Week 10: Professional Experiences: First Responders, Health Care Workers, Death Care Workers Flashcards
First Responders
Emergency Medical Technicians (EMTs), paramedics, police, firefighters.
Health Care Workers
Physicians, nurses, health care aides (nursing homes), residential care aides, social workers, personal support workers (PSWs).
Stressors & Enrichment from Caregiving
-Increased exposure to death, and sometimes traumatic death, as a part of work, can lead to mental health concerns including stress, burnout, PTSD, and compassion fatigue.
-Many who work with dying people, or otherwise provide care to others report being personally enriched by their work.
Compassion satisfaction
being personally enriched, feeling gratified from providing care to others, joy experienced from helping others.
Primary Trauma
direct exposure to traumatic events.
Secondary trauma (vicarious trauma)
exposure to the suffering of others.
-Informing family and friends of a death, exposure to the grief of the bereaved loved ones of patients.
Post-Traumatic Stress Disorder (PTSD)
Categories of symptoms:
1) Re-experiencing (repeated unwanted memories, repeated unpleasant dreams, flashbacks)
2) Avoidance (of reminders of the traumatic event)
3) Emotional numbing
4) Arousal (trouble sleeping, irritability)
Associated with elevated risk of substance abuse, family violence, and suicide.
More likely with repeated exposure to death, particularly with traumatic and tragic deaths.
Former Lt.-Gen. Romeo Dallaire
-Force commander of UN intervention in Rwanda from 1993-1994
-Received orders not to intervene as genocide took place (1994).
-800,000 people were killed in 100 days
-Became a public face of PTSD in Canada after suffering untreated for many years.
Cumulative stress/ trauma
repeated exposure to death, traumatic incidents increases likelihood of PTSD.
Burnout
feeling emotionally drained or depleted; loss of motivation, interest, commitment, empathy; loss of personal sense of achievement in work.
-Emotional exhaustion
-Depersonalization (feeling detached from work, loss of motivation), cynicism.
-Feelings of inefficacy (feeling hopeless, feeling like a failure).
-Arises from workplace conditions
Burnout
feeling emotionally drained or depleted; loss of motivation, interest, commitment, empathy; loss of personal sense of achievement in work.
-Emotional exhaustion
-Depersonalization (feeling detached from work, loss of motivation), cynicism.
-Feelings of inefficacy (feeling hopeless, feeling like a failure).
-Arises from workplace conditions
Moral Distress
when healthcare workers feel conflicted or distressed about the ethics of providing care that may be futile, unnecessary, or harmful to a patient.
-Feel unable to provide the best care. Leads to feelings of guilt.
Moral Distress
when healthcare workers feel conflicted or distressed about the ethics of providing care that may be futile, unnecessary, or harmful to a patient.
-Feel unable to provide the best care. Leads to feelings of guilt.
Compassion Fatigue
-When health care workers lose compassion and empathy for clients over time as a result of ongoing [long-term] stress at work
-Can be related to increases in workload, decreased funding, staffing, pressures caused by an ongoing crisis like Covid-19.
-Arises from contact with people experiencing trauma (emotions of others).
-Secondary trauma + burnout= compassion fatigue.
Gendered Expectations and Emotional Vulnerability
-Emotional vulnerability is frequently associated with weakness, perceived as ‘unprofessional’
-Leads to stigmatization of grief and stress in traditionally male-dominated professions.
-Pressure to ‘be strong’ leads to isolation, disenfranchised grief
-Seeking help can be stigmatized when you are supposed to be the ‘strong’ caregiver.
PTSD and First Responders
-Stress associated with repeated exposure to violent and traumatic deaths, decision-making, risking self.
-First responders experience PTSD at 2 times the rate of general population
-Estimated that up to 22% of paramedics will develop PTSD.
Estimated that 70,000 Canadian first responders have experienced PTSD in their lifetimes.
-The role as ‘helper’ or ‘protector’ limits likelihood of seeking out own help.
PTSD and First Responders
-Stress associated with repeated exposure to violent and traumatic deaths, decision-making, risking self.
-First responders experience PTSD at 2 times the rate of general population
-Estimated that up to 22% of paramedics will develop PTSD.
Estimated that 70,000 Canadian first responders have experienced PTSD in their lifetimes.
-The role as ‘helper’ or ‘protector’ limits likelihood of seeking out own help.
Health Care Workers & COVID-19
-In spring 2020, serve burnout was experienced by 30-40% of Canadian healthcare professionals, by spring 2021, rates were over 60%
-Nurses and younger professionals working with in ICU’s, COVID-19 units, hospitals, emergency departments experienced higher rates.
-Higher risk for PTSD, burnout and compassion fatigue due to multiple and ongoing occupational stressors including short-staffing, long hours, shortages of PPE, higher exposure to rates of death and dying.
-Limited ability to provide sufficient care (due to shortages of space, personnel) can lead to moral distress
-Feelings of guilt, stress related to inability to match personal values with actions
-Working with insufficient resources.
Consequences of Burnout in Healthcare
-Associated with diminished safety
-Diminished quality of care
-Mental health problems, diminished quality of life for healthcare workers
-Staff shortages
Death Care Workers
-Death care workers also report experiencing compassion fatigue due to high demands, long hours, intensity of the work with families.
-Possibly heightened during COVID-19
-“Often funeral directors are the forgotten ones. We deal with the most difficult situations and scenarios on a daily basis. We are dealing with everyone else’s grief. We are not immune to grief ourselves and distress at some of the situations that we come across”
-Secondary trauma.
Seeking Help
-Respondents all professions describe that being able to talk, be vulnerable after a difficult incident is crucial for coping.
-Efforts are being made to normalize mental health struggles, emphasize self-care, and provide access to mental health supports in numerous professions
-Social need to de-stigmatize vulnerability
-Need for structural change; provision of sufficient funding, resources.
Cultivating mindfulness and practicing self-care has been shown to reduce burnout.
-When you walk home from work, pay attention to the sensation of contact between your feet and the ground.
-Keep a folder in your email of ‘nice things’ that people have said about you or your work.
-Develop a ‘role-shedding ritual’ at the end of the day.
-Reward yourself for the completion of a task
-When feeling overwhelmed, go outside or look out the window and notice something in nature. Give it your full attention for a few minutes.
