Work Hospice and Palliative Care Network March 2018 Amanda Moment, LICSW Catherine Arnold, LICSW

Transcription

1 Work Sustainability Social Work Hospice and Palliative Care Network March 2018 Amanda Moment, LICSW Catherine Arnold, LICSW

2 Work Sustainability sus tain able adjective \sə-ˈstā-nə-bəl\ : able to be used without being completely used up or destroyed : able to last or continue for a long time

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4 Feeling Helpless Anger + Cynicism Sense of never doing enough Guilt Signs of the Work s Impact Hypervigilence Sense of Persecution Chronic Exhaustion/ Physical Ailments Deliberate Avoidance Adapted from van Dernoot Lipsky L, Burk C. Trauma Stewardship. 2009

5 Two Components of Work Sustainability Insight Management

6 Developing Insight: Key Domains of Work Sustainability Personal Dynamics Sorrow/Trauma of the Work Work Circumstances

7 Developing Insight: Personal Dynamics Why have you gotten into this work? Are you trying to repair trauma? What are your goals in your work? What are your triggers? Does this work force you to come into contact with them regularly? Is this the right context to achieve what you want? Do you make room for your own processing of the work and how it impacts you? If so, how?

8 Developing Insight: The Sorrow + Trauma of the work Where do you put the grief generated from the work? How do you regroup during the day? What are your triggers? What role (if any) does guilt play in your coping? How do you transition from being at work to being at home?

9 Developing Insight: Work Circumstances Is the work environment supportive? Is the case load reasonable or at least manageable? Do you have control over enough of your work stressors? Is there enough balance between work stress and satisfaction? Is it a productive use of your energy to advocate for structural change? Is the gap between how you want to practice and how you actually practice too large?

10 Practices + Skills for Management: Key Domains of Work Sustainability Personal Dynamics Sorrow/Trauma of the Work Work Circumstances

11 Practices + Skills for Management: Personal Dynamics Pursuing personal/professional counseling Acknowledge triggers and prepare for encountering them Create a Plan B Determine what is really good enough Write down your goals for your work, consider sharing them with a colleague

12 Practices + Skills for Management: The Sorrow + Trauma of the work Keeping a folder that contains reminders of why we do the work Practicing mindfulness grounding self in the moment Holding space for trauma vs. absorbing the patient s trauma Stay in your chair Develop rituals for containing and processing grief/emotion at the end of work day Work towards meaning-making that encourages you to thrive personally

13 Practices + Skills for Management: Work Circumstances Make a list of professional needs and identify how many are met through this job. Locate allies for professional support and goal setting. Do you have control over enough of your work stressors? Identify and create opportunities for fun at work Work towards structural change (if it is a worthwhile use of your energy) Say no and be willing to leave If you don t have control and can t leave, reframe what you do get of the work (financial, etc )

14 Helping Your Teams Conceptual: This is personal reflection (don t require public sharing) Everyone starts from different vantage points, insight, comfort with these questions. Must create safety for vulnerability to exist Cultural shift from passive recipient of trauma to active participant in health Implementation: What do you think you would need to do to introduce these concepts to your teams? What is one thing you learned today that you feel you want to share/take back to teams?

15 References ** van Dernoot Lipsky L, Burk C. Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others. Berrett-Koehler Pub ** Epstein RM. Self-Monitoring in Clinical Practice: A challenge to medical educators. J Cont. Edu. in Health Profes Katz RS, Johnson TA. When Professionals Weep: Emotional and Countertransference Responses in End-of-Life Care. Routledge: New York Halifax J. Being with Dying: Cultivating Compassion and Fearlessness in the Presence of Death Kearney M. Self-care of Physicians Caring for Patients at the End of Life. JAMA Krasner MS, et al. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA Meier DE, et al. The Inner Life of Physicians and Care of the Seriously Ill. JAMA

16 References (con t) Novack DH, et al. Toward creating physician healers: personal awareness, growthand well-being in medical training. Acad Med Rothschild, B. Help for the Helper: The Psychophysiology of Compassion Fatigue and Vicarious Trauma. Norton, W W. & Company, Inc