BURNOUT Flashcards
COMPASSION
A COGNITIVE, AFFECTIVE, AND BEHAVIORAL PROCESS:
1) RECOGNIZING SUFFERING
2) UNDERSTANDING THE UNIVERSALITY OF SUFFERING IN HUMAN EXPERIENCE
3) EMOTIONAL RESONANCE
4) TOLERATING UNCOMFORTABLE FEELINGS AROUSED IN RESPONSE TO THE SUFFERING PERSON (E.G. DISTRESS, ANGER, FEAR)…REMAINING OPEN TO AND ACCEPTING OF THE PERSON SUFFERING
5) MOTIVATION TO ACT/ACTING TO ALLEVIATE SUFFERING
compassion in healthcare
patients who
consistently identify compassion as a central feature of their overall experience of
healthcare
greater attention needs to focus on addressing the growing theory-practice gap
BURNOUT
ORGANIZATIONAL HAZARD
- SLOWER PROGRESSION
- CONSEQUENCE OF UNRELENTING STRESSORS IN THE WORKPLACE
COMPASSION FATIGUE (CF)
OCCUPATIONAL HAZARD
- PROGRESSES RAPIDLY (E.G. PANDEMIC!)
- CONSEQUENCE OF WORKING WITH PEOPLE WHO EXPERIENCE TRAUMA
EXCESSIVE STIMULI + INSUFFICIENT REGULATION =
RESOURCE DEPLETION
burnout vs compassion fatigue
etiology
burnout: Reactional: response to work or environmental stressors (i.e., staffing, workload, managerial decision making, inadequate supplies or resources)
cf: Relational: consequences of caring for those who are suffering (i.e., inability to change course of painful scenario or trajectory)
burnout vs compassion fatigue
chronology
burnout: Gradual, over time
cf: Sudden, acute onset
burnout vs compassion fatigue
outcomes
burnout: Decreased empathic responses, withdrawal; may leave position or transfer
cf: Continued endurance or ‘giving’ results in an imbalance of empathy and objectivity; may ultimately leave position
PERSONAL DIMENSIONS pf burnout
exhaustion
ineffectiveness
cynicism / detachment
Exhaustion
Emotional exhaustion-
psychological overextension and fatigue
Ineffectiveness
Feelings of low personal accomplishment- feelings of low self-efficacy
Cynicism/detachment
Depersonalization of the patient-
self-defense mechanism of detached concern, become emotionally numb
BURNOUT ENVIRONMENTS
workload mismatch
control mismatch
reward mismatch
community mismatch
fairness mismatch
values mismatch
workload mismatch
taking on too much work
doing the wrong kind of work when lacking necessary skills - causing exhaustion
control mismatch
having responsibility with insufficient authority or power
reward mismatch
insufficient financial compensation, social recognition, or self-acknowledgment or pride in a job well done - causing feels of inefficiancy
community mismatch
social isolation or chronic unresolved conflict with coworkers
fairness mismatch
unequal pay or workload
shoddy employee evals
inappropriate promotions
poorly handled grievances
unfairness generates emotional upset, emotional exhaustion, and cynicism
values mismatch
people must do things they believe are unethical
work for organization with mission that does not match the product or practice
SIGNS AND CONSEQUENCES OF BURNOUT - WORKPLACE BEHAVIORS
- CYNICISM, PESSIMISM, GOSSIPING/ COMMISERATING
- BLAMING OTHERS
- DISPLAYS OF ANGER
- FREQUENT COMPLAINING
- APATHY
- DEHUMANIZING INTERACTIONS WITH PATIENTS
- ISOLATION FROM COLLEAGUES
- POOR JOB PERFORMANCE, LOW PRODUCTIVITY
SIGNS AND CONSEQUENCES OF BURNOUT - PERSONAL SYMPTOMS
- FATIGUE, INSOMNIA
- DECREASED MENTAL CLARITY
- PHYSICAL SYMPTOMS, INCREASED ILLNESS
- ANXIETY
- CATASTROPHIC THINKING
- DECREASED POSITIVE EMOTIONS
- DEPRESSION
those at risk for compassion fatigue
NATURAL CONSEQUENCE OF WORKING WITH PEOPLE WHO HAVE BEEN TRAUMATIZED AND/OR ARE EXPERIENCING EXTREME STRESS; SECONDARY TRAUMA
HEALTHCARE PROFESSIONALS ARE ARE HIGHER RISK, ESP. IN CERTAIN SETTINGS (ED, ICU, ONCOLOGY AND TRAUMA UNITS, VETERAN AND PEDIATRIC POPULATIONS, UNDERSERVED POPULATIONS, IMMIGRANT POPULATIONS, MISSION TRIPS)
PEOPLE WITH HIGHER LEVELS OF EMPATHY MAY BE AT HIGHER RISK
DOMAINS OF COMPASSION FATIGUE (STSD): PARALLELS OF PTSD
HYPERAROUSAL/HYPERVIGILANCE-DISTURBED SLEEP, IRRITABILITY, OUTBURSTS
AVOIDANCE-THOUGHTS/FEELINGS/ CONVERSATIONS ASSOCIATED WITH PATIENT’S PAIN AND SUFFERING
RE-EXPERIENCING INTRUSIVE THOUGHTS OR DREAMS
PROFESSIONAL QUALITY OF LIFE SCALE (PROQOL)
COMPASSION SATISFACTION AND COMPASSION FATIGUE SELF-ASSESSMENT
HOW TO PREVENT AND MITIGATE COMPASSION
FATIGUE AND BURNOUT
(INDIVIDUAL)
EMOTION-FOCUSED AND PROBLEM-FOCUSED
- PRACTICE OF SELF-CARE SKILLS/ACTIVITIES
- REFLECTIVE WRITING
- MENTORING
- MINDFUL MEDITATION AND MINDFULNESS-BASED STRESS REDUCTION * ENHANCE HEALTHY COPING (PERHAPS WITH COUNSELING)
- COGNITIVE BEHAVIORAL STRESS PREVENTION (RELAXATION TECHNIQUES, ETC.)
