vital exhaustion Archives - Integral Nursing Solutions

By:padma
April 23, 2017
0

INS on A Mindful Emergence Radio Show

Every Monday evening on WPVM FM 103.7, Eddie LeShure and Margaret Kirschner present A Mindful Emergence from 7:00 to 8:00 pm. I was the guest this week and what a wonderful time I had discussing this work. Here is a link to this week’s program for those of you who’d like to get an idea of what the program is like. Program # 69 http://wpvmfm.org/show/a-mindful-
A Mindful Emergence provides an in-depth and informative look into addiction recovery, trauma relief, and compassionate self-care, featuring conversations with specialists in the fields of mindfulness meditation, therapeutic movement, addiction treatment, post-traumatic stress disorder, and self-compassion therapies.

With Love, Padma
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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

By:padma
March 19, 2017
5

Vital Exhaustion

When I heard Roshi Joan Halifax use the term Vital exhaustion I had a visceral experience of recognition. A profound part of me resonated with those two descriptor words which are also a metaphor. Experimenting with the term, trying it on so to speak for the last few months, I am sharing it with you to help you nuance your understanding of where you may be at in terms of Self care, burnout, compassion fatigue and compassion satisfaction. Next week’s blog will address the last 3 experiences and working with assessments of these experiences to begin addressing the symptoms and underlying causes. The term is not new and it has an interesting history, let’s take a peek.

Vital Exhaustion

Metaphors help us articulate and understand our experiences as sentient beings. Merriam-Webster defines vital as, “concerned with or necessary to the maintenance of life”. The term Vital exhaustion touches all of our interpenetrating fields: physical, emotional, mental and spiritual- and maybe especially the last. When I heard the term Vital exhaustion it was as if the spiritual part of me felt heard too.

In the early 1990’s the concept of Vital exhaustion was explored by cardiologists Appel and his associates. They reported three defining characteristics: (1) feelings of excessive fatigue and lack of energy, (2) increasing irritability, and (3) feelings of demoralization that precedes myocardial infarction and sudden cardiac death. “Therefore, it was suggested that Vital exhaustion is a mental state at which people arrive when their resources for adapting to stress break down.” (my italics)

In 2010 it was reported that European psychiatrists have been using the term Vital Exhaustion as a possible way of defining a nervous breakdown “which is defined by its temporary nature, and often closely tied to psychological burnout, severe overwork, sleep deprivation, and similar stressors, which may combine to temporarily overwhelm an individual with otherwise sound mental functions.”

Research in Heart Math, in “the past two decades has shown that the heart is an information processing center that can learn, remember, and act independently of the cranial brain and actually connect and send signals to key brain areas such as the amygdala, thalamus, and hypothalamus, which regulate our perceptions and emotions.” Though we don’t know where Spirit lives, it is based in a unitive experience and sages refer to the wisdom of the heart. Vital exhaustion seems to relate to the organ of the heart, and to other fields of human experience. Maintaining Vital energy needs to be ongoing and planned. By putting Self care into my calendar daily it has become a habit. Otherwise, it is easy to act on automatic pilot focusing on lengthy “to do lists” moving to exhaustion and becoming drained of Vital energy.

When you contemplate the term Vital exhaustion, what is your experience? What part of you responds- your mind, body, emotions and/or spirit? Over time you may notice that it takes on different meanings depending upon different stressors in your life and your ability to tune in and care for your Self.

Next week we will contrast Vital exhaustion with burnout, compassion fatigue and compassion satisfaction and look at measuring them. In the meantime, notice your experience of your Vital energy. Can you give it words? What strategies and tools do you employ to manage the stress in your life? What do you do to maintain your Vital energy? Do you take time in nature? Maybe you meditate, pray, journal, spend time with pets… Share with us what do you do to nourish your beautiful, kind, generous, courageous Self?

Some find our Self Care for Vitality a free Virtual Connecting Weekly Call-in for Nurses a form of nourishing Self care. 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 You are welcome to join us.

References:

Vital Exhaustion, pp 2032-2033, ©2013, Douglas Carroll, http://link.springer.com/book/10.1007/978-1-4419-1005-9

Benedict Carey, http://www.nytimes.com/2010/06/01/health/01mind.html

Awareness Begins in the Heart, Not the Brain, http://www.mindfulmuscle.com/heart-has-consciousness-knows-before-brain/