Compassion Fatigue in Hospice Staff

QUESTION: I wonder if you have any insight on Compassion Fatigue within Hospice staff?

Wikipedia states: “Compassion fatigue, also known as secondary traumatic stress (STS), is a condition characterized by a gradual lessening of compassion over time. It is common among individuals that work directly with trauma victims such as nurses, psychologists, and first responders. It was first diagnosed in nurses in the 1950s. Sufferers can exhibit several symptoms including hopelessness, a decrease in experiences of pleasure, constant stress and anxiety, sleeplessness or nightmares, and a pervasive negative attitude. This can have detrimental effects on individuals, both professionally and personally, including a decrease in productivity, the inability to focus, and the development of new feelings of incompetency and self-doubt.”

I attended a conference where Dr.Elizabeth Kubler Ross was the keynote speaker. She spoke about disillusion and dissatisfaction with a work environment. She asked all those present who were dissatisfied with their jobs to raise their hand. Many of the 1500 people present raised their hand in the air. Elizabeth in her straight forward manner said, “Then get another job”. After the gasps died down she explained how life was too precious to stay in an environment that causes dissatisfaction and discontent.

Yes, hospice is stressful work, it can have its frustrating and highly charged emotional moments, but---- that is exactly what we signed up for. The challenge of the think on your feet moments; the understanding that all of our patients die, some gently some not so gently; the tears and the sadness. With those challenges also come the fulfillment of guiding a family and patient through one of the most dramatic, meaningful of life’s experiences; of confidently working in a field most people do not understand and fear; of being in a position to neutralize that fear with knowledge and support.

Working in Hospice is being a pioneer, is being outside the medical model, is being the salmon swimming upstream. If we get tired of the challenge our work provides, if we become desensitized, then, we need to as Elizabeth said, “Get another job”.
We of all professionals see the precariousness of life. We see on a daily basis the meaning of the gift of life. If our work becomes too stressful and is not fulfilling anymore then we need to realize that life is suggesting we move on to another adventure.

I think ways of avoid Compassion Fatigue when working in the end of life arena starts with a belief system that involves death being a natural part of life not a failure of the medical system. Recognizing that we can’t carry another’s difficult life experience is also important. We “fix-it” personalities tend to take on other’s challenges as our own instead of recognizing our becoming emotional involved in a family's challenge only diminishes our ability to help them and puts a growing stress on ourselves. Keeping our life balanced with sleep, nutrition, work and play helps us keep our work and the challenges it bring in perspective.

Staff support from the Hospice agency itself can affect CF. Having a safe, supportive work environment with regular staff support sessions is a must to keeping staff healthy and connected to the philosophy of gentle support.

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