COMPASSION FATIGUE RESILIENCY - certified compassion fatigue specialist training. The International

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  • COMPASSION FATIGUE & RESILIENCY

    Renee Rafferty, MS, LPC Director of Behavioral Health Services Providence Health & Services, Alaska

  • The heart can hold what it loves for a lifetime. -Mark Nepo

  • WHAT IS COMPASSION FATIGUE?  Compassion fatigue has been defined as a

    combination of physical, emotional, and spiritual depletion associated with caring for patients in significant emotional pain and physical distress (Anewalt, 2009; Figley, 1995).

     Joinson (1992), a nurse, was the first to describe the concept in her work with emergency room personnel. She identified compassion fatigue as a unique form of burnout that affects individuals in caregiving roles.

    http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-16-2011/No1-Jan-2011/Compassion-Fatigue-A-Nurses-Primer.html http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-16-2011/No1-Jan-2011/Compassion-Fatigue-A-Nurses-Primer.html http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-16-2011/No1-Jan-2011/Compassion-Fatigue-A-Nurses-Primer.html

  • WHAT IS COMPASSION FATIGUE?  Through our efforts to empathize and show

    compassion, healthcare workers are impacted by the suffering and trauma the patients experience and the challenges of the work.

     Unlike Post Traumatic Stress Disorder (PTSD) the caregiver does not physically experience the traumatic event but does experience the event emotionally by caring for the patient (Sabo, 2006).

    http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-16-2011/No1-Jan-2011/Compassion-Fatigue-A-Nurses-Primer.html

  • COMPASSION FATIGUE OR BURNOUT?

    Compassion Fatigue Burnout

    Found in occupations dealing directly with trauma victims. Can be found in all sorts of occupations.

    Occurs from exposure to trauma. Occurs from overworking oneself and occupational stress.

  • WHAT IS SECONDARY TRAUMATIC STRESS

     Traumatic learning through witnessing or interacting with trauma survivors.

     May occur after daily exposure to traumas in conjunction with empathetic response.

     May occur after one overwhelming stressful event.

  • SECONDARY TRAUMATIC STRESS Ambient Professional Vicarious traumatic stress Suffering patient Media Dying patients Entertainment Witnessing suffering Stories Witnessing trauma results

    Witnessing traumatic narratives

  •  Big T – Big events that people recognize as intense and overwhelming. War, Death, Disasters, Abuse, Neglect, Illness, Accidents, physical violence

     Little t – Smaller events that cause people to feel overwhelmed and powerless Rejection, loss, embarrassments, hearing stories of physical violence,

    WHAT IS TRAUMA?

  • SYMPTOMS Physical Emotional Thoughts Behavior Headaches Dread of working with

    certain patients Poor concentration Restlessness

    Digestive Problems

    •Reduced ability to feel empathy

    Loss of objectivity Frequent use of sick days

    Cardiac symptoms

    Hopelessness Memory loss Drinking more

    Muscle Tension

    Anxiety Intrusive thoughts about work

    Avoiding interacting with patients or families

    Sleep disturbance

    Lack of joyfulness “I can’t do this.” Isolating

    Pain Anger “The world is a bad place.” Breaking Professional boundaries

    Loss of energy

    Resentment “ It’s someone’s fault” Aggressive language

    Lethargy Oversensitivity “This work is too hard.” Isolation

  • OTHER CAUSES OF COMPASSION FATIGUE…  Increase in acuity of our patients

     Our system has failed to provide training and treatment for anything other than the presenting medical problems

     Trauma associated with violence in the workplace

  • WORKPLACE VIOLENCE  An increase in violence is occurring in hospital

    settings throughout our nation

     Caregivers are overwhelmed

     Patient population is more acute

     Caregivers struggle feeling ineffective

     Swing between believing they have to “put up with violence” and wanting protection

  • HOW DOES THIS INCREASE IN VIOLENCE IMPACT HEALTHCARE PROFESSIONALS?  Repeated activation of the threat-response

    system through painful learning

     Nervous system becomes chronically dysregulated

     Become disconnected from work, leadership , and co-workers

  • THE IMPACT…  Healthcare professionals are deeply rooted to the

    their purpose

     They want to feel like they can help someone get well.

