The Silent Signs of Compassion Fatigue What every Home Visitor needs to know. Michele Rogers Grace Harris

Transcription

1 The Silent Signs of Compassion Fatigue What every Home Visitor needs to know Michele Rogers Grace Harris

2 THIS JOB IS HARD! No matter how many times you save the world, it always manages to get back in jeopardy again. Sometimes I just want it to stay saved! You know, for a little bit? I feel like the maid; I just cleaned up this mess! Can we keep it clean for...for ten minutes!" ~ Mr. Incredible

3 COMPASSION IS NOT BOUNDLESS

4 even if you really like your job!

5 WHAT IS COMPASSION FATIGUE? Compassion Fatigue has been described as the cost of caring" for others in emotional and physical pain. It is characterized by deep physical and emotional exhaustion and a pronounced change in the helper s ability to feel empathy for their patients, their loved ones and their co-workers. Dr. Charles Figley Professor, Paul Henry Kurzweg Distinguished Chair Director, Tulane Traumatology Institute

6 It is marked by increased cynicism at work, a loss of enjoyment of our career, and eventually can transform into depression, secondary traumatic stress and stress-related illnesses. The most insidious aspect of compassion fatigue is that it attacks the very core of what brought us into this work: our empathy and compassion for others.

7 COMPASSION FATIGUE IS NOT A DISEASE. IT IS A SET OF SYMPTOMS.

8 Compassion Fatigue: Some Silent (and not so silent) Symptoms Each individual will have their own warning signs that indicate that they are moving into the danger zone of compassion fatigue. These may include some of the following: Exhaustion Reduced ability to feel sympathy and empathy Increased use of alcohol and drugs Dread of working with certain clients/patients Diminished sense of enjoyment of career Disruption to world view, Heightened anxiety or irrational fears Intrusive imagery or dissociation Hypersensitivity or Insensitivity to emotional material Difficulty separating work life from personal life Absenteeism missing work, taking many sick days Impaired ability to make decisions and care for clients/patients Problems with intimacy and in personal relationships

9 Bottled up emotions/inability to emote (Can t laugh or cry or frustration chokes out words) Isolation (declining invitations or finding excuses to not go out, engaging in mostly solitary activities) Apathy, sadness (crying at Hallmark Commercials, disengaging from world events ) Impulse to rescue anyone in need (escalating sense of social injustice) Anger/unkind words or thoughts at anyone with needs, or who needs us Feels a need to voice excessive complaints about management/colleagues/patients/ spouse/children/government/weather Uncharacteristic rigidity or resistance to change Persistent physical ailments Prone to accidents Recurring nightmares, flashbacks

10 What are the Causes? Frequently and routinely placing the needs of others before our own needs Unresolved past trauma and pain Lack of healthy professional/personal coping skills Providing care to others w/burnout and stress (negativity can be contagious) Lack of personal boundaries Overdeveloped sense of responsibility

11 Working with young children and their families requires a certain amount of acting skill in order for a professional to manager his/her emotions: In surface acting, the professional may mask their true emotions in order to display socially acceptable emotions. Deep acting often happens when a professional begins reframing situations, perhaps to restore hope for the client or as a necessary step to making an empathic connection with certain clients

12 HOW MUCH ENERGY DOES ALL THIS ACTING TAKE? NO WONDER WE RE TIRED!

13 Who Does It Effect? Compassion fatigue is an occupational hazard, which means that almost everyone who cares about their patients/clients will eventually develop a certain amount of it, to varying degrees of severity. Statistics Canada recently published their first ever National Survey of the Work and Health of Nurses (2005) which found that close to one-fifth of nurses reported that their mental health had made their workload difficult to handle during the previous month.

14 In findings recently reported by Public Agenda ( 40 percent of prek- 12 classroom teachers in the U.S. were characterized as disheartened. The results were higher for those in special education. And, teachers report feeling like they are on the receiving end of our society s collective compassion fatigue.

15 Compassion fatigue exists on a continuum: at various times in our careers we may be more immune to its damaging effects and at other times feel very beaten down by it. Within an agency, there will be, at any one time, helpers who are feeling well and fulfilled in their work, a majority of people feeling some symptoms and a few people feeling like there is no other answer available to them but to leave the profession. Many factors contribute to this continuum most commonly, personal circumstances and the helper s work situation.

