All Courses Forums Course Discussion Forums Burnout: How to Hold Out the Light Without Burning Out Oates Burnout Seminar / Week 1 and 2 Discussion

19 replies, 4 voices Last updated by brandeaton 1 year, 5 months ago
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    • #5956

      Rick Underwood
      Moderator
      @RickUnderwood

      Dear Friends,

      I hope each of you and yours are safe and well.  We are moving along in our discussion.  I am a little late inviting you to share your reflections from week 1 and 2 readings.  Brand has offered some personal sharing and thoughts about week one’s readings.  I appreciate your vulnerability Brand and it sounds like you recognized some factors in the resources that applied to you.  Awareness is always to the beginning of change or coping.  Lisa and Deanna, please join us with your reactions to others as well as your own reflections.

      Rick @ Oates

       

    • #5957

      brandeaton
      Participant
      @brandeaton

      After reading Rick’s article and carefully reviewing Dr. Middleton’s Power Point presentation, I sense some impact on my chaplaincy practice in both areas.  I look back at my mother’s death almost four years ago following a long period of illness and decline from arterial disease and CHF.  When she died, I couldn’t shed a tear.  There were some very rugged family dynamics afterward that we have repaired but not healed.  Her death, I think, somehow capped a number of resident deaths at Bethany Village in which I provided some intense end-of-life pastoral care and in which I had a level of personal investment.  I recognize that I’m dragging in some level of compassion fatigue.  However, I also have had to work with an organizational culture that has been going through some profound shifts during the same period.  Those have caused some stress and personal pain at times, and so a lot of what I feel is burnout as Rick describes it: physical exhaustion; poor productivity; lack of interest; short attention span.  I have engaged many of the strategies Rick mentions in his article:  identify and build on strengths & learn to manage your weakness by simplifying, eliminating, and delegating; evaluating and modifying negative self-talk; learning to relax and recreate.  Even the latest changes in my work due to the Covid-19 restrictions have provided a change in routine that has helped renew some of my energy.  I’m not quite sure about “recognize your stress tolerance.”  I know I “hit the wall” sometimes when my body starts to complain in some pretty tell-tale ways, but pulling up short of hitting the wall feels illusive.  I struggle to know where resiliency stops and damage starts.

      • #5966

        Lisa Wood
        Participant
        @LisaWood

        Brand, your observation that the  burnout you’re seeing in yourself and in your work “culture” as systemic is a keen one.  Certainly the C19 crisis has caused all of us to shift some emotional ballast; I can’t help but wonder if we’re not trading some stressors for new ones (e.g. the demand for heightened emotional and mental energy in the workplace is diminished, but the anxiety of working “healthy at home” with the added stressors of at-home distractions, inaccessible resources left in our offices, and feelings of being quite literally “out of our workplace element.”)

    • #5961

      Deanna Stringer
      Participant
      @dstringer

      I was reflecting on Rick’s article dealing with the risk factors and the current situation we find ourselves in with the COVID-19 epidemic. When I use a check list for the medical staff in our organization, I could check off almost all of the risk factors for every person in the organization. That is the nature of our work to some extent. In fact, we are often applauded when we strive for perfection, measure against an impossible rubric for professional development, don’t need to have a lot of support or take on additional responsibilities beyond the average medical professional. Our world change almost over night it seemed and there are definitely lack of resources with many conflicting opinions as to what we are supposed to do that changes each day. I almost got a sinking feeling that when all the main pandemic is over that we will lose a good portion of our health care professionals due to PTSD type symptoms and vicarious trauma. The existential questions are going to be profound about God allowing the kind of suffering and pain that these professionals are dealing with.

    • #5962

      Deanna Stringer
      Participant
      @dstringer

      I know that sometimes my husband can tell me the boundary between resiliency and hitting the wall before I can see it and suggest some rest and relaxation. I have learned to listen to him and take the time if he sees me getting “short” with the kids or himself because then I know that my work stress is creeping into home life. With sleep and sometimes that needed personal day off, I can go back and tackle what seemed immountable the day before. Our organization actually has given us an extra 3 personal days to be used at our own discretion this year to help with the burnout situation.

