Compassion fatigue (Group A)

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Group A presentation - June 20

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  • From: Clinical highlights: compassion fatigue. Oncology Nursing Forum. 2009;36(1):28.“cost of caring” and secondaty traumatic stress (Figley 2002 p2)Rosario can add: Jan Spilman described CF as a serious, but natural consequence of working with people who are suffering or traumatized.
  • Figley 2002 p125http://www.psychink.com/inpbcfat.htmAvoidance/numbing -
  • http://www.compassionunlimited.com/pdf/CompasionFatigue_ACrucibleofTransformation.pdf
  • http://www.proqol.org/Customize_a_Presentation.html
  • http://www.compassionunlimited.com/pdf/CompasionFatigue_ACrucibleofTransformation.pdf
  • http://www.compassionunlimited.com/pdf/CompasionFatigue_ACrucibleofTransformation.pdf
  • http://www.compassionunlimited.com/pdf/CompasionFatigue_ACrucibleofTransformation.pdf
  • http://www.compassionunlimited.com/pdf/CompasionFatigue_ACrucibleofTransformation.pdf
  • http://www.compassionunlimited.com/pdf/PowerPointPresentation.pdf (Gentry)
  • READ: What are some strategies you might use to battle Compassion Fatigue in your life?Rosario loves this saying by Dr Eric Gentry, PhD: “The truth is, that for all the pain, these symptoms are a blessing. They point out to caregivers that their lives are out of balance and needing intervention.”Suggestion: Before you flip slides, lets ask participants for as many ideas they can come up with for each category
  • *** Jan Spillman suggested finding a therapist you like who works with BOTH what is in your mind and what is in your BODY.** How do participants feel personality styles make one vulnerable to CF? brainstorm thoughts?* Ask Participants what they understand by this. Jan suggested avoiding TV, esp certain TV shows, even the News!
  • Showalter S. American Journal of Hospice and Palliative Medicine. 2010;27(4):239-42.
  • Showalter S. American Journal of Hospice and Palliative Medicine. 2010;27(4):239-42.
  • Compassion fatigue (Group A)

