Compassion FatigueCompassion FatigueCompassion Satisfaction
Presenter: Barbe Creagh, PhD,LCSW FAMI FTLCSW, FAMI, FT
Stressors in Healthcare
Reduced administrative overhead Increased paperwork Increased paperwork Increased workloads
l f Elimination of support systems Short-term savings, but long-term costs Impact on staff morale Quality of care Quality of care
Compassion Fatigue: The Cost of p gCaring
Compassion Fatigue (FT) Compassion Fatigue (FT)
d ( ) Secondary Traumatic Stress (STS)
Vicarious Trauma (VT)
Common Factors
Work-related
Secondary exposure to extremely stressful events
Symptoms-rapid onset and associated with Sy pto s ap d o set a d assoc ated ta particular event
Compassion Fatigue
“a natural consequence of working with people who have experienced extremelypeople who have experienced extremely stressful events”
develops as result of “provider’s develops as result of provider s exposure to there patients’ experiences combined with empathy for therecombined with empathy for there patients.”
(Figley 1995)(Figley, 1995).
Vicarious traumatization
Effect that working with individuals who have experienced trauma have on staff.have experienced trauma have on staff.
“the transformation or change in a “the transformation or change in a helper’s inner experience as a result of responsibility for and empathicresponsibility for and empathic engagement with traumatized clients.”
Signs and symptoms of the cost g y pof caring
Physical Emotional PsychologicalIrritability Grief Changes in life y g
viewSleep Rage Decreased disturbance feeling of
personal safetyAppetite change Anger Loss of
professional identityidentity
Signs and Symptoms
Decreased energy
Powerlessness Increased interpersonal conflicts
Anxiety Numbness Increasing cynicism
Breathing d ff l
Fear Isolation from hdifficulties others
Rapid h tb t
Helplessness Low motivationheartbeat
Signs and Symptoms cont’d
Somatic complaints
Overly sensitive
Decreased ability to cope with stress
Nightmares Depression Negativity
Hypervigilance Sadness Loss of Faith
Impaired immune
Emotional roller coaster
Apathy
system
Organizational Costs
Absenteeism
Morale
Quality of Care
Compassion Fatigue Symptoms
Intrusive Symptoms Thoughts and images associated with client’s Thoughts and images associated with client s
traumatic experiences Obsessive and compulsive desire to helpObsessive and compulsive desire to help
certain clients Client/work issues encroaching upon personal / g p p
time Inability to “let go” of work-related mattersy g
Intrusive Symptoms cont’d
Perception of survivors as fragile and needing the assistance of caregiver (“savior”)
Thoughts and feelings of inadequacy as a caregiver
Sense of entitlement or special-ness Perception of the world in terms of victims
and perpetrators Personal activities interrupted by work-related
issues
Avoidance Symptoms
Silencing Response Loss of enjoyment in activities/cessation of j y /
self care activities Loss of energygy Loss of sense of competence/potency Isolationso at o Secretive self-medication (alcohol, drugs,
work, sex, food, spending, etc.), , , p g, ) Relational dysfunction
Arousal Symptoms Increased anxiety Impulsivity/reactivity
I d ti f d d/th t (i Increased perception of demand/threat (in both job and environment)
Increased frustration/anger Increased frustration/anger Sleep disturbance Difficulty concentrating Change in weight/appetite Somatic symptoms (Figley, 1995)
Burnout
Feelings of hopelessness Difficulties in dealing with work Difficulties in dealing with work Difficulty doing your job effectively
“ l d ” “melting down” Physically emotionally, mentally
Four Phases of Stress leading to gburnout
1. Warning signs. a Emotional in naturea. Emotional in natureb. Feelings of vague anxiety,c. Fatigue, d. Boredom, e. and disinterest with the job
Phases of stress cont’d2. Mild Symptoms
a. Escalation of early warning signsb. Reduced emotional controlc. Sleep disturbancesd. Muscle achese. Loss of energy and focusf. Nauseag. Social withdrawalh E i f ih. Excessive fatigue
Phases of stress cont’d
2. Entrenched symptoms
a. prolonged stress reaction
b. Career, personal, family issues
Phases of stress cont’d
Symptoms include Skin rashes
Loss of appetite Muscle weakness
Increased alcohol intake
High blood pressure Loss of sexual
Severe migraines Excessive irritability
Loss of sexual appetite
Complete social cess e tab ty Irrational feats Rigidity in thought
Co p ete soc awithdrawal
Missed work Rigidity in thought
Phases of stress cont’d4. Debilitating symptoms Destructive phase Coronary disease
Suicidal feelings Thought disorder
Diabetes Heart attack
Uncontrolled crying Very ill person who
ff Asthma Complete agitation
suffers Emotionally Mentally
Constant tension hostility
Mentally Physically(Schneider, M, 2007)
Preventing Burnout Recognize the early
stages of burnout Strengthen relationships
with family and friends. Network of peers to
call. Annual health checks
Maintain balance between work and personal life. Annual health checks
and screenings. Exercise and rest
p Evaluate your workload (Schneider,M., 2007)
Nonrelated work activities
Preventing CF and promoting resiliency Become informed Join Stress study
Bring your life into balance.
group Begin exercise
program today
Develop artistic or sporting disciplineBe kind to yourselfprogram today.
Teach others how to support you.
