In August, my mother was unexpectedly hospitalized. Following two major surgeries and a long hospitalization, she passed away from heart failure in December. During her hospitalization in August and the long autumn of recovery, I had the opportunity to experience palliative care first hand, and later, in December, the blessing of Hospice, which provided the support for me to care for my mother at home, the place she most wanted to be.
Over a 30+ year career in healthcare, I have witnessed a lot of illness and death. At times, there is an absurd juxtaposition of living and dying in the same space, and I am reminded of a time I stood at the bedside of a patient in ICU with a tennis match blaring on one of the TVs while a code took place at another patient’s bedside. In the fast moving world of healthcare, one family grieves, while another celebrates a medical win or respite from a serious illness. We eventually experience the loss of our own parents or other family members, and, after a few days off work for a funeral, containing our grief, we return to work “staying busy,” which we are told is good for us.
We all know that death is an inevitable part of life, and as often as we experience it as healthcare providers, it seems sometimes that we are immune to the associated grief. We spend so much of our time helping patients “battle”, “conquer”, and “wage war” against illness and disease, that when the” battle” is lost, we are sometimes left with the unexpected response of grief.
Yesterday, I heard from the daughter of a patient of mine, that he had passed away. Jim was an active member of my weekly speech class, The LOUD Crowd, and recently, he had reluctantly left Florida and re-located back to his original home in Cleveland, due to a decline in his health. When I hung up the phone with his daughter, I sobbed, and this morning, on an unusually rainy Florida morning, I find that I’m still crying. This morning, the grief seems cumulative, my mom, my friend who passed away this summer, a patient. It should be obvious that eventually, personal experiences of loss coupled with loss of patients wears us down or leads to what some have termed: “compassion fatigue.”
A consequence of caring for suffering patients is the development of compassion fatigue, which has been described as the “awareness of the suffering of another coupled with the wish to relieve it.” When healthcare providers show compassion while caring for patients on a daily basis, a state of exhaustion often described as “running on empty,” or compassion fatigue, may result.
Most of what has been written on this topic has been directed towards nurses, but I would say that any of us, including speech-language pathologists, who work with patients daily, including individuals with chronic, neurodegenerative disease diagnosis, need a bit of self-care. We are so accustom to counseling patients about what THEY need to do, that we are not always as attentive to our own needs.
So a few suggestions I will share and try to undertake myself:
- Establish a method of shedding the professional role at the end of the day, which might include not reading emails after a certain time in the evening.
- Engage in activities that replenish, comfort, and renew the spirit.
- If inclined, set aside time for spiritual practices such as meditation, prayer, or journaling.
- Engage in exercise, or meditative practices such as tai chi, or yoga
- Talk to a professional, if needed
It has become apparent to me, not only from my own experience, but from some of the questions and comments I read on a professional discussion board, that end of life education for all healthcare professionals is needed. Not only do we need to know what services are available for sick and dying patients, but what is also needed are communication skills that might help speech-language pathologists, like nurses, learn how to handle conversations with patients and families who are ill or may be suffering. We also need to recognize when we might need support.
Perhaps this post will lead to some discussion. I would love to hear from you.
Ref: Radley, F., & Figley, C. (2007). The social psychology of compassion. Clinical Social Work Journal, 35, 207–214. doi:10.1007/s10615-007-0087-3 Boyle, D.A. (2011). Countering compassion fatigue: A requisite nursing agenda. Online Journal of Issues in Nursing, 16(1), 2. Clinical Journal of Oncology Nursing • Volume 18, Number 4 • Coping With Grief and Compassion Fatigue
To enlist individuals in their treatment, and help them express their personality & spirit through voice. To educate and empower.
Mary Spremulli, MA, CCC-SLP