Three sentences:
This document discusses stress and burnout in professional caregivers working in hospice and palliative care. It defines key terms like stress, burnout, and compassion fatigue and identifies risk factors. The document also provides an overview of signs and symptoms of burnout, characteristics that can prevent or accelerate it, and evidence-based interventions to promote engagement and prevent burnout.
Review of the latest research in the field on grief therapy and practice tips for practitioners. Topics include:
• The difference between normal grief and complicated or prolonged grief
• Research and issues involved in the inclusion of “Prolonged Grief Disorder” in DSM-V
• Cognitive behavioral techniques to treat prolonged grief
• The importance of self-awareness and the necessity of self-care when providing grief counseling
• Different cultural views of death
Presented by Susan Stuber, Ph.D. at the Philadelphia Society of Clinical Psychologists continuing education conference at the Philadelphia College of Osteopathic Medicine, March 22, 2013. A copy of the full presentation notes accompanying these slides may be obtained by contacting Dr. Stuber at sstuber@susanstuberphd.com.
Looks at different ways of looking at Pastoral Counseling in terms of such things a coaching, discipleship, mentoring, spiritual direction, and historical and clinical pastoral care.
Review of the latest research in the field on grief therapy and practice tips for practitioners. Topics include:
• The difference between normal grief and complicated or prolonged grief
• Research and issues involved in the inclusion of “Prolonged Grief Disorder” in DSM-V
• Cognitive behavioral techniques to treat prolonged grief
• The importance of self-awareness and the necessity of self-care when providing grief counseling
• Different cultural views of death
Presented by Susan Stuber, Ph.D. at the Philadelphia Society of Clinical Psychologists continuing education conference at the Philadelphia College of Osteopathic Medicine, March 22, 2013. A copy of the full presentation notes accompanying these slides may be obtained by contacting Dr. Stuber at sstuber@susanstuberphd.com.
Looks at different ways of looking at Pastoral Counseling in terms of such things a coaching, discipleship, mentoring, spiritual direction, and historical and clinical pastoral care.
'Loss, Grief and Bereavement Coping with Loss and Grief'Dr Wango Geoffrey
A new dawn has come in our lives in which we must be willing to face the reality of our lives. Part of that reality is the imminence of death. Death can be confusing especially with the advancement of medicine, science and technology and various attempts to make meaning and sense of our world. Ultimately, when death occurs, persons may oscillate between feelings of sadness and anticipation, especially when there is a lot of pain and suffering and hence our love and commitment to our loves ones is juxtaposed with relieve from pain. The interrelationships in our lives affect us all. The fact that death takes away our loved ones can be a panacea for disaster. The purpose of this presentation is to assist persons cope with loss and grief.
45 minutes of suffering (or Anesthesia Grand Rounds on Palliative Care)Mike Aref
Presentation on what palliative care is, comparison with hospice, primary palliative care screening, goals-of-care, definitions of DNR, basics of acute pain management and WHO analgesic ladder.
This was released as Episode 373 of Counselor Toolbox Podcast. You can find specific episodes and CEU courses based on the podcasts at https://allceus.com/counselortoolbox You can also subscribe on your favorite podcast app like Apple Podcasts, Google Play or Castbox.
General Overview
Previously had a link to Marsha Linehan's video podcast on Mindfulness. If interested, check the reference section for a direct link for viewing.
First Draft version of Presentation for 11/19/2009 - KU Palliative Care Fellowship Lecture Series. Uploaded to show the evolution of creating a slide presentation
'Loss, Grief and Bereavement Coping with Loss and Grief'Dr Wango Geoffrey
A new dawn has come in our lives in which we must be willing to face the reality of our lives. Part of that reality is the imminence of death. Death can be confusing especially with the advancement of medicine, science and technology and various attempts to make meaning and sense of our world. Ultimately, when death occurs, persons may oscillate between feelings of sadness and anticipation, especially when there is a lot of pain and suffering and hence our love and commitment to our loves ones is juxtaposed with relieve from pain. The interrelationships in our lives affect us all. The fact that death takes away our loved ones can be a panacea for disaster. The purpose of this presentation is to assist persons cope with loss and grief.
