It's really important as we think about palliative care that we also are thinking about how we care for ourselves as providers of clinical care. That could be in our role as a physician and our role as a nurse, or a social worker, or a chaplain. We put ourselves out there everyday to provide the best care possible for our patients. Sometimes that means that our own self-care is compromised. When our own self-care gets compromised, it makes it more difficult for us to provide that excellent clinical care for our patients. We're just going to take a few minutes here to talk a little bit about what it means to recognize when we may not be taking the best care of ourselves, and to also provide some basic strategies for how you can ensure that you do take care of yourselves and be able to provide good care for your patients. Let's talk a little bit about two complex terms, but terms that you may have heard before, and terms that are often confused with each other. There are two ways that your own health could be affected by providing clinical care: one One burnout, and the second is compassion fatigue. When we think about burnout, we're really thinking about what happens to you as a clinical provider over a long period of time. Often, burnout is due to external factors such as a complex electronic health record or the need to write notes by the end of the week, or the fact that you have a manager or a partner that makes your work life more complicated, or the fact that you're not able to get appropriate compensation from the insurance company. That can make you a little bit angry, it can make you cynical, it can make you tired, it can make you angsty about continuing to do the work that you're doing because you're not seeing the positive results of the work. Compassion fatigue is a little bit different. Now, compassion fatigue really has to do with where you might take on your patients or their loved one's needs too much, where you really get into their shoes and you start to feel what they feel, feel the stresses that they're feeling, feel the anxiety that they're feeling, feel the sadness that they're feeling, where you're maybe in their shoes and you can't quite get out, and so you might experience your own sense of anxiety, your own sense of distress. You might experience nightmares or fatigue from owning that emotional response of the patient and owning it as your own instead of realizing and recognizing that it's their experience, not your experience. That can lead to feeling overwhelmed, emotionally exhausted, isolated, anxious, depressed. The reaction to that is that, you might try to distance yourself or you might try to put yourself in a place where you can't get hurt. You start to depersonalize and you start to step away as a clinician instead of stepping in or leaning in as a clinician. When we think about burnout and compassion fatigue, if you're noticing that you're feeling burnt-out or you're noticing that you are developing compassion fatigue, it can really affect your ability to be a good clinician and it can really affect your own health. The two together are not a good combination, where if you're not eating well, if you're not sleeping well, if your mood is poor, or if you're feeling cynical or angry or your career is not giving you what you need, then you are less likely to be able to get up and do your job the next day, and your patients are less likely to feel connected with you and vice versa, leading to overall dissatisfaction in your career, probably, poor health care for your patients and a sense that maybe it's worth leaving this type of work. We know we're in a marathon not a sprint, so we really want to ensure that our health care providers are in it for the long term and are in it because they really love what they're doing. How do we ensure that we don't get burnt-out? How do we ensure that we don't experience compassion fatigue? Or that we can at least mitigate these two and possibly get through it if we do experience these? There are many strategies and it's honestly beyond the scope of this course to go through all of them in huge depth. But we did want to give you a few pointers so that you can start to incorporate some of these strategies into your regular practice. That will really help you to create a routine around self-care so that burnout and compassion fatigue are less likely to occur. These are just a few things that you can do in five minutes or less. One is to just do some gentle stretching. We really believe that moving your body, stretching your body can help enormously with well-being. That might just mean doing a five minute video where you do a stretch routine. It might just mean that between your different patients that you get up, take a walk around the building or get up and move your arms and legs. The second thing is to do some journaling. Writing things down every day that you're grateful for or that gives you joy can really be an affirmation for both what you enjoy about your personal life, but also what you enjoy about your work to remind you why we get up each day and do this really beautiful work. So those written affirmations go along way and on not so good days you can always go back and read some of those positive affirmations, your gratitude journal, remind yourself of all of the wonderful things that have happened, all the wonderful things that you enjoy about your life and your work. Listening goes along way too. I would think about listening in two different ways. One is listening to things that lift your mood. So that could be listening to a song that you really love and really taking a moment to dive in and just enjoy it and maybe even dance a little. But also really listening to your patients and feeling connected to them goes a really long way. I think when you feel like you've listened well, you feel like you've heard them, and the connection just deepens and that can really improve your sense of satisfaction with your work. Finally, think about moving. So in addition to stretching, definitely move, exercise, walk. Sometimes that's a little bit five minutes, like the walk around the building that I mentioned with the stretching. But sometimes it's really incorporating a pretty appropriate exercise routine to your regular day and we keep preaching, help your providers to exercise to our patients. But it really makes a huge difference for us as providers to incorporate exercise into our regular day as well. Then finally, there is huge health benefits to drawing. So drawing or coloring can have a very calming influence in our normal routines and we recommend giving that a go and having some colored pencils and some drop notebooks next to you and taking a few minutes and just filling in some lines or if you're more talented than I am actually drawing a picture without a coloring book next to you. Then in addition to those strategies that you can do in the clinic, we also recommend good daily care. We just need to remind ourselves that we are here as people first, people who have our own commitments, whether it'd be for work or childcare, or to a partner or to a parent and so we're balancing all of those things. So self-care also means doing our routine, daily care. That means some of the basics like getting adequate sleep, remembering to eat nutritious food, continuing to exercise, as I mentioned earlier, finding time for yourself every day to do something that gives you joy or makes you happy. Make sure you laugh. Find ways to engage in humor, watch comedies, or listen to a good joke. Makes sure that when you come home from work, you have a transition period. For some people that's changing their clothes or walking from their work to their house, or ensuring that you're putting aside your phone just so that you know that when you get home, you're transitioning to a different zone of your life and then fully putting yourself into that zone. Some people really benefit from a daily meditation practice or a daily yoga practice. Think about delegation so that you don't feel like you have to do everything within the house, but rather that you get help, sometimes having someone to help do a little bit of laundry or having your kids unload the dishwasher can make a big difference in making you feel more calm when you walk in the door and feeling like you can really be part of the family without those additional stresses. Remind yourself to embrace gratitude and be grateful for each day that the sun comes up and it shines down on you, and that you have your health and that you're able to participate in your family's life and in your patients lives. If there are things that you're going through that are challenging or difficult in your personal life, acknowledge that too and practice acceptance of that and make sure that you're working through those things as you work through your other facets of your daily care. So we hope that this helps you think a little bit about what it means to be a healthy healthcare provider. We can't provide the best care possible if we don't do that for ourselves. So pay attention, makes sure that you're in a place where you understand where you're at. Listen to yourself, understand whether you're experiencing burnout or compassion fatigue. Think about the daily strategies that could really help you to confront each day with joy and each day with an opportunity to take care of yourself and to take care of the people around you and when you're not at work, practice good daily care where you are really ensuring that your physical and mental health are a priority both for yourself and for your loved ones.