    1. 1. Compassion Fatigue<br />Melanie Johnson<br />Rosario Fernandes<br />June 2011<br />
    2. 2. Relevant quotes<br />From physicians<br />“All of us who attempt to heal the wounds of others will ourselves be wounded; it is, after all, inherent in the relationship.” (Figley 2002)<br />“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.” (Rachel Remem, 1996)<br />Charles Figley<br />“The very act of being compassionate and empathic extracts a cost under most circumstances. In our effort to view the world from the perspective of the suffering, we suffer.”<br />
    3. 3. Learning objectives<br />After this inservice, the participants will be able to:<br /><ul><li>describe what compassion fatigue is
    4. 4. describe an example of compassion fatigue in the context of their own practice
    5. 5. recognize signs/symptoms of compassion fatigue
    6. 6. create a compassion fatigue ‘action plan’ to prevent/manage development of compassion fatigue</li></li></ul><li>What is compassion fatigue? <br />“An emotional state with negative psychological and physical consequences that emanate from acute or prolonged caregiving of people stricken by intense trauma, suffering or misfortune” (Oncology Nursing Forum. 2009)<br />Results in a loss of capacity for, or interest in, being empathic with others’ pain<br />A ‘cost of caring’ for others in emotional pain<br />Also described as ‘secondary traumatic stress’<br />
    7. 7. Compassion fatigue (Figley 2002)<br />A state of tension and preoccupation with the individual or cumulative trauma of clients as manifested in one or more ways: <br />re-experiencing the traumatic events, <br />avoidance/numbing of reminders of the traumatic event, <br />persistent arousal <br />combined with the added effects of cumulative stress (burnout)<br />
    8. 8. Compassion fatigue<br />The Gentry/Baranowsky (1997) Model of Compassion Fatigue<br />PRIMARY TRAUMATIC STRESS<br />+/x (synergistic effect)<br />SECONDARY TRAUMATIC STRESS<br />+/x (synergistic effect)<br />BURNOUT<br />____________________________________<br />= COMPASSION FATIGUE<br />
    9. 9. Compassion satisfaction-Compassion fatigue Model<br />From: http://www.proqol.org/Customize_a_Presentation.html<br />
    10. 10. Burnout and Secondary traumatic stress (STS): Co Travelers<br /><ul><li>Burnout
    11. 11. Work-related hopelessness and feelings of inefficacy
    12. 12. Secondary traumatic stress (STS)
    13. 13. Work-related secondary exposure to extremely or traumatically stressful events
    14. 14. Both share negative affect
    15. 15. Burnout is about being worn out
    16. 16. STS is about being afraid</li></ul>© Beth Hudnall Stamm, 2009. Professional Quality of Life Scale (ProQOL). www.proqol.org. This test may be freely copied as long as (a) author is credited, (b) no changes are made without author authorization, and (c) it is not sold.<br />
    17. 17. ProQOL measure<br />Most commonly used measure of negative and positive affects of helping others who experience suffering and trauma<br />Measure of compassion satisfaction and fatigue<br />Free tool <br />30-item self-report<br />Used for over 15 years<br />Available in multiple languages<br />Available at: http://www.proqol.org/ProQol_Test.html<br />
    18. 18. Pre-inservice assignment: ProQOL scale discussion<br />
    19. 19. What are signs and symptoms of compassion fatigue<br />
    20. 20. Signs and symptoms of compassion fatigue (Gentry 1997)<br />Intrusive symptoms<br />Avoidance symptoms<br />Arousal symptoms<br />
    21. 21. Intrusive symptoms<br />thoughts/images associated with client’s trauma<br />obsessive/compulsive desire to help certain clients<br />inability to let go of work-related matters<br />thoughts/feelings inadequacy as a caregiver<br />
    22. 22. Avoidance symptoms<br />loss of enjoyment in activities/cessation of self care activities<br />loss of hope/sense of dread working with certain clients<br />loss of sense of competence/potency<br />secretive self-medication/addiction<br />
    23. 23. Arousal symptoms<br />increased anxiety, impulsivity/reactivity<br />increased frustration/anger<br />sleep disturbance<br />difficulty concentrating<br />
    24. 24. Compassion fatigue trajectory<br />Zealot phase<br />Keen, committed, enthusiastic, extra hours<br />Irritability phase<br />Cut corners, avoid pt contact, mocking, daydream<br />Withdrawal phase<br />Exhausted, clients become irritants, neglect (family, coworkers, clients, ourselves)<br />Zombie Phase<br />Automatic pilot, distain for clients, no compassion, no patience<br />Pathology and Victimization vs. Renewal and Maturation<br />Overwhelmed, ill, leaving profession vs. transformation/resilience<br />Initially from Jan Spilman 2010 inservice: Caring on empty: creative tools for compassion fatigue transformation and resilience<br />
    25. 25. What characteristics do you think would put a person at risk?<br />
    26. 26. Personal risk factors<br />Unresolved personal trauma and loss<br />Current life stressors<br />Low levels of social support<br />Low sense of control over life<br />Lack of meaningful personal relationships<br />Personality-based coping style<br />Enneagram<br />
    27. 27. Work-related risk factors<br />Empathy<br />Insufficient training of experience<br />High frequency of exposure to traumatic material<br />Caring for the most vulnerable in society<br />Insufficient recovery time<br />Poor or no supervision<br />Isolation and systemic fragmentation<br />Lack of systemic resources<br />
    28. 28. What are tools you use to handle stress in yourlife?<br />
    29. 29. Self Care Strategies1. Physical<br />a. Care for your body – sufficient rest and respite, nutritious food, 30 minutes aerobic exercise 3 times per week. Regular medical, dental, and psychological check ups.<br />Recharge/renew daily: exercise, prayer, meditation, mindfulness, good nutrition<br />
    30. 30. 2. Psychological and/or Emotional<br />Engage in personal therapy to resolve traumatic stress, past and present***<br />Be aware of YOUR compassion fatigue early warning signs and have a detailed response plan at hand.<br />Use the Enneagram or other personality system to identify and develop your personality-based coping style**<br />As Spillman says, Exercise your humour muscle! Laugh out loud!<br />Try to soften critical self talk; replace with self-affirming language<br />Assess and reduced your trauma inputs – use low impact disclosure and teach it to others*<br />
    31. 31. 3. Spiritual<br />Journaling<br />Care for your spirit – develop and nurture a supportive spiritual life. Creating a daily mindfulness practice (meditation, awareness pauses, haiku) can be particularly helpful<br />
    32. 32. 4. Professional and/or Workplace<br />Maintain personal/professional life balance<br />Delegate -- learn to say no; learn to ask for help at home and at work<br />Have a transition ritual between work and home<br />Get good, regular supervision or consultation<br />Work at the level of your competence; attend workshops and professional training regularly<br />Consider working partime! What is your ideal schedule?<br />
    33. 33. Action plan: MY self-care ideas<br />
    34. 34. AVOID these strategies<br />Blame others<br />Ignore the problem<br />Make big decisions<br />Complain to coworkers<br />Work harder and longer<br />Self-medicate<br />Neglect your needs, interests and desires<br />Reduce leisure activities<br />Unrealistic expectations<br />Look for easy answers<br />
    35. 35. Suggestions on ways to use the information from this session…<br />Start a self care idea collection, including activities for stress relief, stress reduction and stress resilience.<br />START NOW: Pick 1 self-care technique that is new to you and try it out<br />Periodically complete the ProQOL scale to monitor your compassion satisfaction and fatigue<br />self-care techniques helping?<br />additional support required?<br />Other ways?<br />

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