45 minutes of suffering (or Anesthesia Grand Rounds on Palliative Care)Mike Aref
Presentation on what palliative care is, comparison with hospice, primary palliative care screening, goals-of-care, definitions of DNR, basics of acute pain management and WHO analgesic ladder.
This was released as Episode 373 of Counselor Toolbox Podcast. You can find specific episodes and CEU courses based on the podcasts at https://allceus.com/counselortoolbox You can also subscribe on your favorite podcast app like Apple Podcasts, Google Play or Castbox.
General Overview
Previously had a link to Marsha Linehan's video podcast on Mindfulness. If interested, check the reference section for a direct link for viewing.
First Draft version of Presentation for 11/19/2009 - KU Palliative Care Fellowship Lecture Series. Uploaded to show the evolution of creating a slide presentation
2nd Draft version of Presentation for 11/19/2009 - KU Palliative Care Fellowship Lecture Series. Uploaded to show the evolution of creating a slide presentation
3rd Draft version of Presentation for 11/19/2009 - KU Palliative Care Fellowship Lecture Series. Uploaded to show the evolution of creating a slide presentation
This slideset was used for a presentation to the Palliative Medicine Fellows for the University of Kansas PM Fellowship in association with Kansas City Hospice & Palliative Care
Cancer Survivorship Care: Global Perspectives and Opportunities for Nurse-Le...Carevive
The 18th CNSA Annual Winter Congress, held Perth, Australia will featured On Q Health’s co-founder Dr. Carrie Stricker as a keynote speaker. The theme for this year’s edition is “Cancer Nursing: Expanding the Possibilities” and will focus on exploring the opportunities that exist in cancer nursing in 2015 and beyond.
Who helps the people in the helping professionals manage their stress?? This important workshop was presented at the LiveOn NY's 26th Annual Conference on "The Transformation of Aging". It covers the types of stress (physical and mental) encountered in the workplace. It gives specific assessment tools to help you see how "stressed out" you are, covers "compassion fatigue" and helps you see your personal risk factors contributing to your stress. But, don't fear - the presentation also focuses on self-care; what you can do for yourself to make things better. Bottom line - strengths to combat this stress come from identifying the stress and acting to manage it. And, it ends with extremely practical solutions on things you can do - even if you only have two minutes to relieve your stress!
Physician Burnout Prevention - The Portal to Physician EngagementDike Drummond MD
Physician Burnout Prevention is the Portal to Physician Engagement
Presentation to the ACPE Annual Meeting 2013
The biggest risk in healthcare at the moment is not reform, changing reimbursements, EMR or the tidal wave of newly insured patients. The #1 danger to healthcare is the stress that ALL of this is placing on the front line workers - the physicians, nurses and staff.
In this presentation you will learn
1) The #1 Threat to Healthcare - Physician Burnout
2) Why addressing Physician Burnout Head On will give your group a competitive advantage in the years ahead
3) Physician Burnout New Information with a complete mini-training update
- Physician Burnout Vs. Stress
- Prevalence and Trends
- Symptoms & Gender Differences
- Effects & Complications
- Pathophysiology
- 4 Main Causes of Physician Burnout
- Over 117 Prevention Methods
4) Why it's time to stop the Physician Wellness Crusade
5) A Shortcut to Physician Engagement
6) Why Physician Executives are uniquely positioned to champion these changes for the benefit of
- The Physicians and their families
- The patients and staff
Get your copy of the MATRIX report with 117 ways physicians and organizations can work together to prevent burnout
http://www.tinyurl.com/bpmatrix
Dike
Dike Drummond MD
http://www.thehappymd.com
- The health and bottom line of the Organization
JAIME VINCK - COMPASSION FATIGUE AND PROVIDER RESILIENCEiCAADEvents
Compassion fatigue is the normal physiological and emotional reaction to hearing about another person’s trauma. This exhaustion creates a limited ability to empathise with others in both our personal and professional lives. In the world of substance use disorders, we often see it in our colleagues before we see it in ourselves. This interactive workshop will create ways to care for ourselves while still caring for others and develop action plans for self-care and compassion.
Working with people in crisis causes ongoing exposure to stress and traumatic stress. Reactions to stress and trauma are normal. They must be addressed regularly. Failure to address them as a part of our work can cause secondary trauma.
