I love going to work But I am too tired to go to work

IntNSA 39th Annual Educational Conference
October 21-24, 2015
Helplessness, Hopelessness,
Unconsciousness,
and the Death of Compassion
I love my job
I love going to
work
Noel Holdsworth,
DNH, PMHNP-BC, CTS
I love my job
But I am too tired
to go to work
I hate my job
I don’t want to go to
work
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ProQOL.org
Professional Quality of Life
Awareness
First step is
understanding
where you are on
that continuum
Burnout
It has to do with what we do, how we do it,
and for how long we do it.
It is usually brought on by unreasonable
expectations, (of yourself or from others)
It has more to do with systems, processes
and organizations.
It also has to do with lack of self care and
poor boundary setting.
© B. Hudnall Stamm, 2009-2012. Professional
Quality of Life: Compassion Satisfaction and
Fatigue Version 5 (ProQOL). www.proqol.org.
This test
may be freely copied as long as (a) author is
credited, (b) no changes are made, and (c) it is
not sold. Those interested in using the test
should visit
www.proqol.org to verify that the copy they are
using is the most current version of the test.
Burnout
Once a person is burned
out:
it is almost impossible to
reverse it ….
without changing jobs or
changing professions.
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Compassion Fatigue
Compassion Fatigue is about the
helplessness that goes with
caring;
and is NOT about caring too
much.
Compassion Fatigue occurs when
the feelings of hearing about the
pain or trauma of others begin to
accumulate.
Consequences
The worst consequence of compassion
fatigue is the disconnect that goes with it.
(And in our business it’s all about the
relationship!)
We are not comfortable with
uncomfortable feelings so rather than feel
uncomfortable we stop feeling.
Compassion Satisfaction
When compassion
dies so does your power!
Is not necessarily job satisfaction
which is usually related to what
one does or thinks about their
job.
Compassion satisfaction is
related to how one feels at the
end of the day and how aware
they are that they have made a
difference.
Compassion satisfaction is
inversely related to compassion
fatigue.
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Compassion Satisfaction: (continued)
"Compassion satisfaction" counteracts
the impact of compassion fatigue and
burnout.
Levels of compassion satisfaction (which
we can now measure) make a difference
in how one feels at the end of a work
shift and allow one to "love the job even
after years of doing the job."
Secondary Traumatic
Stress Response
Is what happens when an
individual has a reaction:
physically, spiritually mentally or
emotionally to a trauma event
that happened to another person
or persons.
Vicarious Trauma
Is experiencing a trauma in a
secondhand way (hearing about it,
seeing it, reading about it etc).
Vicarious trauma can be listening to
clients / patients or someone close
to you personally: (secondary
trauma)
Or it can be trauma in your
community state or country:
(tertiary trauma)
STSD
STSR: if not dealt with
can lead to a Secondary Traumatic Stress Disorder
which look like and acts like PTSD
PTSD and STSD Components:
1. A Trauma factor
2. Reliving of the event
3. Intrusive
4. Avoidance
5. Worldview
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In order to understand compassion fatigue
you have to understand trauma.
The Original
Trauma
Scenario
Fight or Flight
When you run or fight
(and use the adrenalin
as it was meant to be
used)
You typically do not get
PTSD
2. Being
Blindsided
Risk factors
(For compassion fatigue)
1. Personal Trauma
History:
(primary, secondary or
tertiary)
especially when it is
accumulative
3. Feelings of
helplessness
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4. Lack of
validation,
support and
minimization of
trauma
6. Stress,
illness, poor
self care
5. Lack of
understanding of the
incident or inability
to integrate it into
one’s personal belief
system
7. Inadequate
Self Awareness
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9. Other Risk factors:
8. Poor Response
management
(Sympathetic
Nervous system vs
Parasympathetic
Nervous System)
10. Distrust of self which
leads to:
AVOIDANCE,
disconnection, and
the death of the
therapeutic self.
*inexperience
*climate of
pervasive,
ongoing change
*accumulative
exposure to
difficult patients or
situations
*poor or no
support
*conflicts with coworkers or
supervisors
*unforgiving
environment
(i.e.: if you can’t
handle it, move
aside...you’ll be
replaced).
Red flags: If you find yourself
saying or thinking:
“How can I enjoy life, with so many
people suffering?”
“If I can’t console you, then I must be
a failure”
“Is that patient here again?”.
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Red flags: (continued)
Red flags: (continued)
If you find yourself getting cynical, or sarcastic.
If you find yourself being annoyed or
even enraged on a regular basis by your
patients.
If you stop feeling anything, when you
hear the stories of pain or when your
brain goes blank, or when you can’t shut
it down.
When all you want to do is sleep, and
when you
can never sleep
YOU ARE NOT CRAZY!!!!!
When you can’t tell the difference
between hunger and a craving.
When your soul becomes weary.
When you fake fun.
When you make a comment, cry
or fly off the handle, and don’t
know where it came from
It’s all about the relationship!!
You are having a
“Normal reaction
to abnormal
events”
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INTERVENTION
Ventilation
Validation
Education
The glass:
You can’t give what you don’t have:
Education
The value of caring (self and
others)
You can not teach your patients
about healing and self care if
you do not practice it yourself:
Its UNETHICAL
Always be aware of what’s on the other
end of the
sea saw
Know what you can control and or
change… and be responsible for
it….
..Know what you can’t…
and let go of it
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Learning to Change what
you can
Letting go of what you
can’t change
and participate in activities
that help you to know the
difference !!
Other Ways to promote
Awareness
Honest interactive professional
relationships and ongoing education
The best thing you can do to reduce
compassion fatigue:
Is to promote the value of simply
showing up
Compassion satisfaction comes
from an internal comfort that it is not
your responsibility to fix the pain of
another. It is only your responsibility
to witness it, share it, show up
and be fully present, and offer
guidance.
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Compassion satisfaction
comes with a sense of peace
even when that individual
refuses or resists your
guidance; you still have
done your job, and done it
well
Some days you are a 3
and some days you get to be a 10,
but every day you can make a
difference.
Compassionate Satisfaction
is the ultimate knowing that
the light house is not
responsible for the safety of
the ship but only responsible
to be the light!
Know your purpose
Knowing what it is you have to do
to feel good about yourself, your
job and your life.
And NEVER lose sight of that
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My new calling:
Creating lifetime relationships for
long-term recovery (Relationships
account for 30% of “why people change” and
ultimately impact patient outcomes.)
Foundations Recovery Network
Black Bear, (GA), The Canyon, (CA), La Paloma, (TN),
Michaels House, (CA)
and Seven Outpatient Facilities
Con
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Foundations Recovery Network’s mission is to be
the leader in evidence-based, integrated treatment
for co-occurring mental health and substance use
disorders through clinical services, education and
research.
Our 1 year post-discharge abstinence rates
continue to be higher than the national
average.
Illegal Substances Alcohol All Substances
*National Benchmark in White (2012) – 30%
What lights you up?
What fills your glass?
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Maybe some days you feel
tired….
“I CHOOSE
And always ….
Always Love your life
LOVE”
And that’s ok…..
but never EVER stay tired!
by Shawn
Gallaway is
used by
permission
and can be
purchased:
Keep your light on!
www.shawn
gallaway.co
m.
Love your Life !!!
Sonia Choquette
(Hay House)
Used by permission
And always Choose love!
Contact Information
Noel E Holdsworth
DNH, PMHNP-BC, CTS
Noel.Holdsworth@frnmail.com
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