Compassion Fatigue Chery Hysjulien RN, PsyD, LP 4/4/2013
NO DISCLOSURES
Objectives 1. Define compassion fatigue 2. Identify the impact of compassion fatigue on self and others 3. Describe the foundations of self care 4. Describe the benefits of self care
Compassion Satisfaction Compassion Fatigue Model (For more information: www.proqol.org Beth Hudnall Stamm, 2009)
Compassion Satisfaction The positive aspects of helping o Pleasure and satisfaction derived from work May be related to o Providing care o Healthcare system o Work with colleagues o Beliefs about self o Altruism Unselfish concern for the welfare with others The belief that acting for the benefits of others is right and good
Compassion Response to the suffering of others that motivates a desire to help Wish for another to be free of suffering
Compassion Fatigue Type of stress caused by caring for others Negative aspect of helping State in which the ability to generate and sustain compassionate energy to others is seemingly lost. It is relationally based. PTSD - can accompany Compassion Fatigue & happens with secondary exposure to traumatic events Burnout- element of compassion fatigue associated with having negative feelings which affect level of functioning in all areas of life.
Burnout Emotional, mental & physical exhaustion resulting from excessive & prolonged stress Cumulative process
Contributors Prolonged, intense, & continuous care of people, use of self, & exposure to stress Experience & age Work/family conflict Perception of demands & resources & organizational attitudes Case load Feeling unable to help or diminish suffering in the patients/clients/families, work becomes meaningless Lack of professional fulfillment
Contributors Misconceptions I can fix this I should take responsibility for the outcome If I care enough everything will be fine They will be grateful for everything I do I will have enough resources to do my work Family & friends will approve of the amount of time & energy I invest in this helping work I know what I am getting into I do not need help ONS presentation
Impact of Compassion Fatigue Physical Exhaustion GI Headaches Sleep disturbance Muscle aches Cardiac issues Frequent illness
Impact of Compassion Fatigue Behavioral Abuse food, nicotine, alcohol & illicit drugs Excessive concern about patients/clients on days off Dread of going to work Lack of joy at work or at home Inappropriate response to situation in comparison to its severity Isolation Issues with boundaries Overextension issues
Impact of Compassion Fatigue Emotional/Psychosocial Depression Anxiety Depersonalization/disengagement Nervousness Sense of helplessness & confusion Sadness Poor judgment Exhaustion
Impact of Compassion Fatigue Emotional/Psychosocial Apathy Oversensitive/mood swings Frustration Boredom Decrease concentration Irritability/anger Loss of joy
Impact of Compassion Fatigue Spiritual Lack of inner reflection & spirituality compounds of compassion fatigue Spiritual disconnection Spiritual Struggle Questioning meaning in work Anger at God Concluding that change in necessary
Impact on Others Increased need for control Decreased desire to be with family & friends Irritability & impatience Increased desire around others & in public places
Self Assessment ProQOL self-test (www.proqol.org) Stress Diary Life Stress Test Self-Care Assessment
Professional Quality of Life Scale (ProQOL) Compassion Satisfaction and Compassion Fatigue (ProQOL) Version 5 (2009) When you [help] people you have direct contact with their lives. As you may have found, your compassion for those you [help] can affect you in positive and negative ways. Below are some questions about your experiences, both positive and negative, as a [helper]. Consider each of the following questions about you and your current work situation. Select the number that honestly reflects how frequently you experienced these things in the last 30 days. 1=Never 2=Rarely 3=Sometimes 4=Often 5=Very Often 1. I am happy. 2. I am preoccupied with more than one person I [help]. 3. I get satisfaction from being able to [help] people. 4. I feel connected to others. 5. I jump or am startled by unexpected sounds. 6. I feel invigorated after working with those I [help]. 7. I find it difficult to separate my personal life from my life as a [helper]. 8. I am not as productive at work because I am losing sleep over traumatic experiences of a person I [help]. 9. I think that I might have been affected by the traumatic stress of those I [help]. 10. I feel trapped by my job as a [helper]. 11. Because of my [helping], I have felt "on edge" about various things. 12. I like my work as a [helper]. 13. I feel depressed because of the traumatic experiences of the people I [help]. 14. I feel as though I am experiencing the trauma of someone I have [helped]. 15. I have beliefs that sustain me. 16. I am pleased with how I am able to keep up with [helping] techniques and protocols. 17. I am the person I always wanted to be. 18. My work makes me feel satisfied. 19. I feel worn out because of my work as a [helper]. 20. I have happy thoughts and feelings about those I [help] and how I could help them. 21. I feel overwhelmed because my case [work] load seems endless. 22. I believe I can make a difference through my work. 23. I avoid certain activities or situations because they remind me of frightening experiences of the people I [help]. 24. I am proud of what I can do to [help]. 25. As a result of my [helping], I have intrusive, frightening thoughts. 26. I feel "bogged down" by the system. 27. I have thoughts that I am a "success" as a [helper]. 28. I can't recall important parts of my work with trauma victims. 29. I am a very caring person. 30. I am happy that I chose to do this work. B. Hudnall Stamm, 2009. Professional Quality of Life: Compassion Satisfaction and Fatigue Version 5 (ProQOL). /www.isu.edu/~bhstamm or www.proqol.org. This test may be freely copied as long as (a) author is credited, (b) no changes are made, and (c) it is not sold.
