PROQOL Archives - Integral Nursing Solutions

By:padma
August 12, 2017
4

Do You Eclipse Your Own Brightness?

On August 21, 2017 our much smaller moon will cover our sun’s light for a full eclipse. For some, the sky will go black, it will appear to be night with stars shining in the middle of the day. Depending where you are on the path of the eclipse, there will be varying degrees of darkness or partial eclipses. With this, I am reminded of how unconscious cultural and personal habits can eclipse a shining light. Joseph Campbell says, “The privilege of a lifetime is being who you are,” and yet too often, as a hospice nurse I heard people say, “I wish I had … “, fill in the blank with an unexplored or unattempted dream. Don’t let this be your story.

Our nursing profession offers infinite and unique opportunities for you to manifest your loving heart and essential bright light. So, if you are not shining your light, what are the obstacles keeping you from doing so? Self compassion is a profound acceptance of your being, regardless of successes and failures and is consequently different from self esteem which is having confidence in your own worth, or abilities. Self compassion is about how you treat yourself, how you talk to yourself and what you say to yourself. When you have self compassion, you recognize you are “a work in progress”- you are kind to yourself and get the help you need when you need it. With self compassion, you shine your light to remove the internal obstacles that eclipse it. Do you give yourself self compassion?

Your answers to the following questions may indicate obstacles to your shine, preventing you from manifesting your gifts.

When someone gives you a compliment can you say “Thanks” without an explanation? Can you take in the positive without minimizing or deflecting it?
Do you have unresolved anger and resentments that keep you from connecting with yourself and others?
Are you procrastinating on taking your next career step? Why?
Are you getting enough sleep regularly?
Are you taking care of your spirit and are you happy?
Are you taking good care of your body with proper nutrition?
Are you getting enough exercise to feel fit?
On a scale of 0-10 what is your confidence in taking new steps in your life?
On a scale of 0-10, what is your shame factor?
When was the last time you completed a PROQOL (Professional Quality of Life) assessment?
When you accomplish something do you take time to savor and appreciate your success, no matter how small?

Remember self compassion can start as a healing process. It is a lubricant for getting unstuck and is a muscle that can be developed. Learning and practicing it is a boon for us all since no one else can shine your beautiful, unique light. Sharing your gifts in the world is not only a source of happiness for you, but can be a source of inspiration and healing that benefits the world we live in. Removing whatever is eclipsing your light is a win/win.

There is an early bird discount for the next Vitality in Progress: Healing and Preventing Burnout for Nurses which begins August 27, 2017. We support you in changing habits that eclipse your light as you build your self compassion muscle, so you can manifest your gifts and exercise your talents.

Please join us on our weekly phone call

Self Care for Vitality

Free Virtual Connecting Weekly Call-in for Nurses

Phone 712-432-3066

Pin 177444

Wednesdays 6:30-7:00 pm EST

There is a short guided relaxation, followed by a short time for silence

in community and optional sharing

We present tips and strategies for Self care on a variety of topics such as:

Setting boundaries, balance, healing, self love, vulnerability, and other topics as they arise.

You can join in with a share or just listen in.

In the meantime, have a great week taking great care of yourself.

With love, Padma

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