The History of Compassion Fatigue • Post Traumatic Stress Disorder (PTSD) is first included in the DSM III in 1980 • Trauma may be experienced either “directly” or “indirectly” (secondary traumatic stress) • An evolution of names for secondary traumatic stress including: Secondary Victimization, Vicarious Trauma, Secondary Trauma, and finally “Compassion Fatigue” which was coined by a nurse, Carla Joinson, in 1992
Compassion Fatigue Is Not the Same As Burn Out • Burn out: a state of physical, mental and emotional exhaustion caused by long term involvement in demanding circumstances • Burn out is a process, not a condition • Origins are usually organizational • Symptoms are directly related to the cause
Compassion Fatigue Is Not Counter-transference • The process of seeing oneself in the patient • Limited to certain relationships • Temporary • Compassion Fatigue is a cumulative process that is felt beyond any particular relationship
The professional work centered on the relief of emotional suffering of clients automatically includes absorbing information that is about suffering. Often it includes that suffering as well.- Charles Figley, 1995
Vulnerability for Compassion Fatigue • Exposure – daily barrage of traumatic material • Empathy – the greater the empathy the more effective the relationship and the greater the risk for Compassion Fatigue • Other factors include: emotional state, limited stress management, poor self care, poor support and spirituality
Emotional Indicators • Anxiety / increased negative arousal • Numbness / flooding • Lowered frustration tolerance / irritability • Grief symptoms • Anger • Sadness • Depression
Physical Indicators • Intrusive thoughts / images • Headaches • GI symptoms • Insomnia / nightmares / sleep disruptions • Decreased immune response • Lethargy • Becoming more accident prone
Personal Indicators • Perceptive / assumptive world disturbances • Decrease in subjective sense of safety • Self isolation • Difficulty separating work life from personal life • Diminished functioning in non-professional circumstances • Increases in in-effective or self destructive self soothing behaviors
Work Indicators • Avoidance of certain patients / clients • Hyper vigilant response to certain cases • Diminished sense of purpose / enjoyment • Feelings of therapeutic impotence
Spiritual Indicators • Questioning the meaning of life • Questioning prior religious beliefs • Anger at God • Increased skepticism • Loss of hope
Awareness • Being attuned to ones needs, limits, emotions and resources • Knowing your “renewal zones” • Practicing mindfulness • Accepting and acknowledging that we are changed by what we do
Balance • Maintaining balance among our life activities – work, play, rest • Have a personal life! • Pursue joyful activities
Connection • To oneself • To others • To the bigger picture • Connection increases validation and hope
Jillian’s Coping Strategies • Host a pickle eating contest • Go to the beach!
Why Spiritual Care? • Spiritual care of the “meaning maker” • Chaplain as professional listener • Respected and viewed as agents of hope • Access to various disciplines and units within the institution • The time to organize and offer staff support
Disciplines to include • RN’s • Physicians / medical interns & residents • Social workers • Counselors • Rehab therapists • CPE students • Other chaplains!
Formats for information and support • In-service session • Orientation sessions: RNs, hospital staff, interns and residents • In lieu of / as part of a regularly scheduled staff meeting • Lunch / break room • Regularly scheduled support groups
Compassion Fatigue In-Service • Over view – differentiate from burn out • Symptoms of Compassion Fatigue • The ABCs of Compassion Fatigue management • Give participants time to talk about it! • Explain and offer the self Test for Helpers
And let us not grow weary in well doing: for in due season we shall reap, if we faint not.- Galatians 6:9God bless you!