Self-care Physical Exercise regularly Health nutrition Adequate sleep Maintenance/preventative care medical appointments Hygiene haircuts, pedicures, massage One nurturing activity daily
Self-care Emotional/Psychological Routines to establish work & home Set emotional boundaries Have outside hobbies and interests Nurture outside of work relationships Journal Receive/ask for needs to be met Seek counseling
Self-care Emotional/Psychological Allow emotions to be present laughter and tears Express feelings to trusted peers Allow yourself to grieve Practice positive & recognize negative Assertively express anger Take time to celebrate accomplishments Establish coping strategies for difficult times Play
Self-care Social Spend time with positive supportive people Join professional and social organizations Nurture your relationships at home & work Ask for help work & home Collaborate with others on a project Establish debriefing sessions with trusted peers Avoid comparing work accomplishments with others accepts compliments an& support for work ethics
Self-care Spiritual Make regular time for prayer, meditation & reflection Make efforts to connect with nature Seek out spiritual care leaders during difficult times Have rituals for gratitude Tea for the soul Blessings of hand
Benefits of Self Care Decrease negative physical, mental, & spiritual symptoms Increase coping skills Greater optimism & joy Increased initiative for problem solving Improve care to others Healing for self & others
Benefits of Self Care Increase collegiality/connection Increase trust among colleagues & willingness to share professional concerns in a proactive, problem solving manner Increase compassion satisfaction Assertiveness& having a voice in your professional environment
Compassion Response to the suffering of others that motivates a desire to help Wish for another to be free of suffering
Self-Compassion Treating oneself with warmth, compassion & understanding during times of suffering
Self-Compassion Compassion for oneself in the basis of compassion for others Compassion for oneself is extending compassion for self in times of perceived inadequacy, failure of general suffering
3 Components Self Compassion 1.Self Kindness 2.Common Humanity 3.Mindfulness
Self Kindness Unlimited friendliness toward ourselves, with a clear implication that this leads to unlimited and natural friendliness toward others
Loving Kindness and Compassion
Common Humanity Remember what we have in common with other people Decreases our judgementalness with ourselves A human being is part of the whole, we call universe, a part limited by time & space. He experiences himself, his thoughts & feelings, as something separate from the rest a kind of optical delusion of consciousness. This delusion is a kind of prison for us, restricting us to our personal desires & to affection for a few persons nearest to us. Our task must be to free ourselves from the prison by widening our circle of compassion to embrace all living creatures & the whole of nature in its beauty. Einstein
Mindfulness
Before we can generate compassion and love, it is important to have a clear understanding of what we understand compassion and love to be. In simple terms compassion and love can be defined as positive thoughts and feeling that give rise to such essential things in life as hope, courage, determination, and inner strength. In the Buddhist tradition compassion and love as seen as 2 aspects of the same thing: Compassion is the wish for another to be free from suffering; love is wanting them to have happiness. The Dalai Lama
Bibliography Smith, P. To Weep For A Stranger: Compassion Fatigue in Caregiving. 2009 Kyer, B. Surviving Compassion Fatigue: Help For Those Who Help Others. 2016 Skovholt, T & Trotter-Mathison, M. The Resilient Practitioner: Burnout and Compassion Fatigue Prevention and Self-Care Strategies for the Helping Professions 3rd Edition Stramm, H. Professional Quality of Life: Compassion Satisfaction & Fatigue Version 5 2009-12