I almost always say this when I speak to families about the condition of their critically ill loved one. Usually, when I say these words, my patient is very sick, and they are at high risk of dying. I have lost count how many times I have said the above words to families of patients suffering from COVID-19.

Most recently, I said these exact words to a family who was grieving after their mother, suffering from COVID, just got placed on a ventilator. She had been sick for a long time, and now that she required mechanical ventilation, her prognosis was likely very poor.

I did not pull any punches with the family. I gave them “brutal honesty” about how their loved one was doing. I told them that, while I do not want to crush all hope, I also did not want to give them false hope, which was much worse. I could tell they did not like what I had to say, and – to be honest – I didn’t feel right after our interaction. For some reason, I was may more blunt than usual.

The following day, I got feedback that the family really didn’t appreciate they way I spoke to them. They felt that, as a physician, I should have had more compassion for them and their situation. The nurse, in fact, told me I probably should not go in the room with the family present. I felt I had to rectify the situation, repair the damage to our relationship. And so, I went in the room and spoke to them again.

I said that it is essential that we – myself and my patient’s family – have a good relationship because, we are a team, and if we don’t work well together, then my patient – their loved one – will ultimately suffer.

They told me that they didn’t appreciate how I spoke to them, that it made them feel that I had “given up” on their loved one, that I had no hope left or didn’t want to fight for her. This was the worst day of their life, and my interaction left them wondering what kind of physician I was to whom they left their loved one in his care.

I listened to this “brutal honesty” about how I acted, and I apologized. I didn’t mean to come off this callous and uncaring. I totally understood how they were made to feel, and that was never my intention.

I told them that, if I didn’t care, I would not be there the bedside. I thought about leaving medicine, I told them, but I never did because, I really do care. They were very appreciative of what I said, and I felt we were able to establish rapport once again.

I still believe in being honest, sometimes brutally honest, with my patients’ families. I truly believe that giving false hope is the absolute worst thing I can do as an ICU physician. At the same time, there is a balance between honesty and compassion, and my recent interaction taught me that.

Although I have seen the movie of how critically ill patients with COVID fare time and time again, my patients’ families have not seen it before. For them, seeing their loved one get worse and need a ventilator is the worst moment of their lives. I need to be more cognizant of this fact and do my best to deal with families in a gentle manner.

That doesn’t mean I sugar coat how my patient is doing. I will never do that. At the same time, I need to make absolutely sure I do not come off as if I could care less about their loved one. I need to make sure that I am not conducting myself as if to say, “Why even bother?” It can be a tough tightwire to tread, but tread over it I must as a critical care physician.

We are all exhausted. We are exhausted from the relentless death, destruction, and despair wrought by this pandemic. We are frustrated at the senseless death, especially now with widely available vaccines. People need to understand that. At the same time, it is as important – if not more important – that we understand that our patients’ families are devastated when they see their loved ones crash with COVID. We need to be careful not to be brutally callous in the attempt to be brutally honest.

The post The Double-Edged Sword of “Brutal Honesty” appeared first on Medika Life.

Compassion fatigue is a type of secondary stress that healthcare workers can experience as a result of assisting others who have an acute health issue, chronic illness, or disability and are dealing with related stressors.

As a health worker, you may be a nurse, personal support worker, physiotherapist, occupational therapist, community service worker, doctor, paramedic, psychologist, therapeutic recreationist, social worker, respiratory therapist, or another professional amongst the many valued staff that provides healthcare services to clients on an inpatient, outpatient, or community level. Helping vulnerable people day in and day out can naturally lead to a build-up of stress that makes it hard to do your job in the way you want to or are used to.

While no two health professionals experience compassion fatigue in the same way, workers can learn how to recognize signs of compassion fatigue and use strategies to help them handle symptoms.

Signs of compassion fatigue:

1. You are less motivated and have less enjoyment in your daily work

You may find that you are not as enthusiastic about your career, don’t have as much drive in accomplishing your regular job responsibilities compared to before, and you have less interest in your daily duties. This is a major shift from how you used to feel about your position and work environment and you find it unsettling.

2. It requires more of your energy, concentration, and focus to do routine tasks

In connection with the reduction in motivation and enjoyment, you may also find that the responsibilities that usually seemed easy or straightforward to you may suddenly seem more complex, draining, time-consuming, and difficult.

What used to take you 15 minutes to finish now takes you an hour. An issue that used to be simple for you to problem solve now appears very challenging. You notice you are easily distracted and lose your focus often.

3. You feel helpless, overwhelmed and less engaged in working with your patients or clients

In the daily sessions or interactions with your patients or clients, you may start to observe that you feel helpless, overwhelmed, and overall less connected to your clients. It’s now much harder to empathize with them and help them address their needs. You feel drained and exhausted by the end of the day.

4. You take work “home with you”

When your shift is done at the end of the afternoon or evening (or maybe even the next morning depending on your type of shift), you are aware that you start going over difficult clinical situations, moments, and interactions in your mind.

