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Healing the Heart of the Critical Care Nurse: Combating Compassion Fatigue Preventing Burn-out Michelle A Post, MA, LMFT Clinical Aftercare Specialist OneLegacy, Downtown Los Angeles mpost@onelegacy.org 213-229-5687. Objectives. List 3 warning signs of compassion fatigue

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Healing the Heart of the Critical Care Nurse:Combating Compassion FatiguePreventing Burn-outMichelle A Post, MA, LMFTClinical Aftercare SpecialistOneLegacy, Downtown Los Angeles mpost@onelegacy.org213-229-5687

objectives
Objectives
  • List 3 warning signs of compassion fatigue
  • Utilize a check-list tool to assess levels of compassion fatigue in self/others
  • Develop self-care plan for daily, weekly, monthly, and yearly renewal that includes self-care techniques
  • LAUGH!
slide3

Wise Quote…

Tell me and I'll forget.

Show me and I'll remember.

Involve me and I'll understand.- Confucius

quick surveys
Quick Surveys:
  • How many of you feel on-the-job stress, or stress in your life as a side effect of your job?
quick surveys5
Quick Surveys:
  • How many of you deal with chronic pains or illness of some sort?
    • Headaches
    • Back or neck pain
    • Digestive problems (IBS, Diarrhea, Stomach aches, or Constipation)
    • High Blood Pressure
    • Knee pain, arthritis, joint pain
    • Circulatory or neurological symptoms
    • Shortness of breath
    • Or others
quick surveys6
Quick Surveys:
  • How many of you believe that the mind is connected to the body?

2 examples

-Problem focus

-Lemon

slide7

What is Compassion Fatigue?

aka Practitioner Decay?

aka Vicarious Trauma?

slide8

Signs and Symptoms

What are the Warning Signs?

slide9

What is Compassion Fatigue?

aka Vicarious Trauma?

aka Practitioner Decay?

how does this affect me
How Does This Affect Me?

Symptoms?

Sleep Disturbance

Fatigue

Weight Change

Sadness

Irritability

Frustration

Take Are You Burning Out Survey

compassion fatigue trajectory
Compassion FatigueTrajectory

Adapted from Charles R. Figley

Which Phase describes where you are?

a) The Zealot Phase

b) The Irritability Phase

c) The Withdrawal Phase

d) The Zombie Phase

e) Pathology vs. Renewal/Maturation

*Make a note about which phase describes you as we discuss them. ARS later.

zealot phase
Zealot Phase
  • Committed, involved, available
  • Solving problems/making a difference
  • Willingly go the “extra mile”
  • High enthusiasm
  • Volunteers without being asked

Adapted from Charles R. Figley

the irritability phase
The Irritability Phase
  • Begin to cut corners
  • Begin to avoid clients/patients
  • Begin to mock co-workers and clients
  • Begin to denigrate the people we serve
  • Use of humor is inappropriate
  • Oversights, mistakes and lapses of concentration
  • Start distancing ourselves from friends and coworkers

Adapted from Charles R. Figley

the withdrawal phase
The Withdrawal Phase
  • Enthusiasm turns sour
  • Clients become irritants, instead of persons
  • We make complaints about our work life and our personal life
  • Tired all the time, don’t want to talk about what we do.
  • We start to neglect our family, clients, coworkers and ourselves
  • We try to avoid our pain and sadness

Adapted from Charles R. Figley

the zombie phase
The Zombie Phase
  • Our hopelessness turns to rage
  • We begin to hate people…any/all people
  • Others appear incompetent or ignorant to us
  • We develop a real distain for our clients
  • We have…no patience…no sense of humor…no time for fun

Adapted from Charles R. Figley

pathology and victimization vs maturation and renewal
Pathology and Victimization vs.Maturation and Renewal
  • Overwhelmed and leaving the profession
  • Somatic Illness
  • Perpetuity of Symptoms

or

Hardiness

Resiliency

Transformation

Adapted from Charles R. Figley

compassion fatigue trajectory18
Compassion FatigueTrajectory

Which Phase describes where you are?

a) The Zealot Phase

b) The Irritability Phase

c) The Withdrawal Phase

d) The Zombie Phase

e) Pathology vs. Renewal/Maturation

how does this affect me19
How Does This Affect Me?

See

Symptoms of Compassion Fatigue Handout

how does this affect me20
How Does This Affect Me?