     They become distressed when they don’t have the tools and they cannot see that what they are doing is effective.

  • INTERVENTIONS ARE MULTI-TIERED  Environmental and legal protection

     Whole person care

     Clinical pathways

     Debriefings

     De-escalation training

  • DOES EVERYONE IN HEALTHCARE HAVE TO GET COMPASSION FATIGUE  No!

     We can continue to thrive by changing our perceptions and growing our skill sets.

     We are resilient.

  • BUILDING BLOCKS OF RESILIENCY

     Self-regulation Tools – Can I get calm?

     Purpose- Am I connected to the meaning behind my work?

     Community of health – Where? With who? How?

  • CAN YOU HAVE TOO MUCH COMPASSION?  Feeling deeply allows us to connect with the

    patient

     Creating “Armor” can hurt us too

     Awareness of the impact of the trauma can help us to navigate the complexity and keep our bodies healing

     Boundaries protect us

  • SELF-REGULATION  Behaviorally: Self-regulation is the ability to act

    in your long-term best interest, consistent with your deepest values.

     Emotionally: Self-regulation is the ability to calm yourself down when you're upset and comfort yourself up when you're experiencing a big emotion.

    https://www.psychologytoday.com/therapy-types/acceptance-and-commitment-therapy

  • SELF-REGULATION  Keeping your body calm

     Managing your thoughts

     Managing your feelings

     Mindful Pleasure

     Minimize distractions

  • WHY DO WE NEED SELF-REGULATION?

  • DIAPHRAGMATIC BREATHING  One hand on abdomen, one on chest.  Inhale to count of 7,  Focus on moving abdomen forward and not

    moving chest.  Exhale to same count.  Once comfortable, you won’t need hand

    placement.

  • “In my experience, healthily vulnerable people use every occasion to expand, change, and grow.”

    -Fr. Richard Rohr

  • REDUCING OUR OVERALL ANXIETY  According to Dr. David Lewis-Hodgson

    of Mindlab International, which conducted the research, the top song produced a greater state of relaxation than any other music tested to date.

     In fact, listening to that one song -- "Weightless" - - resulted in a striking 65 percent reduction in participants' overall anxiety, and a 35 percent reduction in their usual physiological resting rates.

    Weightless

    http://themindlab.co.uk/ https://www.psychologytoday.com/blog/pressure-proof/201403/maxed-out-doctors-the-high-cost-burnout-in-medicine

  • ARE YOU DOING YOUR OWN HEALING?

    “We’d like to believe that there are two kinds of people in the world – those who need help and those who offer help.

    The truth is that we are both. We need to give and we need to need.”

    -The Compassion Collective

  • RELATIONSHIP THEORY  Koloroutis (2007) identified three core relationships

    for transforming practice using RBN (The nurse’s relationship with patients and families, the nurse’s relationship with self, and the nurse’s relationship with colleagues.

     The nurse’s relationship with self is a core concept in managing compassion fatigue. Nurses need to be assertive, to express personal needs and values, and to view work-life balance as an achievable outcome.

     This relationship with self is essential for optimizing one’s health, for being empathic with others, and for being a productive member of a work group within a healthcare facility.

    http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-16-2011/No1-Jan-2011/Compassion-Fatigue-A-Nurses-Primer.html

  • EMPOWERING OUR THOUGHTS

     Our thoughts create our reality and impact our health. What we believe about our environment becomes the reality.

     Do we process or vent?

     What beliefs do we hold that keep stress stuck?

  • Kelly McGonigal Ted Talk

    https://www.ted.com/playlists/315/talks_to_help_you_manage_stres

  • RESOURCES  The Greater Good Science Center-

    -University of California Berkeley

  • BUILDING A COMMUNITY OF HEALTH  Build relationships that are open and require

    vulnerability

     Practice having the “real conversation”

     Focus on strengths

  • HEALTHY COMMUNITY  The people around u