Meeting People Where They Are: Taking Spiritual Assessment - Tessie Mandevill...wwuextendeded
Meeting People Where They Are: Taking Spiritual Assessment – Tessie Mandeville, Reverend & Bobbi Virta, Reverend
Presented at the 2015 Palliative Care Summer Institute conference at Bellingham Technical College
Burning Questions About Burnout- An Abbreviated GuideErika del Pozo
As I am developing my expertise in understanding burnout in healthcare, I have compiled some of the most common questions I receive with abbreviated answers. This presentation covers some common myths, as well as where to get started in terms of addressing burnout in the healthcare industry.
directly affects cancer outcomes, some data do suggest
that patients can develop a sense of helplessness
or hopelessness when stress becomes overwhelming.
This response is associated with higher rates of death,
although the mechanism for this outcome is unclear.
It may be that people who feel helpless or hopeless
do not seek treatment when they become ill, give up
prematurely on or fail to adhere to potentially helpful
therapy, engage in risky behaviors such as drug use, or
do not maintain a healthy lifestyle, resulting in premature
death.
Communication of prognosis has multiple barriers to achieve shared understanding between patient and clinician. In this slide deck designed for Hospice and Palliative Medicine fellows, I look at some key studies and applied techniques to best address talking about 'How long do I have, doc?'
This slide deck does not cover how to formulate a prognosis.
Hospice and Palliative Care Online: From clutter to curationChristian Sinclair
My slidedeck from the 13th Australian Palliative Care Conference. Features the tools I use and my workflow for finding good information online to curate, create and share.
Updated slidedeck for 2014 University of Kansas Medical Center Hospice and Palliative Care Fellowship Lecture series.
Presentation skills two hour workshop. Please also see updated handout and presentation preparation worksheet
Pallimed/GeriPal Blogs to Boards - Hospice/Palliative Medicine Board Review 2...Christian Sinclair
Blogs to Boards
Created by Pallimed and GeriPal contributors in 2012 as a free study tool for the 2012 Hospice and Palliative Medicine board certification test. Creative Commons license - you must include attribution and links to Pallimed and GeriPal, and cannot reproduce for any commercial use.
We have posted the questions and answers separately if you are looking for those.
Pallimed/GeriPal Blogs to Boards - Hospice/Palliative Medicine Board Review 2...Christian Sinclair
Blogs to Boards
Created by Pallimed and GeriPal contributors in 2012 as a free study tool for the 2012 Hospice and Palliative Medicine board certification test. Creative Commons license - you must include attribution and links to Pallimed and GeriPal, and cannot reproduce for any commercial use.
We have posted the questions without the answers separately if you are looking for those.
Plenary presentation at the American Academy of Hospice and Palliative Medicine 2012.
This presentation is licensed under a Creative Commons Attribution-ShareAlike 3.0 Unported License. Please give attribution to Christian T Sinclair, MD, FAAHPM for use of this slide deck in parts or in whole.
Please see the Creative Commons License on the second slide. This slide deck is for medical education uses only and does not constitute medical advice. Please consult with your own health care provider.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Stress And The Professional Caregiver Ver 1.0
1. Stress and Burnout in the Professional Caregiver in Hospice & Palliative Care Christian Sinclair, MD, FAAHPM Kansas City Hospice & Palliative Care November 19th, 2009
2. Taking a Test The Professional Quality of Life Scale-IV
4. Objectives 1. Identify risk factors associated with stress and burnout for professional caregivers in hospice and palliative care 2. Define the psychological and relationship characteristics which can prevent or accelerate caregiver stress 3. Perform a self-assessment of professional caregiver burnout
5. Overview Death and dying “That must be depressing?!” Emotionally charged environment ≈25% of palliative care staff * report symptoms leading to psychiatric morbidity and burnout Lower than that of other specialties† Like oncology and critical care *Ramirez 1995; Turnipseed 1987, Woolley 1989 †Mallett 1991, Bram 1989