Compare Symptoms of Compassion Fatigue

With

Normal Grief Handouts

slide21
Compassion Fatigue – it exists!
  • www.compassionfatigue.org
slide22

So, we have it!

Now, What Do We DO?

Tell me and I'll forget.

Show me and I'll remember.

Involve me and I'll understand.- Confucius

how can you care for yourself
How can you care for yourself?
  • Be gentle with yourself.
  • You are a helper, not a magician. You cannot change anyone else; you can only change how you relate to them.
  • Give support, encouragement and praise to your peers and supervisors. Learn to accept praise in return.
  • Remember: Feeling helpless at times is normal. Admit it without shame. Caring and being there are often more important than DOING.
how can you care for yourself24
How can you care for yourself?
  • Change your routine often and your tasks when you can.
  • Recognize the difference between complaining that RELIEVES and complaining that reinforces negative stress.
  • Before going to bed at night, focus on a good thing that occurred during the day.
how can you care for yourself25
How can you care for yourself?
  • Be CREATIVE!
  • Seek affirmation and re-direction from your peers and supervisors.
  • Avoid “shop talk” when socializing with peers.
  • Schedule “withdraw” periods during the week, and strictly limit interruptions to this time away from your usual tasks.
how can you care for yourself26
How can you care for yourself?
  • Change your vocabulary:
    • Say “I CHOOSE” instead of “I should, I ought to or I have to.”
    • Say “I won't” rather than “I can't.”
  • If you never say “NO”, what is your “YES” worth?
  • Frustration and irritability are far more harmful than admitting you’re unable to do something.
  • PUT A LOT OF LAUGHTER AND JOY IN THE FABRIC OF YOUR LIFE.
slide27
Research & Studies that support journaling as a way of improving health

- James Pennebaker

- Stephen J. Lepore

- Annette Stanton, Ph D

- Ariel Gore (Body & Soul, March 2010)

some scientific research shows

that brief, intense bursts

of emotional release writing

– 15-20 min/day for 4 consecutive days – is directly related to increased immune system functioning which can last for several weeks.

where to start
Where to Start?

Again….

Explore Your Own Grief

Take sometime to self-reflect.

Adapted from J. William Worden, Ph.D.: Personal Death Awareness

two we are going to discuss
Two we are going to discuss:

Exploring Your Own Grief

1) How do you know when you are coping well? How do you know when you are not coping well?

two we are going to discuss30
Two we are going to discuss:

Exploring Your Own Grief

2) How has your work affected your views about grief and loss?

slide31

What do you do to care for yourself?

Write down what you do

to take care of yourself over the last year:

Daily?

Weekly?

Monthly?

Yearly?

slide32

What do you do to care for yourself?

Do these address your needs on various levels of self care?

PHYSICAL

NUTRITIONAL

SPIRITUAL

SOCIAL

EMOTIONAL

slide34

What do you do to care for yourself?

Easy ideas for daily/weekly:

-Take a break

from watching news

-Biofeedback w Meditation

-Laughing Yoga

(Experiential)

slide35

What do you do to care for yourself?

Easy ideas for daily/weekly:

Cotton Ball with Nice Smell

-take one home

slide37

What do you do to care for yourself?

Easy ideas for weekly/monthly:

Free Flow Writing/Poetry w timer

slide38

Rituals to say good bye in crisis work or grief work:

How do you say goodbye to clients who die?

How do you say good bye to your work day?

slide39

Mementos - Crafts

  • -My Worry Doll
  • Grover
  • – Funny Pens
  • Space on your desk
slide40

Weekly/Monthly?

ME>>>> DODGERS!!!

slide41

What do you do to care for yourself?

  • Easy ideas for weekly/monthly:
  • Art work
  • Bubbles*** (release your stress and pop the bubbles)
  • Play – Parachute
  • Swing on the swings at a park, walk in mud
slide42

Office Olympics

or

Pageant of the Masters

slide44

Yearly Self Care Ideas?

- Vacation on a Va-Cobligation

slide45

Yearly Self Care Ideas?

- Vacation on a Vacobligation

slide46

Yearly Self Care Ideas?

  • Scrapbook – particularly changes or losses in life
slide47

Your Other Ideas?

Now, add one item to your:

Daily

Weekly

MonthlyYearly

slide48

Your Other Ideas?

Do these address your needs on various levels of self care?

PHYSICAL

NUTRITIONAL

SPIRITUAL

SOCIAL

EMOTIONAL

slide49

Closing

~Fingerprints