HOW TO PREVENT AND MITIGATE COMPASSION FATIGUE AND BURNOUT
(WORKPLACE)
Sustainable workload; shift in workload acuity or patient case mix (CF)
Balint group model (safe space, patients as human beings, deepen understanding)
Promotion of feelings of choice and control; increase autonomy
Appropriate recognition and reward
Continuing educational activities
Development of self- awareness and self- regulation skills
Promotion of fairness and justice in the workplace
Supportive work community/culture
Address organizational dysfunction, bullying
Training in communication skills, boundary-setting, “professional distance”
EXQUISITE EMPATHY
HIGHLY PRESENT, SENSITIVELY ATTUNED, WELL-BOUNDED, HEARTFELT EMPATHIC ENGAGEMENT
TRAUMA THERAPISTS WHO ENGAGED IN EXQUISITE EMPATHY WERE “INVIGORATED
RATHER THAN DEPLETED BY THEIR INTIMATE PROFESSIONAL CONNECTIONS WITH
TRAUMATIZED CLIENTS” AND PROTECTED AGAINST COMPASSION FATIGUE AND BURNOUT
FACILITATED BY CLINICIAN SELF-AWARENESS; SENSE OF EQUANIMITY- RETURNING TO BASELINE, FINDING HEALTHY EMOTIONAL STATE (INTERNAL BALANCE)
PSYCHOLOGICAL RESILIENCE:
THE CAPACITY TO RESPOND QUICKLY AND CONSTRUCTIVELY TO CRISES
PROCESS OF ADAPTING WELL IN THE FACE OF ADVERSITY, TRAUMA, TRAGEDY, THREATS OR SIGNIFICANT SOURCES
OF STRESS — SUCH AS FAMILY AND RELATIONSHIP PROBLEMS, SERIOUS HEALTH PROBLEMS OR WORKPLACE AND FINANCIAL STRESSORS
IT MEANS “BOUNCING BACK” FROM DIFFICULT EXPERIENCES
ABSORB RATHER THAN SHOW AGGRESSION AGAINST CHALLENGES
BUILDING RESILIENCE
AMERICAN PSYCHOLOGICAL ASSOCIATION:
Make connections
Avoid seeing crises as insurmountable problems
Accept that change is a part of living
Move toward your goals
Take decisive actions
Look for opportunities for self- discovery.
Make connections
Good relationships
Accepting help and support
active in civic or faith- based groups or other local groups for social support and can help with reclaiming hope
helping others in their time of need
Avoid seeing crises as insurmountable problems
You can’t change the fact that highly stressful events happen, but you can change how you interpret and respond to these events
Accept that change is a part of living
Certain goals may no longer be attainable as a result of adverse situations
Accepting circumstances that cannot be changed can help you focus on circumstances that you can alter
Move toward your goals
Develop some realistic goals
Do something regularly — even if it seems like a small accomplishment. ask yourself, “What’s one thing I know I can accomplish today that helps me move in the direction I want to go?”
Take decisive actions
Act on adverse situations as much as you can
Take decisive actions, rather than detaching completely from problems and stresses and wishing they would just go away
Look for opportunities for self- discovery
People often learn something about themselves and may find that they have grown in some respect as a result of their struggle with loss
NURTURE A POSITIVE VIEW OF YOURSELF
DEVELOPING CONFIDENCE IN YOUR ABILITY TO SOLVE PROBLEMS AND TRUSTING YOUR INSTINCTS HELPS BUILD RESILIENCE
KEEP THINGS IN PERSPECTIVE
EVEN WHEN FACING VERY PAINFUL EVENTS, TRY TO CONSIDER THE STRESSFUL SITUATION IN A BROADER CONTEXT AND KEEP A LONG-TERM PERSPECTIVE
AVOID BLOWING THE EVENT OUT OF PROPORTION
MAINTAIN A HOPEFUL OUTLOOK
TRY VISUALIZING WHAT YOU WANT, RATHER THAN WORRYING ABOUT WHAT YOU FEAR
TAKE CARE OF YOURSELF
PAY ATTENTION TO YOUR OWN NEEDS AND FEELINGS
ENGAGE IN ACTIVITIES THAT YOU ENJOY AND FIND RELAXING
EXERCISE REGULARLY
SLEEP
BUILDING RESILIENCE: HUMOR
INCREASED HUMOR CAN OFTEN HELP AN INDIVIDUAL COPE MORE SUCCESSFULLY WITH TRAUMATIC SITUATIONS
INCREASED HUMOR CAN CONTRIBUTE TO THE ENHANCEMENT OF POSITIVE LIFE EXPERIENCES, AND LEAD TO GREATER POSITIVE AFFECT AND PSYCHOLOGICAL WELL-BEING
NEED TO CLARIFY THE EFFECTS OF VARIOUS STYLES AND TIMING OF HUMOR ON RESILIENCY TO STRESS AND TRAUMA
THERE IS VERY LIMITED EMPIRICAL SUPPORT THAT GREATER USE OF HUMOR RESULTS IN
POSITIVE PERSONAL GROWTH AND A “BOUNCE-BACK FROM ADVERSITY” POSTURE
