Compassion Fatigue Nurses' Week Presentation

Look around you...

It is the people that will make an organization successful

"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. This sort of denial is no small matter. The way we deal with loss, shapes our capacity to be present to life more than anything else. The way we protect ourselves from loss may be the way in which we distance ourselves from life. We burn out, not because we don't care, but because we don't grieve. We burn out because we have allowed our hearts to become so filled with loss that we have no room to care."

Rachel Naomi Remen

Kitchen Table Wisdom 1996

Stress Factors

THE COMPASSION FATIGUE RESILIENCY PROGRAM

Trauma

STIGMA

RESILIENCY

Compassion

Fatigue Fundamentals

Personal

Resources

KGH

Resources

By Romney Pierog BA, RN, CFE (c)

for RNAO Fellowship February 2016

The Cascade of Consequences

Put YOU first so that you can continue to help others.

Too much work

Too fast pace

Too high expectations

Too much pressure

Too few resources

Stress

+ Hypervigilant

+ Compassion Stress

=Chronic

Poor Coping Strategies

Self-Neglect

Long Hours

Bad Behaviour

Sickness Depression

Family Strain

Decreased Productivity

Mindfulness - Based Stress Reduction

Jon Kabat-Zinn

1. Attention ~ Improves our ability to focus our attention

2. Emotion Regulation ~ Improves our ability to respond vs. react

3. Self View ~ Improves our self view, enables us to be non- judgemental with ourselves and improves our mind body connection.

Starting the Conversation

Compassion Fatigue

What we all want

The three biggest problems that lead to stress:

1. Volume

2. Velocity

3. Abuse

~ Wake up inspired

~ Feel comfortable and safe at work

~ Come home fulfilled

"Compassion Fatigue is the natural consequence of doing a good job"

Francoise Mathieu M.Ed., CCC

Francoise Mathieu and Dr David Posen

RISK FACTORS

Coping Strategies To Improve Resilience

~Overly conscientious

~Perfectionists

~Self-giving

~Low levels of social support

~High levels of stress in personal life

~Previous history of trauma

~Those who bottle up or avoid emotions

~Those who have an enormous capacity

for feeling/expressing empathy

~Sandwich generation

~Child with special needs

~Workaholic background

SLIMING

1. Increased self awareness~ How do you debrief when you have seen or heard difficult stories?

2. Fair Warning~ Giving fair warning allows the receiver to prepare for a traumatic story.

3. Consent ~ Once you give warning, you need to ask for consent. This gives the listener a chance to decline or to control the amount of details that they want to hear.

4. Low Impact Disclosure ~ Start with least traumatic information, only share what's necessary. You don't have to share all the gory details in order to get support or feel relieved. Too much detail can retraumatize you and the listener.

Environment

Thoughts

CBT

( Cognitive Behavioural Therapy)

Moods

Physical

Reactions

Behaviours

~ Raise awareness

~ Think Positive

~ Low Impact Debriefing

~ Self Care (dentist, doctor, exercise, good nutrition, sleeping,

massage therapy, counseling, finances)

~ CBT

~ Socialize

~ Mindfulness/Meditation

~ Relaxation Techniques

~ Yoga

~ Sports that require concentration/focus like golf, ju jitsu, hockey

~ Self Awareness & Self Compassion

~ Establish professional boundaries

~ Acceptance that successful outcomes are not always achievable

~ Read books, educate yourself

BURNOUT

Sports

What is Compassion Fatigue?

Interests

Beliefs

Nurse/Doctor

role

Sense of Self

Hobbies

Nurse/Doctor role

Family & Friends

Goals

Values

There's more to life than work

There's a lot to look forward to

Compassion fatigue, also known as secondary traumatic stress disorder, is a condition characterized by a gradual lessening of compassion over time. It stems from absorbing the suffering of others. Some literature views CF as a type of Burnout.

*Workplace Hazard

Not in the DSM V*

Signs and Symptoms

The frontline workers are the foundation of KGH ... the strength of any organization is in it's foundation

1995

PHYSICAL

Physical

~ Physical Exhaustion

~ Insomnia/Hypersomnia

~ Headaches/Migraines

~ Recurrent Colds

~ Hypochondriasis

"There is a cost to caring. Professionals

who listen to clients' stories of fear, pain and suffering may feel similar fear, pain,

and suffering because they care. Sometimes we feel we are losing our sense of self to the clients we serve. Those who have enormous capacity for feeling and expressing empathy

tend to be more at risk of compassion stress."

~ Charles Figley

BEHAVIORAL

Behavioral

Loss of Sense of Humor

Cynicism disbelief mistrust

~ Anger disrespect mistrust

~ Absenteeism

~ Irritability

~ Addictions (alcohol, drugs, sex, gambling, shopping, workaholism, compulsive overeating)

~ Self doubt

~ Personal relationship problems

~ Exaggerated sense of Responsibility (addicted to the need of being needed)

~ Avoidance of clients

~ Forgetfulness

~ Impaired ability to make decisions

~ Compromised care for Clients

~ The silencing response

Hallmarks of CF

VS

Psychological

(Mathieu, Francoise 2012)

Compassion Fatigue stems from absorbing the suffering of others

Burnout stems from dissatisfaction with the work environment

*If Compassion Fatigue is ignored and not dealt with it will eventually lead to burnout*

PSYCHOLOGICAL

~ Emotional Exhaustion

~ Distancing self/Detachment

~ Negative Self Image

~ Depression

~ Apathy

~ Resentment

~ Anxiety with irrational fears

~ Disengagement

~ Hypersensitive/Insensitive

~ Dissociation

~ Inability to tolerate strong feelings

~ Problems with intimacy

~ Hypervigilance

~ Hopelessness

~ Intrusive Imagery

~ Failure to nurture and develop non-work related aspects of life.

THE 12 PHASES OF BURNOUT

(Freudenberger, Herbert & North, Gail 1974)

1. Excessive ambition, competitiveness, trying to prove oneself

2. Having high expectations of self

3. Neglecting self, family, friends, eating and sleeping

4. Awareness of not feeling right, but can't determine the source.

5. Isolate themselves from others

6. Becomes intolerant

7. Withdrawal

8. Friends and family notice

9. Lose self

10. Feel empty inside

11. Depression

12. Collapse physically and emotionally, can have suicidal ideation.

According to stats Canada, Canadian nurses experience one of the highest burnout rates in the world

58% burnout in nursing graduates

62% nurses work through breaks

67% feel that they have too much work for one person

45% feel that they are not given enough time to meet expectations

83% more absenteeism in nursing compared to all other professions

Stats Canada 2011

* NEED TO SEEK MEDICAL ATTENTION IMMEDIATELY*

Medically proven to change our brain by : neuroplasticity

Romney Pierog BA, RN, CFE (c)

Critical Care Float RN and Certified Compassion Fatigue Educator