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Caitlin Whyte, (Host): COVID-19 is taking its toll on all of us. And as we enter this second year of pandemic life, it's harder than ever for our healthcare workers, especially. So, today we are talking about compassion fatigue, and how we can fight it with Beth Thierer. She is the Director of Customer Solutions at BHS, the new Employee Assistance Program with Upper Chesapeake.

This is the Healthy Hero podcast from UM Upper Chesapeake. I'm your host, Caitlin Whyte. Now Beth start us off here. What is the difference between stress and compassion fatigue?

Beth Thierer, LCSW-C, SHRM-CP (Host): Most people who go into the caregiving professions tend to be highly empathetic and natural caregivers outside of their jobs. And so that makes them wonderful at their job. But these qualities tend to increase them for the risk of compassion fatigue. Without even realizing it, they are really starting their job by being fatigued, by giving so much to family or friends, or maybe taking care of others before their own needs. So, with that, the demands of caregiving and dealing with loss and difficult situations really can hit them harder. And compassion fatigue can manifest in different ways, but usually it's in the form of physical symptoms. It's also called vicarious trauma or secondary trauma, which it's an emotion, that's really a shared sense of suffering. And so it's most often combined with a desire to eliminate or reduce the suffering of another person.

So, a lot of times, you get preoccupied with thinking about the trauma of clients, and then it starts to impact you really physically. And so, you know, compassion fatigue is different than stress because professionals you know, they're, they're dealing with the normal stress or struggles of the workday, but this adds on top of it, the emotional and personal feelings for those that are suffering and those that they're caregiving for. So, taking a few days off, doesn't help alleviate compassion fatigue, and it's not burnout. It's really just a cumulative stressor and vacations or things like that don't have an impact on compassion fatigue. So, it's just like, you're, you're running on empty because you're giving so much to others.

Host: And you mentioned this affects a lot of healthcare workers. What else makes you vulnerable to compassion fatigue?

Beth: Yeah. Healthcare workers are really impacted because of the continuous exposure to patients and some of those patient's family dynamics. We're certainly seeing it even more with, with COVID and having to work with families maybe by the phone or on FaceTime and, you know, managing with that, but really it's individual personality traits. So, you often hear the word about resiliency. And, you know, everybody has their own baggage that they bring to the table or that they bring to the workplace. But everybody's individual sense of resiliency is different by environmental factors, how they grew up, what other struggles that they might have. It's kind of like when you hear the glass half empty, you know, versus folks that view it as half-full. So, certainly their own personality and sometimes we see for inexperienced clinicians versus more experienced. So, so sometimes tenure has an impact on that. The support at home, you know, you're more vulnerable if you don't have that outside support network.

And then just on top of it, other stressors that you might be managing, whether you're having parenting stressors, social stressors, stress at work, you know, that makes you a little bit more vulnerable to compassion fatigue.

Host: So, what are some signs that I can look out for, you know, in myself and my coworkers that might be a red flag that we're kind of suffering from this?

Beth: Sure. It's not unusual for our body to tell us something is wrong before our brain does. So, constant headaches, stomach issues, reoccurring illnesses or aches and pains are usually an indicator of emotional strain. So, it's really important that you listen to your bodies and of course, rule out any kind of medical issues. But if those aren't present, it could be that it is stress-related or emotional. So, compassion fatigue symptoms include aches and pains, GI issues, reoccurring illnesses, exhaustion, mental exhaustion and physical, weight gain or weight loss, maybe change in your appearance due to lack of hygiene or self care.

So, that's not only what you can look out for your, in yourself, but also others from a physical perspective. From a behavioral perspective, compassion fatigue can also impact your mood and lead to many different emotional symptoms. So, you might feel some sadness. You might stop caring as much about the things that you used to, or you might not have the energy to manage them. You might have a little bit of a shorter fuse, so you might lose your patience a little more, especially if you were, things that you're managing might seem small to towards that traumatic event or, you know, the cumulative trauma that you are managing with. You could also experience loss of pleasure in activities that you once enjoyed, or you might have difficulty concentrating. You may be experiencing that, or you might not really be sure what you're feeling or know the difference between compassion fatigue, burnout, and stress. And so it's important to remember that we're not always consciously aware of how we're feeling because we might be distracted or overwhelmed or even feel guilty about our feelings and trying to push them away.

But it's important just to check in with yourselves and just acknowledging, you know how this might be impacting you and acknowledging how you might be feeling.

Host: So, if we've gotten to the point, you know, we're feeling all these symptoms, we've self-diagnosed as having compassion fatigue, how do we cope with it? Or how do we even prevent it from happening?

Beth: Yeah. You know, preventing compassion fatigue is really, the key. Is so it's easier to stop it from occurring in the first place than it is to repair it once things set in. So you have to continually practicing good emotional health maintenance along the way and have that sort of balance in your life. So, I almost think of stresses like a water bottle and you have to imagine you have a big gallon water jug, and you're just holding that there by your side, with your arms in the air. And just thinking about how long can you hold it? And then people just are adding to that gallon. And it's getting heavier and heavier. Eventually your arm's going to drop or you're going to overflow. So, it's almost like the pot runs over with that. So, you have to practice good self-care and really pour out some of the stressors. Otherwise, it's just going to be too much. And you're just going to start feeling overwhelmed or having some of those physical, emotional symptoms.

