Week 4- interprofessional team approach/ self care Flashcards
who should always be at the table
patient and family
every situation is different
what are boundaries
invisible lines in relationships that help you to distinguish where your values & beliefs end and someone else’s begin
Establishing/maintaining therapeutic boundaries can (4)
- allow us to care deeply but still think clearly and wisely
- Decrease the occurrences of compassion fatigue
- helps us remember our role as an “intimate stranger” not family or friend
- Help us to focus on whose needs you are trying to meet and whose emotions you are feeling
Signs that professional boundaries are not clear (3)
- You experience extreme emotions
- You feel ownership for the dying people you are caring for
- You try to take control
good boundaries (5)
- Able to listen, might not agree but can provide support
- Can still cry, show emotions but its not about us.
- Share personal information within reason, things that can help build a connection and relationship not if it puts us at risk or is to influence
- “you are in good hands, I’ve told them about how you want your care” you dint have ownership, instilling confidence in other members of the care team.
- Don’t respond to social media
what is very important throughout career
Talk to a supervisor, colleague or counsellor if in a situation where boundaries seem blurred
providing care for the dying can (4)
The good things
- Amplify your enjoyment in life
- Increase appreciation of the little things
- Help you identify and prioritize what is important
- Provide strength and determination to face life’s little challenges
compassion fatigue
A profound physical, biological and social exhaustion and dysfunction from repeated exposure to emotional events
3 stressors unique to palliative care nurses:
- Personal factors: our own personal beliefs, distractions, inadequate preparation or training
- Patient or caregiver: rapid decline in their health, non-compliant
- Work environment: no one available to help, short staffed.
indicators of compassion fatigue (4)
- Apathy (don’t care as much)
- making assumptions
- not engaging as much
- no longer seeing individuals,
antecedents of CF (3)
- ability to experience compassion and empathy
- exposure to suffering
- repeated exposure to stressors
consequences of CF (5)
LBBM D
- loss of ability to feel compassion and empathy
- burnout
- breakdown
- disinterest
- moral distress
attributes of CF
(5)
emotional: empathy imbalance
professiona/intellectual: diminished performance
Physical: increased complaints
Social: inability to share in suffering
Spiritual: poor judgment
empirical referents of compassion fatigue
- irritation, depression, anxiety, self doubt
- poor performance, calling out, mistakes, inability to concentrate
- HA, nausea, chest pain, exhaustion, sleep loss, malaise, poor endurance
- difficulty in maintaining relationships
- inability to provide judgement, lacks awareness
5 domains identified as elements of compassion fatigue
emotional and psychological, intellectual and professional, physical, social, and spiritual.
moral distress
The impact and toll on a HCP’s wellbeing when they are prevented from providing the best course of action or care from a moral/ethical perspective
implications of moral distress at 3 levels
- Direct Provider: Erosion of sense of self, ethics & standards, burnout,
- Care recipient: diminished quality of care via avoidance
- Organization: Quality of care & retention
emotional responses to burnout
- feelings of powerlessness or being overwhelmed
- fear, disgust, discouragement
- depression
- anxiety
- bitterness, cynicism, resentment
- shock
- dismay
- burnout
spiritual responses to moral distress
5 FDDDL
- faith crisis
- dampened moral sensitivity
- deterioration of moral integrity
- disconnection from work or community
- loss of self worth
behavioral responses to moral distress
- impaired thinking
- nightmares
- lashing out at others
- addictive behaviors
- controlling behaviors
- defensiveness
- avoidance
- agitation
- shaming others
physical responses to moral distress
- heart palpitations
- GI disturbances
- insomnia
- HA or other pain symptoms
- fatigue
- hyperactivity unplanned weight gain or loss
- susceptibility to illness
reframe experiences of moral distress as
opportunities for growth, empowerment & increased moral resilience
Moral distress is indicative of
moral consciousness, not moral failure!
benefits of ethics education
evidence that nurses that have had this are more confident in addressing ethical issues, and use resources
What can nurses do to address moral distress?
- recognize the symptoms of moral distress
- reflect on and be curious about ethical aspects of clinical situations
- reconnect to your original purpose and intention for being a nurse
- commit to your personal wellbeing
- support and restore your moral integrity
learn to listen to your intuition and somatic responses - develop ethical competence
- speak up about your ethical concerns
take principled action
vicarious trauma
▪ The emotional residue of exposure to traumatic stories and experiences of others
vicarious trauma pre readings
