Compassion Fatigue: Caring Compassion Fatigue: Caring for Professional Caregiversfor Professional Caregivers

Part I: Part I: Understanding Compassion Understanding Compassion

FatigueFatigue

The History of Compassion FatigueThe 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 Compassion Fatigue Is Not the Same As Burn Outthe 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 conditionOrigins are usually organizationalSymptoms are directly related to the cause

Compassion Fatigue Is Not Compassion Fatigue Is Not Counter-transferenceCounter-transference

The process of seeing oneself in the patientLimited to certain relationshipsTemporaryCompassion Fatigue is a cumulative process

that is felt beyond any particular relationship

Remembering “Sam”Remembering “Sam”

The professional work centered on the The professional work centered on the relief of emotional suffering of clients relief of emotional suffering of clients

automatically includes absorbing automatically includes absorbing information that is about suffering. Often information that is about suffering. Often

it includes that suffering as well.it includes that suffering as well.- - Charles Figley, 1995Charles Figley, 1995

Vulnerability for Compassion Vulnerability for Compassion FatigueFatigue

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 IndicatorsEmotional IndicatorsAnxiety / increased negative arousalNumbness / floodingLowered frustration tolerance / irritabilityGrief symptomsAngerSadnessDepression

Physical IndicatorsPhysical Indicators

Intrusive thoughts / imagesHeadachesGI symptomsInsomnia / nightmares / sleep disruptionsDecreased immune responseLethargyBecoming more accident prone

Personal IndicatorsPersonal IndicatorsPerceptive / assumptive world disturbancesDecrease in subjective sense of safetySelf isolationDifficulty separating work life from

personal lifeDiminished functioning in non-professional

circumstancesIncreases in in-effective or self destructive

self soothing behaviors

Work IndicatorsWork Indicators

Avoidance of certain patients / clientsHyper vigilant response to certain casesDiminished sense of purpose / enjoymentFeelings of therapeutic impotence

Spiritual IndicatorsSpiritual Indicators

Questioning the meaning of lifeQuestioning prior religious beliefsAnger at GodIncreased skepticism Loss of hope

Managing Compassion Managing Compassion FatigueFatigue

AAwarenesswareness

Being attuned to ones needs, limits, emotions and resources

Knowing your “renewal zones”Practicing mindfulnessAccepting and acknowledging that we are

changed by what we do

BBalancealance

Maintaining balance among our life activities – work, play, rest

Have a personal life!Pursue joyful activities

CConnectiononnection

To oneselfTo othersTo the bigger pictureConnection increases validation and hope

Jillian’s Coping StrategiesJillian’s Coping Strategies

Host a pickle eating contest

Go to the beach!

Part II:Part II:Caring for Professional Caring for Professional

CaregiversCaregivers

Why Spiritual Care?Why Spiritual Care?

Spiritual care of the “meaning maker”Chaplain as professional listenerRespected and viewed as agents of hopeAccess to various disciplines and units

within the institutionThe time to organize and offer staff support

Disciplines to includeDisciplines to include

RN’sPhysicians / medical interns & residentsSocial workersCounselorsRehab therapistsCPE studentsOther chaplains!

Formats for information and Formats for information and supportsupport

In-service sessionOrientation sessions: RNs, hospital staff,

interns and residentsIn lieu of / as part of a regularly scheduled

staff meetingLunch / break room Regularly scheduled support groups

Compassion Fatigue Compassion Fatigue In-ServiceIn-Service

Over view – differentiate from burn outSymptoms of Compassion FatigueThe ABCs of Compassion Fatigue

managementGive 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 And let us not grow weary in well doing: for in due season we shall reap, if we faint not.due season we shall reap, if we faint not.

- Galatians 6:9- Galatians 6:9

God bless you!God bless you!