Compassion fatigue Q&A
Suzanne Mackay is a narrative therapist who has suffered from Compassion Fatigue (CF) herself. She runs two CF groups with the Charlotte Maxeke Hospital ICU nursing staff and one with the therapeutic contingent of an NGO’s staff. Here she tells us more about these programmes and working in a caring profession.
What is compassion fatigue? CF is also known as Secondary Traumatic Stress. It’s similar to Post-Traumatic Stress Disorder but the “stress” is as a result of indirect trauma, through working continuously with (and caring for) those who have emotional, social and/or physical challenges. Due to the continuous role of caring, these carers can have a gradual decrease in compassion and many other symptoms. It can lead to burnout but burnout is a broader condition of complete physical and emotional exhaustion. In caring professions, CF can be a huge contributing factor to burnout.
Your CF programme is in the pilot phase, could you tell us a little more about it and what you hope to achieve?
I have designed a three-part group programme:
1. Group debriefing: Facilitate the “unpacking” of the group’s work, roles and specific challenging cases.
2. Individual counselling: The second phase includes making individual counselling available for those who desire it.
3. Skills development: The aim is for the group to continue in the same manner, giving the participants a space to debrief their work, to be supported and mutually cared for.
I am running three groups at this stage – two with the Charlotte Maxeke ICU nursing staff and one with the therapeutic contingent of an NGO’s staff. The goal of these groups is for me to receive feedback regarding my process and the value of the three-part programme. This will inform how I implement them in future. They have also agreed to give me HR information to track absenteeism and turnover to see if there is an impact beyond the subjective impact. So far the programme has been received very positively and the participants have noticed an improvement in their emotional wellbeing.
Ideally, my next phase will be to approach other hospitals and paramedics. If this grows to the point where I can train others to facilitate similar groups, I would like to expand to police, social workers, and so forth. The scope is endless.
A huge part of self-care is rejecting the sense of guilt and self-blame for CF, including the realisation that you are finite. You are most effective in your role if you are wisely ‘selfish’ when needed.
What do you love about your job? Caring professionals give so much to society in a variety of ways but often the manner in which they give leaves them depleted and not able to give to those they care for at home and even less so to themselves. I love the fact that this programme seems to reinvigorate and refresh the carers, renewing their original passion for their work.
How do you treat someone with CF? For treatment to be most effective, it needs to be holistic in its approach. Firstly, the person needs to encourage self-care. For example, time off, time relaxing, eating, sleeping and exercising properly, and seeking healthy, supportive relationships. A huge part of self-care is rejecting the sense of guilt and self-blame for CF, including the realisation that you are finite. You are most effective in your role if you are wisely ‘selfish’ when needed. Secondly, carers need to receive professional support – either through supervision or a support group. This will create the space for debriefing certain cases or situations in a constructive manner. This support is also necessary in altering the job demands or responsibilities.
How can you create conditions that reduce the risk of CF? Through implementing the above two strategies preemptively, one reduces the risk of CF. Caring professionals need to be intentional about their self-care because an empty jug is not able to give any water where it is needed. They also need to be cognisant of their own thoughts, emotions and behaviours, and to seek assistance if they see a change. Isolation and an imbalance between professional and private arenas are contributing factors.
To read the full version of this story go to page 132 of the November 2013 issue of DESTINY