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Pulse - AJC.Com Article
Caring too much Retreats, support groups help combat compassion fatigue By Rebecca Rakoczy Pulse editor
Jennifer Farrell, a nurse in the hematology/oncology unit at a major medical center in Atlanta, GA. Farrell, who has suffered from compassion fatigue, talks about her experience at the hospital's Care for the Caregiver retreats for employees. Jennifer Farrell can see the signs in her co-workers' faces and attitudes.
Another 2-year-old with a neuroblastoma brain tumor succumbs to the disease; another patient is readmitted to the hospital, no longer in remission. There will be a week when four children die in succession.
In her seven-and-a-half years working as a nurse in the hematology/oncology unit, Farrell has come to recognize the signs of caring too much - and losing perspective on the rest of your life. She was there four years ago - mentally exhausted, emotionally depleted.
"You do so much; give - and give and give," she said.
What she has experienced in the past - and what her peers may be going through - is compassion fatigue, or secondary traumatic stress. The term describes the experiences of nurses and other health care personnel who deal so often with pain and death that they become desensitized, not only in their jobs but in the rest of their lives.
"The third year [working in the hematology/oncology unit] seems to be the hardest," Farrell said. "There are all sorts of things piling up, a lot of deaths, and it starts weighing down on you and you can't seem to filter it out."
Farrell "muddled though" this period in her career, and is now in a "mentally good place," she said.
Johnnathan Ward, a chaplain for the unit, asked Farrell to speak to other nurses at the hospital's Care for the Caregiver retreat. She was asked to give an experienced perspective on handling the stresses associated with their jobs.
Held at Simpsonwood Conference Center in Norcross, the retreats are for nurses experiencing what many think is professional burnout, but often is more a reflection of the constant stress of dealing with death and dying. The retreats are open to any nurse in the hospital, or anyone who may be experiencing signs of compassion fatigue.
Compassion fatigue is not limited to health care workers who deal with sick patients. Many adults who care for their elderly parents and their own children often suffer from compassion fatigue.
Burning out
"When a care provider starts to lose a sense of caring, and becomes emotionally tired, this affects their ability to care, and depletes their emotional and mental health resources," Ward said.
When compassion fatigue takes hold, a person's productivity and enthusiasm decrease and he or she may feel burned out, he said.
"The retreats provide education about compassion fatigue and its impact on the health care worker; encourage development of a self-care plan that addresses their needs; and help identify available resources that will enhance a self-care plan," Ward said.
Compassion fatigue isn't directly addressed in nursing school, Farrell said. "They do talk about establishing professional boundaries, but that is a gray area and different with every nurse," she said. "I know in the beginning I was giving my phone number to every family and visiting the children in the hospital on my days off."
The retreats help put jobs and feelings in perspective, she said.
"We tend to think that the only person who can even comprehend what we feel are those who work in the field. So you can't talk to your husband or best friend; can't explain how tough the job is, or how rewarding," Farrell said.
"So the only person that helps us is us. And [the retreat] helps us learn how to take what we experience and put something tangible on it and learn to deal with it."
The retreats grew out of staff support groups that began two years ago, Ward said. Although the staff support meetings are for all health care employees, Ward said the group is especially helpful for nurses who care for seriously ill [patients] and have dealt with a series of deaths.
The support groups, which meet twice a month to accomodate various shifts, are there to help workers deal with the overwhelming emotion that often occurs during the work week, stated Ward.
"There are ground rules that everything is confidential, and people can share, talk and relax," he said. "This is a nontherapeutic session, to talk about the stresses you may feel, and talk about taking better care of themselves. It's a time to learn that other people will be feeling the same thing."
For Farrell, that means learning perspective.
"What's important is to know how to put it on a shelf, so I know I can go on to the next day and the next year."
Comments from past Retreat and Workshop Participants:
My experience at the retreat was eye opening for me. I understood that as a caregiver I had the tendencies to not focus on my needs. What I didn't realize or maybe even denied, was the effect of the lack of attention to myself, did to me. The retreat made it very clear that taking care of me should be a priority and that is how I have been treating myself ever since. Learning the techniques of "destressing" has been valuable. As a manager, it is extremely important to know when I need to get away to get some "me" time. I am a better manager because I can notice when my staff are exhibiting behaviors of becoming burnt out and needing to get away. I would encourage anyone to attend and get the most out of it for personal growth and enhancement. –RN/Clinical Operations Manager Inpatient
I encourage all employees to attend the retreat. One of the things the retreat teaches you is to relax, de-stress, and take care of your health. In our jobs as health care workers, it is almost impossible to give good customer service and accurate care if we are stressed, tense and not feeling well because of an illness that is not being controlled. By taking time out for myself, I have been happier and more efficient in my job which makes me feel that the cost of the retreat is well worth it; if it was possible, financially, I think the retreat should be extended a day and mandatory for all employees. – Paramedic ER Department
I attended the recent Care for the Care Provider Wellness Retreat and it was a fantastic experience! It needs to be continued for all staff from management to down, and should be mandatory for ALL NEW employees. The retreat reminded me of the importance of taking care of myself, so I can render the best possible care to my patients and be at my best as part of the health care team at CHOA/HSOC. I have talked to my fellow co-workers & have strongly encouraged them to sign up for upcoming retreats! The Wellness Retreat is definitely worth the cost and then some. I consider the Wellness Retreat as an invaluable staff benefit that needs to be continued. – Respiratory Therapist
As one who reluctantly attended the staff wellness retreat held, I have become one of its strongest proponents. Previously, I was of the belief that I knew best what I needed to do to promote my own wellness. However, this retreat opened my eyes to the realization of a holistic view of wellness as well as equipping me with tools to go forth. Other hospital staff are now strongly encouraged by me to attend as I can provide personal testimony as to how it has benefited me. Whatever the cost incurred is far exceeded by the benefits the individual employee brings back to the organization. – 25 year Social Work Supervisor
