compassion fatigue Archives - Integral Nursing Solutions

By:padma
March 31, 2017
2

Compassion Satisfaction ≠ Vital Exhaustion , Burnout or Compassion Fatigue

Let’s clear up any confusion about the terms we have been using in the last 3 weeks. You explored Vital exhaustion– you were encouraged to see what comes up for you in terms of your experience. Then you addressed measuring your experiences of compassion satisfaction, compassion fatigue, burnout, and Vital exhaustion to receive an objective reflection of what you might be experiencing, undoing any shackles of shame, fear and denial to move into the solution. The experience of healing or preventing these states is very empowering.

Burnout

In the 1970’s Herbert Freudenberger coined the term burnout, based on his observations of the drug addicts he worked with- sitting with blank looks, staring at cigarettes until they burned out. In that same decade, psychotherapists began using the term describing their own overstressed condition where there is “Total and incapacitating exhaustion; inability to go on”. In addition to signs of exhaustion, the person with burnout exhibits an increasingly negative attitude toward his or her job, low self-esteem, and personal devaluation. There is a conflict between what needs to be done and what can be done, so the work environment is part of the equation.

Compassion Fatigue

Compassion fatigue, also called “vicarious traumatization” or secondary traumatization (Figley, 1995) is the emotional residue or strain of exposure to working with those suffering from the consequences of traumatic events. Michael K. Kearney et al. have considered compassion fatigue to be similar to PTSD posttraumatic stress disorder except that it applies to those emotionally affected by the trauma of another (eg, client or family member) rather than by one’s own trauma. Compassion fatigue can occur due to exposure to one case of trauma and/or there can be a cumulative effect. When Mother Teresa mandated that her nuns take a year off every 4-5 years to allow time to heal from the effects of their caregiving work, she demonstrated understanding compassion fatigue.

Distinguishing

Compassion fatigue and burnout are not the same. They both occur over time, and can co-exist and produce very similar symptoms. An important factor that distinguishes them is that a person experiencing compassion fatigue does not loose their ability to empathize and desire to help whereas those experiencing burnout become cynical, inefficient in their job roles and loose their ability to empathize. The American Institute of Stress succinctly distinguishes between the terms.”Burnout is the cumulative process marked by emotional exhaustion and withdrawal associated with increased workload and institutional stress, NOT trauma-related.”

Dr. Rachel Remen, nuances our understanding with, “We burn out not because we don’t care but because we don’t grieve. We burn out because we’ve allowed our hearts to become so filled with loss that we have no room left to care.” Here I would suggest that she is actually referring to compassion fatigue within a burnout context. If your workplace does not recognize the value of affording staff time and space to decrease some of the stress, burnout and compassion fatigue become greater risks. Left unmitigated Vital exhaustion can ensue.

I have noticed that nurses can start with either burnout or compassion fatigue. If left untreated Vital exhaustion can happen. Subsequently they may leave the profession which is a loss. If they stay in the profession, they are unhappy colleagues creating difficult work relationships and climates.

Moving into Healing and Engagement

Nurses and other practitioners in the human services fields are at great risk of burnout, compassion fatigue and Vital exhaustion in part due to the high-stress work environments, and the emotional demands of our jobs. With information, intention, and support you can assess your self-care practices, compassion satisfaction, compassion fatigue, burnout, and Vital exhaustion. Then, using our beloved nursing process, you can empower yourself with interventions that nourish your well-being and compassion satisfaction. We know that a supportive work climate positively impacts compassion satisfaction because it encourages relationships, mutual learning, and self-care (Harr, 2013) and thereby empowers the staff. Maybe you will want to share your discoveries, thereby empowering not
only yourself but others.

Maybe you’d like to join our Self Care for Vitality a free Virtual Connecting Weekly Call-in for Nurses. There is a short guided relaxation, followed by a short time for silence in community and optional sharing.