16 Organizational Compassion Fatigue What should Supervisors look for? High rate of Worker s Comp claims High absenteeism Constant changes in co-workers relationships Inability for teams to work well together Desire among staff members to break company rules Outbreaks of aggressive behaviors among staff Inability of staff to respect and meet deadlines Negativism toward management Strong reluctance to change Inability of staff to believe improvement is possible Lack of vision for the future Disregard for the Mission and Values of the organization

17 SO WHAT CAN WE DO? Compassion Fatigue is a treatable problem providing we recognize the signs and symptoms early and that the level of intervention is appropriate to the level of compassion fatigue present in the helper. There are strategies and solutions both at the personal and at the organizational level.

18 Organizational Strategies Openly discuss and recognize compassion fatigue in the workplace Work towards developing a supportive work environment that will encourage proper debriefing, regular breaks, mental health days, peer support, Assess and change workloads as necessary Maintain access to further professional development Designate regular check-in times where staff can safely discuss the impact of the work on their personal and professional lives. Mix-up your day: Research has shown that working part time, or only seeing clients or patients part time and doing other activities the rest of the workday can be a very effective method to prevent compassion fatigue.

19 Lists! Personal Strategies Developing a Compassion Fatigue Prevention Toolkit for yourself What things do I have control over? What things do I not have control over? What stress relief strategies do I enjoy? What stress reduction strategies do I know? What stress resiliency strategies can I use? Awareness of Warning Signs how will you monitor yourself?

20 Be Exceptional for your 50% My 50% What I Can Control Other Person s 50% What I Can t Control

21 Stress Release: RELAXATION EXERCISES Why do relaxation exercises work? Helps to change your physiology. When you are stressed, you are on guard for perceived threats. You have a negative bias. When you are less stressed, you are more in control and therefore can be more intentional and better at what you do. Think of it not as stress management, but as selfmanagement.

22 RELAXATION EXERCISES Mental Reset Exercises Three Part Breath: Inhale-Hold-Exhale for equal counts. (3-11 minutes a day, remember you can practice before you get up in the morning) Breath: Inhale through nose for 4, hold for a count of 7, exhale through the mouth (with a whoosh) for a count of 8. Reverse Frustration/Anger Cooling Breath: Inhale like sipping on a straw. Exhale through nose. Flush Negative Memories/Feeling Shame Inhale 4 quick segmented breathes through nose. Exhale 1 breath with a whoosh through mouth.

23 RELAXATION EXERCISES Anger Regulation Karate Chop use hands in a chopping motion as fast and vigorous as you can. Other activities include flicking and shadow boxing while thinking about what angered you. (Away from the source of anger!) Relax to Release Control Inhale to a count of 3, exhale to a count of 6. Practice to make your inhale/exhale longer, but both of the same length. Relax to Sleep If you wake up at night, try left nostril breathing to put you back to sleep. Thanks to Elena for making us stress balls and to Therapy Works for the idea and information.

24 Stress Release: Using a Stress Ball Formula for Making a Stress Ball- one plastic folding sandwich bag, 2 balloons and equal parts sand and flour. Stress balls can be used to help you use your brain more bilaterally. Toss the ball from one hand to the other and back for a minute or so. Take a breath and focus on the exhalation. Toss from hand to hand again. Breath and repeat.

25 Other Stress Release Ideas: Meditate Massage Sleep Nutrition Exercise Humor Therapy

26 Stress Reduction Ideas: Time Management Organization/Preparation Techniques STOP Saying Yes! Set Priorities Exercise Routinely DOT Do One Thing

27 Stress Resiliency: Sleep Nutrition Relationships Vacations Balance Build in laughter/positive experiences Spirituality

28 Stress Monitoring: ProQOL Compassion Fatigue Self-Test The Professional Quality of Life (ProQOL) Test was developed by Dr. Beth Hudnall Stamm, Director, Institute of Rural Health, Idaho State University. Measures both compassion fatigue and compassion satisfaction

29 THANK YOU!