    • #5963

      Deanna Stringer
      Participant
      @dstringer

      OK, I will put this response where it belongs.
      I was especially struck by the statement in Rick’s article about self-care. “Self-care is an ethical imperative not to be damaged by the work we do.” and the NASW Code of Ethics, “Impaired professionals should not continue to practice: duty to clients.” When a person gets to the point of “impairment” I don’t think that we see it as an ethical issue even though it really is an ethical issue. We are physically and emotionally done, ready to throw in the towel and will do whatever needs to be done to “get out.” The issue is about physical and emotional survival. If there is a reason that that professional can’t find a way out that is where it gets dangerous and we see either the person’s body collapse or serious emotional damage or suicide. As chaplains we have the responsibility to occasionally just take emotional temperature and gauge whether we or the people around us are being “damaged” by the work we do. I never have really given thought to that concept before of being damaged by the work. I was always pushed to do my best at all cost and didn’t consider that compassion is good but too much can not only cause damage to the boundaries between clients and ourselves but also to our own physical and emotional well-being.
      I often work with grief as a hospice chaplain  and think of grief in the 4 quadrants mentioned of before death, during the process of death, right after death, and long term grief, but I have never thought of self care dealing with a traumatic situation of before, during, right after and later self-care. I think this will really help my own self-care when I go into a home that is dealing with death. thinking about not just taking emotional temperature occasionally but maybe taking my own emotional temperature several times and “checking in” with myself in those 4 quadrants will help me be aware of self care or the lack of it sooner

    • #5965

      Lisa Wood
      Participant
      @LisaWood

      Rick’s article and the Middleton powerpoint complement each other in clinical and pastoral application.   I need to clarify (for myself) the term “emotional resources” in the context of Rick’s sentence:  <span style=”font-family: TimesNewRomanPSMT; caret-color: #000000; color: #000000; font-size: medium;”>Christina Maslach in Burnout, defines burnout as a psychological syndrome of emotional exhaustion (feelings of being emotionally overextended & depleted of</span><span style=”font-family: TimesNewRomanPSMT; caret-color: #000000; color: #000000; font-size: medium;”> </span><span style=”font-family: TimesNewRomanPSMT; caret-color: #000000; color: #000000; background-color: yellow;”>emotional resources</span><span style=”font-family: TimesNewRomanPSMT; caret-color: #000000; color: #000000; font-size: medium;”>), depersonalization (negative & cynical detached response to others & may include a loss of idealism) and reduced personal accomplishment (decline in feeling of competence & productivity at work).</span><span style=”font-family: TimesNewRomanPSMT; caret-color: #000000; color: #000000; font-size: medium;”> </span>

      Additionally, in his illustration using “Jim,” Rick writes, “..<span style=”font-family: TimesNewRomanPSMT; caret-color: #000000; color: #000000; font-size: medium;”>He poured himself into the job but he wasn’t very open to the feedback about how to do things better…” </span><span style=”font-family: TimesNewRomanPSMT; caret-color: #000000; color: #000000; font-size: medium;”> I wonder whether Jim’s not being open to feedback is a personality trait, or an acquired defense mechanism he’s developed from having been unfairly or inappropriately criticized in the past – either in the workplace, or in his personal life.</span>

      Regarding the Middleton article, I was struck by the idea of the u<span style=”font-family: TimesNewRomanPSMT; caret-color: #000000; color: #000000; font-size: medium;”>nrealistic expectation that I can be “immersed” in pain and suffering of others daily and not be affected by it.</span><span style=”font-family: TimesNewRomanPSMT; caret-color: #000000; color: #000000; font-size: medium;”> </span><span style=”font-family: TimesNewRomanPSMT; caret-color: #000000; color: #000000; font-size: medium;”> The question of “</span><span style=”font-family: TimesNewRomanPSMT; caret-color: #000000; color: #000000; font-size: medium;”>Soooooo, what are my resources for coping/processing it?” were met with practical, albeit somewhat unfamiliar methods for that coping/processing and managing the ill effects. </span><span style=”font-family: TimesNewRomanPSMT; caret-color: #000000; color: #000000; font-size: medium;”>The idea of an “ethical imperative” not to be harmed or to damage others by the work we do is profound.  I just have to wonder… </span><i style=”font-family: TimesNewRomanPSMT; caret-color: #000000; color: #000000;”>What would that “damage” look like in the people with whom we do pastoral care/counseling.</i>
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    • #5967

      Lisa Wood
      Participant
      @LisaWood

      Deanna, as I read your first post, an image of your healthcare colleagues in “super hero” attire came to my mind, causing me to ask the question:  What is their (and my) kryptonite when it comes to living in our respective workplace cultures?  What’s that one thing – that tipping point – that will always send us careening toward that wall?  I’m glad to read that your organization recognizes its employees’ crucial need for self-care right now.

