self and soul care: sustaining meaningful work in oncology · “self transcendence” in nursing...

Self and Soul Care:

Sustaining

Meaningful Work

in Oncology

Rev. Jennifer Jenkins Gill

Chaplain

Seattle Cancer Care Alliance

Goals

• Consider what makes oncology work meaningful: “Self-Transcendence”

• Explore barriers to sustaining meaningful work in oncology

• Self and Soul Care: Vulnerability and its relationship to sustaining meaningful work in oncology

Meaning and Work

Satisfaction

• Story of “Dan”

• Where do you notice meaning, work satisfaction in this encounter? For me? For his nurse?

• What brings meaning to your own work?

• When do you feel most satisfied with your work?

Meaning and Work

Satisfaction

–Authentic human connection

–Affirmation of his needs and values

–Engage story: what he finds most meaningful about life

–Acknowledge and Accept Vulnerability

“Self TranScendence”

in Nursing

• Pamela Reed, Theory of Self Transcendence. • Self Transcendence defined:

– “the capacity to extend self boundaries intrapersonally(toward greater awareness of one’s philosophy values and dreams), [Self]

– interpersonally (to relate to others and one’s environment), [Other/Relational/Communal/Cultural]

– temporally (to integrate one’s past and future in a way that has meaning for the present), [Historical]

– and transpersonally (to connect with dimensions beyond the typically discernable world).” (Reed, 2003, p. 147) [Spiritual]

In the chaplain world we call this: Integration…Wholeness

Work Engagement

Results

• Self transcendence is positively correlated with Work Engagement.

• Vulnerability “to what extent does your work in nursing give you an awareness of the vulnerability of human beings?

– 76% Very Much

– 23% Somewhat

Theory of Self-Transcendence

From Palmer, ppt. 2008: Adapted from: Reed, P. (2003). The Theory of Self-Transcendence. In M. Smith & P. Liehr (Eds.),

Middle Range Theory for Nursing. New York: Springer Publishing Company, Inc.Adapted with permission of the author

VulnerabilityAcute care staff RNs:

exposure to human

suffering & mortality

Well-being

Work

Engagement•Vigor

•Dedication

•Absorption

Self-TranscendenceOf acute care staff RNs

Personal and contextual

factors that may affect the relationshipsAge, gender, ethnicity, years in nursing, years

of acute care employment, highest nursing

degree, work status, primary work role and

certification status

+

+

Vulnerability

• We encounter vulnerability when we are exposed to Human Suffering and Mortality

• Everyone is inherently vulnerable in that we all are mortal and we all suffer.

• Question: Is vulnerability a Barrier or Doorway to finding Meaning?

Entering the whirlwind of mortality and suffering

Painting titled “Dreamscapes” by Ginny Gaura, www.ginnygaura.com

One pathway is a barrier: Burn Out

• Too much suffering…

• Too much pain…

• Too much need…

OVERWHELMING!!!!

Have you experienced this?

• Burnout predictors: emotional exhaustion, depersonalization (Hunnibell, et al.)

Another Pathway is a doorway:Self transcendence

• Hunnibell et al. Correlational study among hospice and oncology RNs

• When Self transcendence increased, Burnout decreased.

• So what’s the difference between these two pathways?

The Key: Our Vulnerability?Our great need

A Great Need

Out

Of a great need

We are all holding hands

And climbing.

Not loving is a letting go.

Listen,

The terrain around here

Is

Far too

Dangerous

For

That.

~ Hafiz

On Dangerous Terrain: Exposure to another’s vulnerability

forces us to acknowledging our OWN vulnerability

• Do we deny/run away from our vulnerability or do we integrate/accept our vulnerability?

• Becoming aware of our own mortality = Knowing and accepting our inherent struggles, places of brokenness, places of disconnection.

Whole-hearted, Connected Living

TED talk: Brene Brown, PhD MSW Researcher on Vulnerability

http://www.ted.com/talks/brene_brown_on_vulnerability.html

• Understanding Vulnerability as the Key to Whole-hearted Living

• “They were willing to let go of who they thought they should be in order to accept who they really were.”

Integrating Vulnerability:Practicing Self and Soul Care

• Taking this a step further: “Believing that what makes us vulnerable ALSO makes us beautiful.”

Worthiness

• Practicing our worthiness.

• Self transcendence – integrating and moving beyond ourselves can be tricky

• Moving beyond ourselves does NOT mean denying ourselves, but rather, accepting our worthiness so we can accept another’s worthiness.

• Practicing worthiness = Practicing self-compassion.

Connection• Practicing worthiness can lead to connection

• Sharing our experiences of vulnerability with others can lead us toward:

– Believing our stories of vulnerability are beautiful and worthy.

– Believing our stories of vulnerability can make a difference.

– Believing we are not really all that different from another human being, at our core

Soul Care and Meaning

• Spirituality and Spiritual Distress

• Theodicy: Where is God in the midst of suffering?

• How do we access our spirituality when we are suffering too?

• How can we take care of our grief over our own losses?

Meaning• Spirituality is NOT just about religion,

talking about God, prayer/meditation, going to a holy place, or reading sacred texts…

• Spirituality is ALSO about exploring and sharing meaning that comes from our life’s experiences, joys, and hardships

• Finding meaning in your own stories of vulnerability, meaning in connection to another’s

The Color Purple – Alice Walker

• Celie, an abused black woman, is writing the story of her life in letters to God

• Through telling her story, she becomes more aware of her own suffering, and she discards her beliefs about God.

• After finding love for herself and others (worthiness), she finds meaning and is free to believe in God in a new way.

• She moves through spiritual distress

What is soul care for you?

• We come to understand what brings our souls joy and peace through process of elimination and listening to our bodies.

• Try something new – notice what happens to your body, your heart, your mind.

• Stay in touch with yourself – your authenticity – this is the path to soul care.

Ideas• Meditation or Prayer• Attend a blessing or church service• Yoga, Dance, Body Movement, Interplay• Painting, Drawing, Music• Soul Collage• Learn a new skill, sport, or craft • Journal, Write poetry• Try reading “The Artist’s Way” • Walk your dog or walk someone else’s dog• Read a good book• Go on nature walks, get outdoors to climb, hike, ski• Watch a funny movie, TV show, or read a funny book• Spend time with trusted friends and family• Visit a counselor, Visit a Spiritual Director• Plan your next vacation• Join a small group – and share your story

Discussion/Questions?

Thank you!