Perhaps you think about what you could have done differently or how you could have handled things better — and agonize over it. Perhaps you criticize yourself for what you said or did — or what you didn’t say or didn’t do. You feel it is getting harder and harder to separate yourself from your work when you are at home.

5. There is a change in your personal habits (e.g. sleep, eating, exercise, social life)

You may sleep more or sleepless, see an increase or decrease in food intake, feel less motivated to exercise and are less active overall, withdraw from even remote social connection (given current COVID-19 pandemic requirements), and notice other major differences in your typical personal habits and routines. All are signs that you could be experiencing compassion fatigue.

6. You notice changes in your mood or physiological response as they relate to anxiety, depression, and stress

Are you feeling more irritable and impatient or are you more emotional about issues at work that don’t usually bother you? Are you experiencing headaches, stomach aches, or muscle tension before, during, or after clinical meetings? Do you feel emotionally numb when hearing upsetting stories from patients or clients? Are you feeling sad, worried, or stressed in the workplace? These kinds of changes may reflect compassion fatigue.

7. You interact differently in your personal and professional relationships

Compassion fatigue can also have an impact on your personal relationships and your coworker relationships. You may have less energy remaining to put into quality time with your loved ones or you may have trouble focusing on those interactions without thinking about work. You could have less interest in connecting with your coworkers as you begin to see your work environment as a source of stress and dissatisfaction and seek as much distance as possible.

Strategies for dealing with compassion fatigue:

1. Reflect on why you started your career path in the first place

What drew you to your profession, to begin with? It may help to remind yourself of your reasons when you are feeling discouraged about your day to day work. Whether it’s the particular client population you work with, the pace or flow of your unique position that attracted you, or the teamwork and collaboration your work environment offers — recall these values as they likely still hold true today.

2. Consider your goals for professional growth and development

Even though you may have specific reasons why you chose your career, this doesn’t mean that you need to stay stagnant or in the exact same position for your entire working life. There is room for movement within and between as your needs, interests, priorities, and other key aspects of your life change.

Perhaps you started out as a front line worker but now want to make a shift to educating students or new health professionals. Maybe you would like to take on more of a leadership role in your particular specialty or department. Or you possibly could want to start a private practice and use your skills, knowledge, and experience to focus on a certain niche that fits with your business vision. The options are endless. Taking time to reflect on your future professional goals might reinvigorate and rejuvenate you at a time when you need it most.

3. Take your lunches, breaks and vacation days

Making sure you take your lunches, breaks, vacation days, education days, and any other time that you are eligible for in your position can go a long way toward helping you feel refreshed and relaxed when you feel overloaded in your job.

4. Connect with colleagues for support

Who are the key people that surround you at work who you can rely on and trust? If you are comfortable, let them know how you are feeling. Bonding through similar experiences and learning from each other on how to handle work stress can help you feel more capable to manage your challenges.

5. Lean on your social network

Call your family or friends when you need a listening ear (given current physical distancing measures due to the coronavirus). Talk with your partner and let them know how you are feeling. Reach out to those closest to you for much-needed support.

6. Do activities that relax you

Building up your interests outside of work can help improve your outlook and refuel you. How do you like to spend your spare time? Meditating, being in nature, exercising, reading, journaling, deep breathing, listening to music, or watching funny movies? Spend 30 minutes a day or even an hour if you can — whatever amount of time sounds realistic and feasible to you — doing one or more activities. It will remind you that you have to take care of yourselfin order to take care of others.

7. Get professional help

If your stress level gets to a point where you begin using substances in an attempt to cope, experience thoughts of self-harm, start to have flashbacks of distressing events or notice you are having more intense physiological responses (e.g. difficulty breathing, a rapid heart rate, fainting, a loss of awareness, a loss of a sense of control, etc.), you may want to call your family doctor to describe your symptoms and ask how they can help.

Your doctor may refer you to a psychologist or psychiatrist for assessment, diagnosis, and intervention. If you have been diagnosed with acute stress disorder or post-traumatic stress disorder (PTSD) and it is significantly affecting your life, you may wish to seek help from a professional who specializes in PTSD treatment.

If you have a mental health emergency, call 911, or go to your nearest emergency room. For non-urgent crisis support, call a crisis phone line such as the Ontario Mental Health Help Line at 1–866–531–2600.

If you are generally trying to find ways to cope with compassion fatigue, you can seek out counseling to help you explore what is already working well and what you would like to change. Counseling might also help you figure out new methods you think could work for you. You can contact the Employee and Family Assistance Program (EFAP) connected with your employer as a first step as this may be the most financially feasible, short term option.

If you feel you need more intensive or ongoing support, seek out a counselor who you feel you have a good therapeutic rapport with and who tries to help you discover strategies to handle your concerns in a supportive manner. You can find a Social Worker through the Ontario Association of Social Work (OASW) directory or a Psychologist through the Ontario Psychological Association (OPA), as an example.

Wishing you well in your journey as you continue to explore ways to find meaning, growth, and fulfillment in your professional life.

The post 7 Signs of Compassion Fatigue and 7 Strategies to Deal With It appeared first on Medika Life.