7. Stress Stress Demands from the work environment exceed the employee’s ability to cope with or control them Relationship between employee and environment Consider stress at multiple levels Individual Team (formal or ad hoc) Organizational
8. Signs and Symptoms of Burnout Fatigue Physical exhaustion Emotional exhaustion Headaches GI disturbances Weight loss Sleeplessness Depression Boredom Frustration Low morale Job turnover Impaired job performance decreased empathy increased absenteeism Vachon 2009
9. Burnout “Progressive loss of idealism, energy and purpose experienced by people in the helping professions as a result of the conditions of their work” Need to believe in meaningful work/life Chronic interpersonal stressors Exhaustion Cynicism/detachment Lack of accomplishment Vachon 2009
11. Characteristics of Burnout Demographics Single Younger No gender difference Personal characteristics Neuroticism Low hardiness Low self-esteem Maslach 2001
12. Characteristics of Burnout Strongest association with job characteristics Chronically difficult job demands Imbalance of high demands, low resources Presence of conflict (people, roles, values) Maslach 2001
13. How Does Burnout Start? Kumar 2005; Image from Flickr user itshideE
14. Is Burnout Just Depression? Overlapping constructs If you have severe burnout higher risk of major depressive disorder If you have major depressive disorder higher risk of burnout
15. Moral Distress You know the ethically appropriate action to take, but you are unable to act upon it. You act in a manner contrary to your personal and professional values, which undermines your integrity and authenticity 4 A’s Ask, Affirm, Assess, Act Jameton 1993; http://www.aacn.org/WD/Practice/Docs/4As_to_Rise_Above_Moral_Distress.pdf
16. Compassion Fatigue Secondary traumatic stress disorder Identical to post-traumatic stress disorder Except the trauma happened to someone else Bystander effect Strive for “Compassion Satisfaction”
17. Post-Traumatic Stress Disorder Traumatic event Experienced/witnessed serious injury, death of self or other As a response, the person experienced intense helplessness, fear, and horror Re-experience Intrusive thoughts, nightmares, flashbacks, or recollection of traumatic memories and images. Avoidance and emotional numbing Detachment from others; flattening of affect; loss of interest; lack of motivation Persistent avoidance of activity, places, persons, associated with the traumatic experience Unable to function Impairment in social, occupational, and interpersonal functioning Month Symptoms > 1 month Arousal startle reaction, poor concentration, irritable mood, insomnia, and hypervigilance DSM-IV
18. Counter-transference Whole person care Not always a Freudian bad thing “Alchemical reaction between patient and caregiver at the most vulnerable time in ones life. Thru the experience both can be transformed.” Vachon 2009
19. How Do We Achieve Engagement and Avoid Burnout?
21. Engagement or Burnout? Prevent or Control Hardiness/ Resilience Adaptability Emotional sensitivity Social support Workplace resources Helping others Secure attachment style Self-awareness Emotion work-variables Accelerate or Sustain Stressful life events Emotional sensitivity Overwhelming demands Genetics Lack of education Fearful/dismissing attachment style Unresolved conflict
22. Hardiness/Resilience Sense of commitment, control and challenge Helps perception, interpretation, successful handling of stressful events Prevents excessive arousal Not avoiding stress Stress that leads to self-confidence thru mastery and appropriate responsibility Kobasa 19789, Kobasa 1982, Kash 2000, Papadatou 1994
23. Emotional Sensitivity Hospice Nurses Extroverted Empathic Trusting Open Expressive Insightful Group oriented Cautious with new ideas Potentially naïve in dealing with those more astute Lacking objectivity Gambles 2003
25. Social Support Early identified as important Similar to critical nurses* Buffer to stress in workplace and associated with optimism^ Lack of social support predicted anxiety and psychosomatic complaints# *Mallett 1991; ^Hulbert 2006; #Cooper 1990
27. Stressful Life Events Death of spouse Divorce Marital separation Jail term or death of close family member Personal injury or illness Marriage Loss of job due to termination Marital reconciliation or retirement Pregnancy Change in financial state Citation ??
