Tuesday, August 11, 2009


True to this blog's title, I have a confession to make. Somewhere along the way, I have lost my self-confidence. This might be due to the stress of my job or just burn-out. It snuck up on me out of nowhere. Who ever sees burn out coming? And who ever knows how they will be affected? I've realized that lately I am more irritated with people when they tell me it takes a special person to work in hospice or that they could never do my job. I don't feel special. Right now, I feel like anyone could do my job. How hard is it to listen to someone? I listen to life stories, I listen to people talk about how they are coping, I listen to the unfinished business. I advise where applicable. But mostly I listen. Anyone can do that. I realize I'm being irrational as I write this. I know not everyone wants to think about death and grief when they go to work. (Although, I'm not convinced I want to think about it either- I just happen to be skilled in helping others cope with end-of-life issues.) I know that I have above average listening skills; I credit my mom on this one, thanks to her "conversation is like throwing a ball back and forth" speech. I have cards that speak of how I personally have helped families through the hospice journey. I have families on my caseload right now that are dependent on my visit. In fact, one week I wasn't able to see a patient due to a conflict and when I met with his wife the next week, she confided that she'd had to work really hard to get through the week without my visit. So I know on some level that I am making a difference. I just don't feel it right now. The on-call schedule has become more and more demanding. There is more of a blur between my professional and personal lives. And it's taking a toll. I have a vacation lined up in less than a month, which will help. I'm trying to figure out if I can group the on-call in different ways so I'm not on-call at some point every week. I'm trying to figure out better ways to take care of myself. And I'm trying to figure out how my self-confidence crept out of my life like a thief in the night so I can make sure it never happens again.


luvmypeanut said...

It's the first step, recognizing you might need to take a break! And also re-scheduling your on-call so you can some down time is another good plan!

Do some things that make you happy, some just for you things! Get out and take a walk or exercise (that always helps me!).

I lurk on your blog and I've really enjoyed reading it. Hang in there!!!

SocialWkr24/7 said...

Yep - those are the first symptoms of Caregiver Fatigue! And, even on my best days the words "You must be a special person" make me want to scream - I hate being treated like a saint when, in fact, I have no more "special" talent than anyone else, it just is in a different arena! I highly recommend taking some time for you - even if its just a day here and there over the next few weeks/months and spend them doing quiet happy things (as opposed to a huge 10 day vacation).

I also highly recommend grouping on call so that its in big blocks with lots of free time in between. I do two full weekends (48 hours straight) a month - those weekends are nuts, but then they are OVER! I much prefer it to doing just a day or two every week. Just a thought!

Leslie Ann Lovett, MSW, LCSW said...

Compassion Fatigue is a serious problem in the profession. The literature talks about the importance of supervision, humor, peer support, and organizational policies to protect and/or reduce the impact of CF. In social work education, we don't teach the skill of self-care effectively, which is a shame. You need a solid self-care plan that your supervisor and peers support. Write down what you need to do each week to rest and regenerate. It would be very cool if you shared about your self-care plan in your blog..... you know you are not alone and others would benefit from your reflection on this ongoing process for professional development. Thanks for being honest and real!

LeighSW said...

Thanks for the advice and the encouragement! Leslie, I am planning on writing down my self-care plan soon so stay tuned...

Christian Sinclair, MD said...

Thanks for being so honest in posting this. This hits a lot of people working in medicine and especially hospice. Compassion Fatigue is very real and often it takes other people to point it out. It is a hard thing to self-identify.

Exercise is a great stress reliever once you get past the trouble with inertia. I really would hope hospices would institute mandatory sabbaticals. It would do a lot to make our field a lot more sane over the long run.

Anonymous said...

Thank you for sharing your blog! I, too, have run into Compassion Fatigue or as some have called it, Professional Grief. We work in a high loss environment and we need to create and honor boundaries as well as our own self care. There are some good suggestions from others here who have commented on your blog. Here are some other suggestions:

1) Connect with nature. Make sure you go outside and enjoy nature. Do you live near an ocean, a forest, a dessert, a garden? A park will do, too.

2) Keep a success journal. What are some things that you have done that don't exactly fit into documentation? Besides listening and more importantly, being present, we social workers often find something that can bring one of our patient's great joy. Think of the times you have helped bring meaning into someone's life.

3) What has helped you before? A comedy? Ben & Jerry's Ice Cream? A little retail therapy? Having a glass of wine with friends? (Remember - Moderation!)

4) Honor your time off! Respect your weekends, holidays, vacations. Regenerate and refresh. In taking care of yourself, you can continue to do the good work that we hospice social workers do. I hate it, too, when people tell me that I'm an angel or someone special because I work with dying patients and their families. I know one thing is for certain, I could never be a high school teacher. THAT would be hard work. I love what I do and feel good that I can use my skills to help others.

Keep up the good work!

Lorena Stewart, MSW