Wednesdays 6:30-7:00 pm EST Phone 712-432-3066 Pin 177444

By:padma
March 24, 2017
0

Increasing Your Compassion Satisfaction

Last week I suggested we would compare Vital exhaustion, compassion fatigue and burnout. Now, I think it might be better to do the measurements first, so you can get into the solution and then come back to discussion. Compassion satisfaction is a sweet and happy place to be. Some of us live in that space a lot and for others it is fleeting. It is that sense of fulfillment and well-being. It is the positive feeling you experience as a result of knowing you did a good job. You have the sense that you make a difference in your work setting. You enjoy knowing you have a positive impact in the lives of those you care for. In fact, your compassion satisfaction may motivate you to continue your work.

On the other hand, you intuitively know if you are experiencing burnout, compassion fatigue, Vital exhaustion and compassion satisfaction. However, in our evidence-based world, you can measure your experience and your risk for these states which can be very useful to corroborate your felt sense.

So, why, how and what do we measure? Everything changes including compassion satisfaction. Many nurses become paralyzed by fear, shame and denial, tolerating experiences of burnout, compassion fatigue and Vital exhaustion for very long periods. This discomfort is stressful and impacts others- colleagues and those we care for. Having an objective reflection of your experience can help reduce shame and confusion and help with moving into the solution rather than staying in the problem.

For some nurses burnout starts in nursing school. When was your first experience of one of these states and what did you do about it? Are you now happy at work? The sooner you identify an unhappy situation, which might mean measuring your professional satisfaction, the sooner you can mitigate it.

My first experience was 2 years into my first job and my responses were typical- changing jobs (geographical solution) and getting more education. Those changes did not give me tools to heal or prevent the burnout, compassion fatigue and Vital exhaustion experiences which would come and go several times in my 40-year career. Now I have tools to prevent burnout and I use them because it makes a big difference in my happiness. Regardless of your position or status in the nursing world, measuring your professional satisfaction is informative, helpful and a form of self-care.

The PROQOL (Professional quality of life) measures Compassion Satisfaction and Compassion Fatigue, Burnout, Secondary Traumatic Stress, Vicarious Tramatization, and Vicarious Transformation. “Professional quality of life is the quality you feel in relation to your work as a helper. Both the positive and negative aspects of doing your work influence your professional quality of life. Understanding the positive and negative aspects of helping those who experience trauma and suffering can improve your ability to help them and your ability to keep your own balance.”

We use the PROQOL as a measure in the Vitality In Progress: Healing and Preventing Burnout for Nurses prior to the program in the middle and again at the end as a measure for participants to track their progress.

It is free and is available to individuals and organizations.

Another measure that could be used is The Maslach Burnout Inventory (MBI) which addresses three general scales:

Emotional Exhaustion measures feelings of being emotionally overextended and exhausted by one’s work.
Depersonalization measures an unfeeling and impersonal response toward recipients of one’s service, care treatment, or instruction.
Personal Accomplishment measures feelings of competence and successful achievement in one’s work.

Maslach and her colleague, Michael Leiter, defined the antithesis of burnout as engagement. Engagement is characterized by energy, involvement, and efficacy, the opposites of exhaustion, cynicism, and inefficacy.

Where are you on the continuums of compassion satisfaction, compassion fatigue, burnout, Vital exhaustion, engagement? Have you taken the PROQOL? It is free. Will you consider it? If you have taken it recently, what do your scores tell you? Do they match your felt experience of your professional life? When was the last time you did an inventory of the beautiful ways that you care for yourself? Even that measurement could be useful to increasing your compassion satisfaction. A few tweaks to your current habits could make a big difference in the joy and happiness you experience in your life.

Maybe you’d like to join our Self Care for Vitality – a free Virtual Connecting Weekly Call-in for Nurses. There is a short guided relaxation, followed by a short time for silence in community and optional sharing.

Wednesdays 6:30-7:00 pm EST Phone 712-432-3066 Pin 177444We are looking forward to your answers and comments to the above questions~~

With love, Padma