Be kind to yourself Seek short-term
treatmentsupport you. Develop your
spirituality
treatment (Gentry/Baranowsky,
1997)
Negative Coping Blame others Look for a new job, buy a new car, get a
divorce or have an affair Habit of complaining with your colleagues
Hi l Hire a lawyer Work harder and longer
S lf di t Self-medicate Neglect you own needs and interests. (Pfifferling & Gilley 2000) (Pfifferling & Gilley, 2000)
Positive Coping
Find someone to talk to Understand that the pain you feel is normalp y Start exercising and eating properly Get enough sleep Get enough sleep Take some time off Develop interests outside of work Develop interests outside of work Identify what’s important to you (Pfifferling & Gilley, 2000)(Pfifferling & Gilley, 2000)
Compassion Satisfaction
The pleasure you derive from being able to do your work well.
Pleasure in helping others through your work Feel positively re your colleaguesp y y g Feel positively re your ability to contribute to
the work setter and good of society.(Stamm & Stamm, 1997)
Compassion Satisfaction
Caring is in balance.
Self-care plan in place
Self-care plan strong enough to balance the stress of the emotional impact and suffering.
HeartMath™ Tools
Heart Lock-In
BreatheActivate a feeling of appreciation Activate a feeling of appreciation
Send feelings of care
www.HeartMath.org
Positive Coping
Develop your own self-care plan Spend plenty of quiet time alone Spend plenty of quiet time alone
Recharge your batteries daily Recharge your batteries daily
Hold one focused connected and Hold one focused, connected and meaningful conversation each day.
The Quick Coherence® Technique for Adultsq
Create a coherent state in about a minute with the simple, but powerful steps of the Quick Coherence® Technique Using theQuick Coherence® Technique. Using the power of your heart to balance thoughts and emotions, you can achieve energy, mental clarity and feel better fast anywhere Useclarity and feel better fast anywhere. Use Quick Coherence especially when you begin feeling a draining emotion such as frustration, irritation anxiety or anger Find a feeling ofirritation, anxiety or anger. Find a feeling of ease and inner harmony that’s reflected in more balanced heart rhythms, facilitating b i f ti d t hi hbrain function and more access to higher intelligence.
Quick Coherence® will help you find a feeling of ease and inner harmony that will be reflected in your heart rhythms. The heart is a primary generator of rhythm in your body, influencing brain processes that control your nervousbrain processes that control your nervous system, cognitive function and emotion. More coherent heart rhythms facilitate brain function, ll i hi hallowing you more access to your higher
intelligence so you can improve your focus, creativity, intuition and higher-level decision-creativity, intuition and higher level decisionmaking. When you’re in heart-rhythm coherence, you perform at your best – what thl t ll b i i th Y f lathletes call being in the zone. You feel
confident, positive, focused and calm yet energized.energized.
You can do the Quick Coherence® Technique anytime, anywhere and no one will know you’re doing it. In less than a minute, it creates positive changes in your heart rhythms, sending powerful signals to the brain that can improve how you’re feeling. Apply this one-minute technique first thing in the morning, before or
The Quick Coherence® Technique for AdultsCreate a coherent state in about a minute with the simple, but powerful steps of the Quick Coherence® Technique. Using the power of your heart to ba
The Quick Coherence® Technique helps you create a coherent state, offering access to your heart’s intelligence. It uses the power of your heart to balQuick Coherence® will help you find a feeling of ease and inner harmony that will be reflected in your heart rhythms. The heart is a primary generatStep 1: Heart Focus. Focus your attention on the area around your heart, the area in the center of your chest. If you prefer, the first couple of times yStep 2: Heart Breathing. Breathe deeply but normally and feel as if your breath is coming in and going out through your heart area. As you inhale, Step 3: Heart Feeling. As you maintain your heart focus and heart breathing, activate a positive feeling. Recall a positive feeling, a time when you fQuick Coherence® is especially useful when you start to feel a draining emotion such as frustration, irritation, anxiety or stress. Using Quick Cohere
p y g pp y q g g,during phone calls or meetings, in the middle of a difficult conversation, when you feel overwhelmed or pressed for time, or anytime you simply want to practice increasing your coherence. You can also use Quick Coherence whenever you need more coordination, speed and fluidity in your reactions.RecommendationsTransforming Stress: Childre, Rozman. This first in the HeartMath Transforming Series books contains a complete discussion of the Quick Coherence Technique – a simple, straightforward method you can easily learn for transforming stress by shifting your heart rhythms. This book is one of HeartMath’s most important works, relying on years of research into stress and emotional management and providing you with , y g y g p g yscientifically based and proven methods for transforming your stress and your life. Also available in e-booklet. emWave® PC / emWave® Mac Stress Relief System: The emWave PC/Mac allows you to watch your heart rhythms in real time and see how intentionally changing emotions affect them. With a patented, noninvasive y y g g p ,heart-rhythm monitor, the emWave PC/Mac is a software/hardware program that collects pulse data through a fingertip or ear sensor and translates the information from your heart rhythms into user-friendly graphics displayed on your computer monitor. You’ll discover which emotions you can activate to effectively manage stress and boost vitality. Among other features, the emWave PC/Mac package includes the Coherence y g p gCoach™, an entertaining software application that teaches the Quick Coherence Technique.
IHM is dedicated to conducting research and providing programs for schools and familiesproviding programs for schools and familiesto facilitate heart-based living.
copyrights 2010, Institute of HeartMath
Compassion Fatigue: a call for growth
“That which is to give light must g gendure burning.” (Frankl, 1963, p. 129).129).
Promoting quality of care Leadership interventions
A i f CF B t Assessing for CF or Burnout
Education and skill building Education and skill building
Create a culture of caringC eate a cu tu e o ca g
(White, D., 2006)
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