*Disclaimer: As with all of my posts, the opinions expressed here are my own, unless otherwise noted. I am not describing any particular situation or person or organization, but am speaking in general terms about health care.
In my last post, I described my own red flags for compassion fatigue. You can read the post here, but my major red flags include lack of empathy or sympathy for others, and an almost constant state of low grade anxiety. When it starts spilling over into areas of life other than work, I know it’s time to to something. Here is what I do (or try to do).
When the red flags of compassion fatigue start waving . . .
1. Identify your red flags.
It usually starts with one or two signs that cannot be ignored. When you see those first couple of signs, stop and make a list. What other signs are there that you may be “burned out”, or experiencing compassion fatigue. How is this spilling over to your life outside of work? Awareness can help you realize that it may be affecting you more than you first realized. Also, I find that making a list of my own red flags can help me earlier identify when I’m heading down that path the next time.
2. Don’t make any major decisions right away.
Often our first instinct when we realize something is painful is to remove the cause of our pain. Our first instinct may be to change our case load and so that we don’t have to deal with that difficult patient. Or tell finally tell that co-worker who sits next to you how much you hate it when she steals your pen every day. Or say what you really feel to that insurance company on the phone who cannot seem to answer a simple question with a simple answer. Maybe you want to send off a fiery email to the head of your department or organization and tell them just what is wrong with your coworker/your department/your organization/the health care system in general. You may even want to apply for another job or even start looking for another profession.
My advice is to STOP. Do NOT make any sudden decisions in the midst of compassion fatigue. If you look at each of these situations individually, none of them in and of itself is the cause of your ‘pain’. Theses are just outside symptoms, manifestations of what is going on in your heart. Lashing out and doing something you might later regret will only make your situation worse. So take a breath and STOP. If you need to, make a list of everything that is wrong in your world. Write a note to your coworker, write your letter to your boss, make a list of jobs you think would be better than what you have now. And then set it aside.
Don’t act on anything in the midst of compassion fatigue, because you likely don’t have a clear perspective.
3. Do what you KNOW to do to take care of yourself.
I find that the road to compassion fatigue often starts with my own lack of self-care. It’s hard to take good care of others if you cannot care for yourself.
You know, those things we know we should do, but as caregivers we often do not do.
Eating right. Exercising. Getting enough sleep. Keeping good boundaries. Leaving work at work, and not taking it home. Having fun. Maintaining relationships. Meditating. Seeking spiritual strength. Talking about what is bothering us rather than letting it build up. Grieving loss. Taking time off. Whatever it is you are not doing, start doing it immediately.
4. Get Help.
Tell someone that you are struggling. Tell someone who is safe and supportive. Your manager, your co-worker, your significant other – any one who is safe to vent to. Seek professional help if needed. Find a good counselor.
Break your situation into bite sized pieces, and ask for help where you can.
Maybe you need to share that very challenging patient with symptoms out of control and the emotionally draining family. Perhaps you need social work to help you establish better personal boundaries and keep you in check. Maybe you just need a good three day weekend. Ask a friend to walk with you a few times a week. Tell your manager that you need to put a cap on your caseload for a short time because you are struggling. Set aside a regular time to go out with friends and have fun. Whatever you need to do to become grounded again so that you can see the situation from a fresh perspective.
5. Find a way to survive the crisis.
Sometimes you may not be able to do much to change your situation. Maybe your census is high and it’s the middle of flu season, and you are going to be short staffed. You can’t change that. Maybe you’re working night shift and can’t move to days until there is a spot open. Maybe your boss is going through a messy divorce and he’s just going to be grouchy for a while.
Find a way to make your situation FUN, or at least more tolerable.
Plan a potluck. Have a party for no reason. Play upbeat music. Go out to happy hour with your co-workers. Start a countdown to Christmas, or plan a Christmas party in July. Be creative.
6. Remember, these crisis times are only temporary.
When life and work get crazy, it is usually only for a season. I know that sometimes it feels like it will last forever, and that things will never change, but that is ‘crisis mindset’ thinking. Do what you know you need to do to be healthy (as discussed above), and then see where the dust settles. For myself, if a situation still lays heavy on my heart 24 hours later, I probably need to do something with it – tell someone, get help, make amends. If I feel like things are out of control for more than a couple of weeks (which means I probably didn’t get help in the beginning when I should have), then I really need to STOP and look at what is happening and why, and tell someone so that they can help me be accountable to take healthy steps before I’m over the edge. If I have done the things I need to do, and it has been four or more weeks, then I need to consider what needs to change.
7. When the dust settles, NOW consider if you need to make a change.
Once you are through the emotion of the situation, or at least on the other side of the crisis, look with fresh eyes. You might see that you simply need to practice better self-care and identify your red flags BEFORE your situation turns into a personal crisis.
Or maybe your really need to change something. Maybe you need to devote more time to your family, and you need to work part-time? Maybe your body just can’t adjust to night shift, and you need an alternative, even if it means moving to another department. Maybe you need a break from patient care and should consider a different type of nursing. Maybe you need a vacation. Or perhaps it really is time to make a move to another department or organization? Just don’t make a snap decision.
Make sure you have carefully considered your situation, and that you are making healthy choices along the way. And you will get your compassionate heart back once again.