    • #5968

      Deanna Stringer
      Participant
      @dstringer

      Lisa, That is the image that some of our people portray at times. It is sometimes not a far leap into that Kryptonite wall when we put on the suit of superhero and pretend we are God. It is like the story of the Dutch boy who saw the dam begin leaking and went to put his finger in the dike to plug the hole and then he sees another leak and tries to plug that one too. Eventually it gets beyond him. That is how I see this issue of compassion fatigue and even burn out. Once we say “Ok” and “I’m in” we get close to the suffering and if we don’t have boundaries and help, the dike springs more holes and our anxiety rises to a point we can’t handle. We are mortal and we are not God. Finite beings with finite ability for compassion and relieving suffering.

       

    • #5969

      Deanna Stringer
      Participant
      @dstringer

      Sometimes when I do pastoral counseling a lot of anger comes out. Hurting people do hurt others and I think that damage is manifested not only by depression and defeat but also by anger.

       

    • #5985

      Deanna Stringer
      Participant
      @dstringer

      Last week I tried to post on Dr. Louw’s journal article for week 2, and in saving it, hit the wrong key and wiped it out so I will try again. I have always thought of compassion fatigue in physical terms (more as the articles describe burnout), so thinking of compassion fatigue from a spiritual viewpoint is a new perspective. I see almost all medical personnel struggle with the idea of a calling to care and the idea that they can’t give up because of the suffering of the vulnerable. We want to honor our calling but need to balance and be realistic in our boundaries. Some people can compartmentalize but what affects one portion of our lives affects all the compartments eventually. (family, work, leisure, etc.) It is when we cross the “God” boundary and begin to think that we are  indispensable to the caregiving that the compassion fatigue takes it’s greatest toll. Rather than having a realistic understanding of our caregiving, we push and don’t give up or we compare our caregiving to a standard of perfection (God’s caregiving) and always come up short. We begin to see ourselves as inadequate, hopeless, ineffective even when we have given the physical, mental, and emotional energy that we have to offer.   From a personal perspective, I guess, I did this yesterday myself. My son is 11 and has developmental delays, epileptic, and we believe autistic. I kind of had a meltdown after he had a fit yesterday and said, “I am ready not to be his mom anymore.” We adopted him a little  over a year ago. I felt that I could no longer continue doing all the “right” counseling techniques and positive reinforcements, and all the things you are supposed to do with a child that has gone through trauma and has behavioral issues. In talking with my daughter who is 27 and had experience with orphans in foreign countries, I did find myself feeling inadequate, hopeless, and ineffective. In doing this reflection, guess I need to give myself some grace or I am going to crash from being a mom to a child that has gone through trauma himself.

    • #5986

      Deanna Stringer
      Participant
      @dstringer

      With the summary of John Sanford’s book on the exhausted ego, I was struck by the amount of energy that is used up trying to live up to other people’s expectations combined with our own sense of inadequacies and fear/guilt. I do think that is a good portion of my own difficulties as I have always been a bit of a perfectionist and measure that perfection based often times on others reactions/reflections. I am not really sure how to gauge the value of what I do based not on a reflection from others. If we take this idea of expectations draining the emotional ego then, when I look at the renewing energy area, I don’t see much there that would help me deal with this issue other than possibly journaling which I do find occasionally helpful. What I do find the most helpful for me is taking that journey to God and deepening my relationship with him not necessarily with other people. Allowing God’s grace and perspective of being loved and cared for because of being his creation and not for my caregiving or what I do is much more helpful than striving to have a good mindfulness session or activate my imagination or dream world. Too much doing in this list rather than just being in God’s presence (I guess that is meditation to a point, Maybe?)