28. Religiosity & Spirituality Hospice staff more deeply religious* Religious associated with decreased risk of burnout in oncology staff^ Really self-awareness and meaning making? *Amenta 1984; ^Kash 2000
29. Emotional Work Variables Closeness vs. distance Controlled closeness is the goal Strategies: Patient rotation Choosing when and where closeness Rational reflection of internal process Concentrating on one’s own role Anticipating patient death Maintaining appropriate composure “No, within love” avoid being destroyed in the process of caring Pfeffer – “We Die Here Better Than Anywhere Else” (German)
30. Inability to Live Up to One’s Standards The ‘Good Death’ haunts palliative medicine Expectation of an unattainable ideal Avoid dramatization of ideals Practice modesty and humbleness
31. Death Acuity/Volume Rarely studied in hospice Few studies in oncology Relationship between stress/burnout and volume
32. Evidence Based Interventions Few studies Poorly powered Mindfulness fully present without judgment Narrative driven workshops ABCD of dignity conserving care Attitude, behavior, compassion, dialogue Chochinov 2006: http://caonline.amcancersoc.org/cgi/reprint/56/2/84.pdf
35. Burnout – Team/Organization • 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 complete assignments and tasks • Inability of staff to respect and meet deadlines • Lack of flexibility among staff members • Negativism towards management • Strong reluctance toward change • Inability of staff to believe improvement is possible • Lack of a vision for the future http://www.compassionfatigue.org/pages/symptoms.html
40. Bibilography Amenta MM. Traits of hospice nurses compared with those who work in traditional settings. J Clin Psychol. 1984 Mar;40(2):414-20. Bram PJ, Katz LF. A study of burnout in nurses working in hospice and hospital oncology settings. OncolNurs Forum. 1989 Jul-Aug;16(4):555-60. Cooper CL, Mitchell S. Nursing the Critically III and Dying. Human Relations 1990 43: 297-311 Gambles M, Wilkinson SM, Dissanayake C. What are you like?: A personality profile of cancer and palliative care nurses in the United kingdom. Cancer Nurs. 2003 Apr;26(2):97-104. Hawkins AC, Howard RA, Oyebode JR. Stress and coping in hospice nursing staff. The impact of attachment styles. Psychooncology. 2007 Jun;16(6):563-72. Hulbert NJ, Morrison VL. A preliminary study into stress in palliative care: optimism, self-efficacy and social support. Psychol Health Med. 2006 May;11(2):246-54. Jameton A. Dilemmas of moral distress: moral responsibility and nursing practice. AWHONN’S ClinIssues PerinatWomens Health Nurs. 1993;4(4):542-551. Kash KM, Holland JC, Breitbart W, Berenson S, Dougherty J, Ouellette-Kobasa S, Lesko L. Stress and burnout in oncology. Oncology (Williston Park). 2000 Nov;14(11):1621-33; discussion 1633-4, 1636-7. Kobasa SC. Stressful life events, personality, and health: an inquiry into hardiness. J Pers Soc Psychol. 1979 Jan;37(1):1-11. Kobasa SC, Maddi SR, Kahn S. Hardiness and health: a prospective study. J Pers Soc Psychol. 1982 Jan;42(1):168-77.
41. Bibilography Kumar S, Hatcher S, Huggard P. Burnout in psychiatrists: an etiological model. Int J Psychiatry Med. 2005;35(4):405-16. Mallett K, Price JH, Jurs SG, Slenker S. Relationships among burnout, death anxiety, and social support in hospice and critical care nurses. Psychol Rep. 1991 Jun;68(3 Pt 2):1347-59. Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol. 2001;52:397-422. Papadatou D, Anagnostopoulos F, Monos D. Factors contributing to the development of burnout in oncology nursing. Br J Med Psychol. 1994 Jun;67 ( Pt 2):187-99. Ramirez AJ, Graham J, Richards MA, Cull A, Gregory WM, Leaning MS, Snashall DC, Timothy AR. Burnout and psychiatric disorder among cancer clinicians. Br J Cancer. 1995 Jun;71(6):1263-9. Sinclair S, Raffin S, Pereira J, Guebert N. Collective soul: the spirituality of an interdisciplinary palliative care team. Palliat Support Care. 2006 Mar;4(1):13-24. Turnipseed DL Jr. Burnout among hospice nurses: an empirical assessment. Hosp J. 1987 Summer-Fall;3(2-3):105-19. Vachon MLS. The stress of professional caregivers. Oxford Textbook of Palliative Medicine 3rd edition (2004). p992-1004. Vachon MLS, Muller M. Burnout and symptoms of stress in staff working in palliative care. Oxford Handbook of Psychiatry in Palliative Care (2009). p236-264. Woolley H, Stein A, Forrest GC, Baum JD. Staff stress and job satisfaction at a children's hospice. Arch Dis Child. 1989 Jan;64(1):114-8.