So, you have to have a portion in your life that you really need to take, rather than give some times. So, practicing that fundamental self care skills, putting yourself in situations in which you try to see the positives in life. So, a great example is sledding with your kids and really being in that moment and mindful. It can also be helpful to volunteer or help others in some way outside of work.

So, you have to think of a way that's COVID friendly, but if you're able to give back, a lot of times, it helps you and sometimes you can't prevent compassion fatigue from occurring. We definitely see that in the healthcare professions. So, practicing some of those self-care techniques can help restore your ability for feeling that compassion and having sensitivity to the troubles and difficulties of others.

So, for prevention, really just having that personal support system, do things that that make you happy, your interests, like whether it's exercising or something creative. It also is helpful to have some workplace boundaries and personal boundaries. So, resetting to your home life, having that routine, whatever it is. I've heard that, you know, sometimes the touching of the doorknob and just really taking a mindful second when you open the door to come home can be helpful. Maybe you take a shower when you get home or change from work clothes to house clothes, like something like that can be really helpful. And of course, nutrition, good sleeping habits, exercise, and also getting, getting help before it gets to be too much is really helpful in prevention.

For coping, if you are struggling, you know, we would love as a clinician to wave a magic wand and make you feel better, but it takes time, and it takes some time to heal. And so cognitive behavioral therapy can really help you put what you're experiencing into perspective. And if counseling and therapy is not for you, you have to find out what, what is for you. So, finding somebody to talk to whether that's, you know, a friendship at work or at home, or maybe it's a spiritual resource, you have to tap into that. And as much as possible, whoever you are talking to, find somebody that fills your bucket up instead of somebody that is draining your bucket.

And so, you know, you all have those people that that can be a little much. And so when you're feeling that compassion fatigue, you need to find somebody that makes you feel good, and that's going to kind of help you refill your bucket.

Host: Now, we talked a bit about how compassion fatigue and stress are different things to deal with. So, when it comes to that general stress of work, especially for our healthcare workers, are there any other ideas to cope with that?

Beth: Yeah. So, there's a lot of things that can help you. And a lot of times healthcare workers feel as though that time is an issue while you're at work. So, if you're going a long time without taking a bathroom break or a lunch break, I hear you, but there are things that we can incorporate throughout our day. And so one really easy thing that you can do to help with stress management is take a deep breath. So, you can take a deep belly breath and you just breathe in through your nose and suck your air all the way down and fill up your belly and really push that stomach out. And then if you can hold it for four and then push the air back out.

And so, just taking a deep belly breath is really helpful. You can look on YouTube or online, you can search box breathing. That's a really easy technique that you can do. I'm a mom of two toddlers. So, sometimes I lock myself in the bathroom and do that. And it's surprising how, you know, one or two deep breaths can be really helpful in just resetting.

So, if, if you've tried deep breathing and that maybe hasn't worked for you, you can try that box breathing. Or I really like five finger breathing. Again, you can look it up online to get some practices. It's also really great if you have kids because it engages more of your senses. So, you hold your hand up, like you're giving a really big high five, and as you trace your fingers, you kind of go around your thumb and then your pointer finger, and then you use that as an opportunity to breathe.

So, you breathe in as you trace up your thumb and then you breathe out. And then again, trying to take those deep breathings, but that's a little bit more of a technique that engages more senses. So, that's certainly something that, that you can try. You can also do mindfulness, meditation, keeping a journal or anything kind of self-centering activities. So, maybe you set an alarm for, for noon and then take those deep breaths. Or maybe when you're washing your hands, just be a little bit more mindful of how the water is hitting. How does that feel? And try to tapping into those different senses. And, you know, again, don't be afraid to ask for help with that.

And if none of these techniques reviewed seems like they would be helpful for you to manage your stress, I would encourage you to just think about what can you do? What do you have control over that you could maybe incorporate in your day? So, the, the key to managing stress is really providing yourself an outlet to express those emotions, or, you know, hopefully one day lead to better physical health. So, just thinking about what you enjoy doing or what you're willing to do in the work day, and that can go a long way.

Host: Great. Well, Beth, these are all wonderful tips for preventing this fatigue and stress at work. Is there anything else we didn't touch on that you want to add?

Beth: You know, I just encourage you to be a little bit more thoughtful about how you're feeling and whether it's stress, whether it's burnout or compassion fatigue, you know, try to incorporate those little self-care activities. And if you're really feeling to the point where it's like, I can't do anything, you know, that's a good time to ask for help. And so, there's a lot of resources that, that you can find, both online or through your HR department, that, that might be helpful for you. So, I would encourage you to take advantage of the resources and just give yourself permission to, to help others. You have to, to help yourself first. You know, so it's really important when you hear that, that airplane analogy where it's like you have to put on your mask first, before you help anyone else. So, I would encourage you to do that. There, there is an assessment online called the ProQOL, the Professional Quality of Life Assessment, where you can also take an assessment to see whether or not you have some of that compassion fatigue, or secondary trauma.

Again, there's some good books out there. I read the Trauma Stewardship. That's a good one, but certainly there's many resources out there if you are seeking assistance, or just want to learn more about compassion fatigue.

Host: Well, Beth, thank you so much for being with us and for providing these tips at such a vital time. We appreciate all the work you do in supporting our healthcare staff. If you need support, please reach out to your human resources team for assistance or to connect with someone from BHS. Thanks for listening. I'm Caitlin Whyte. Stay well.