    • #5987

      brandeaton
      Participant
      @brandeaton

      Deanna, I was struck by your insight about the potential loss of healthcare professionals through PTSD, or related disorders, when the current crisis abates.  One of the elements of concern we have in my setting is the impact of social distancing and isolation on the elder population.  One cannot be “contained” in a small assisted living apartment for months without the experience of trauma.  When this is layered upon the psychological and spiritual effects of cognitive decline experienced by many elders, the concern is quite acute.  If we have a surge in such issues presenting themselves to a care team already depleted from the anxieties of seeking to physically protect those in their care, the problem is multiplied.  Being able to identify compassion fatigue, and operationalizing the treatment recommendations in Daniel Louw’s article, will be of paramount importance.

    • #5988

      brandeaton
      Participant
      @brandeaton

      Reading the Sanford summary in relation to Daniel Louw’s article distinguishing compassion fatigue from burnout and from vicarious suffering has helped me to identify my own struggle as burnout and to begin to consider an effective strategy to treat the problem.  Both offer similar responses to burnout despite the distance in time between the two writings.  Burnout calls for a redirecting some of one’s activities into outlets that will restore personal energy.  I think it also is incumbent to climb down from seeking to achieve and over-functioning and focus on the good one can do with the resources at hand, rather than become fixated on what one can’t do but could if more resources were available.

      On a related note, I have been speaking more candidly with some of our nursing professionals during the current health crisis.  While they are not being directly impacted, since we are blessed in not having any active cases in our community, some who are at the waning ends of a career are expressing a greater desire to retire than they had previously felt.  The thought that their work has now likely changed forever has them considered the energy needed to negotiate the “new normal,” and taking a hard look at their energy to negotiate that change at this time in their career.

    • #5990

      Lisa Wood
      Participant
      @LisaWood

      I just hit “submit” and my post on the Louw article went…somewhere!  But not here.  I’m looking for it and will try to copy and paste in order to place it in this thread.

      Meanwhile, another thought I had concerning the Louw article addresses the concept of feelings of failure.  Louw makes the statement that a pastoral caregiver’s or counselor’s feelings of failure “to meet the demands of human suffering” may be projected onto an omnipotent God.  To that, I can only say that my prayer is that God – in God’s omnipotence, lovingkindness, and mercy – will redeem my failures, inadequacies, and weaknesses.

    • #5991

      Deanna Stringer
      Participant
      @dstringer

      I agree Lisa. My failures are not God’s failures and he can even work through my shortcomings to do his work and make a success for his glory out of them.

    • #5992

      Deanna Stringer
      Participant
      @dstringer

      Brand, I am glad that you seem to have labelled your own situation which gives you a great opportunity to come up with steps that will help give you more energy. I look forward to hearing some of your action plan. It saddens me though to hear some of your fellow workers are considering and weighing retirement. They have so much wisdom to offer. Deanna

    • #5994

      Lisa Wood
      Participant
      @LisaWood

      Brand, your statement about “redirecting some of one’s activities into outlets that will restore personal energy,” struck a chord with me.  As a former children’s minister, teaching through PLAY was not only gratifying and fun for me, but also life-renewing.  Attentiveness to bugs and clouds and a rock that looks like turtle is just part of a child’s ability to live fully in the moment – and appreciate what’s there, just for their enjoyment.  As you said, being able to RECOGNIZE the “resources at hand” is a practical use of our God-given imagination and innovation.  Sometimes I think the best way to restore my personal energy is to play with the kids, draw hopscotch squares on the side walk and watch people hop, hop, hop along in front of my house – and then smile.  I feel like I, as clergy, walk a delicate balance between presenting as “The Reverend” and just plain ol’ me.  There’s only so much of either I have to spend without bankrupting the other.  And it sure feels like I’m “in the red” right now.

    • #5995

      Deanna Stringer
      Participant
      @dstringer

      I tell my hospice patients. Do the things that bring joy into your life. Sometimes we have difficulty doing that ourselves. Balancing joy and responsibility is a tightrope to walk sometimes.

    • #6007

      brandeaton
      Participant
      @brandeaton

      Hi Lisa,

      I appreciated your comment about walking a fine line between being “The Reverend” and being “just plain ol’ me.”  Having spent twenty years in parish ministry before serving as chaplain in a retirement community, I know the stressors that come with the persona we feel must be maintained while our heart yearns for playful engagement at the simple level of being human.  It can be a challenge to remind ourselves that we are children of God just as those whom we lead and pastor, and we require the same loving care as they do.

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