Chaplain Tom Becraft on Caregiver Burnout

***Update*** Additional resources added below: 2/7/18

I recently read a fantastic article by Tom Becraft on managing the seemingly unmanageable barrage of stress and grief that can come in heathcare chaplaincy. He begins with the summary of the first hour of one day:

  • 6:30 a.m.   The morning shift is just starting. I have just entered the office and am taking off my coat. The desk phone rings. It is from the nighttime hospital supervisor regarding an unfolding situation in Room 1040. A 34 year-old mother of four small children has had a massive stroke apparently caused by a sudden dissecting carotid artery. Brain death is likely. Considerations: how to emotionally and spiritually support this large non-English speaking family; how to facilitate the organ donor requester process; how staff, some of whom are young mothers, might experience this death; how to prioritize. I clip my cell phone and pager to my belt and head out.

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Problems in Caregiving Relationships: Neglect of God

We’ve seen how neglect can happen in caregiving relationships between the Chaplain and the person being cared for. For example the caregiver can neglect the other in the relationship by taking away their power and authority regarding healing, and the caregiver may neglect their own needs as well. These problems often show themselves in co-dependency, overcompensating and undercompensating, burnout and meaninglessness.

Now to the third member of the therapeutic relationship, God. It’s interesting to note that we tend to relate to God similarly to how we relate to others, yet God does not relate to us in the way others do. Perhaps this is why our relationship to God can be so puzzling and frustrating at times! Continue reading

Problems in Caregiving Relationships: Neglect of the Other

Last time I wrote about how caregivers, including Chaplains, can neglect themselves in caregiving relationships. This happens when Chaplains, clergy and others who are providing care to another don’t recognize or reject their own power and authority, and also when caregivers don’t recognize their own needs and therefore neglect themselves. Continue reading

Problems in Caregiving Relationships: Neglect of the Caregiver or Chaplain

***update 9/15/17: I received a link to an excellent, comprehensive article by Rachelle Slotman on identifying and coping with burnout. The link is here and I have also posted the full article here. Thanks to John Hawthorne for the link!***

 

I wrote previously about what I call the Therapeutic Triad, describing how any counseling or caregiving relationship includes three elements: myself, the other and God.

What I’ve experienced in my years of counseling and chaplaincy is that often the relationships between these three can be problematic and can malfunction. Where ideally the relationships between the three elements should flow freely in both directions, it seems that problems arise when these relationships only flow in one direction or when one of the three elements is neglected. This neglect can impact the counselor’s effectiveness and also create stress, tension and helplessness in both the counselor and the counselee. Continue reading

So Many Straws: Reflections on Self Care, and the Lack Thereof

“You’d better be careful, Sam. You’re going to burn out like this.”

These were words from my CPE supervisor several years ago. At the time I was a bit taken aback. After all my schedule certainly seemed manageable, and I felt I was doing OK at work and at home. Sure I had my struggles, but found a way to pick up and keep going every time. This March I realized he was right. Continue reading

The Caregiver’s Dilemma

A week or so ago I sat down to plan some things out. I find that I don’t tend to be a planner unless I feel the need to have something concretely in front of me to refer back to. This was less of a planning than a brainstorming session, really. Brainstorming to develop the plan. The plan was how to fix myself. The brainstorming was to figure out how.

Caregivers rarely take the time to consider their own needs. They are constantly putting others’ needs before their own, in some cases to their own detriment. Sometimes it’s saintly, and sometimes it’s sick. After talking with a few people I found that I was teetering toward the sick end of the spectrum myself. Continue reading

Why I’m a Chaplain IV: Nancy – the Gift of Recognition

“You’re smart, Sam. You need to go to Harvard or something.” These words were spoken to me by Nancy, who was one of the LPN’s on the geri psych unit where I worked after I graduated from college.

I mention Nancy because she was able to speak into my life in a way that was simple yet profound. It speaks to me now of how important and significant it is to not just say big, thoughtful things but also to speak – and listen to – the simple truth. I can speak personally from this experience and others that when someone tells me something positive about myself in a simple way it makes more of an impact than when pronounced with fanfare. I don’t trust fanfare. When someone I respect recognizes something in me and brings it out, that means everything. My CPE supervisor and my academic adviser and mentor at YDS both nearly brought me to tears just by saying “you’re good at this”. Continue reading

Poignant Thoughts on Suicide Among Physicians

While perusing some articles I found this on KevinMD. It brought me back to a prior post I had concerning burnout among caregivers. I think it has insights not only for those of us who serve as caregivers but to those who work with and among caregivers. Read on after the jump:

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Too Close to Home: Hospice workers and personal loss

Within the past 6 months two of the nurses I work with lost their mothers. In both of these cases, they chose to have their mothers on our hospice.

This is a very hard thing to do. It was awkward for a while for all of us at team especially to be referring to and discussing someone in a very clinical manner, yet knowing that this was a team member’s mother. Yet it was also a good reminder for all of us that all of our patients are someone’s mother, father, brother, sister, or even child.

The awkwardness goes away after a brief time. However when that loss finally happens it can be devastating, not only to the family member but to the whole team. Continue reading

Verbatim: Being good to the person in the mirror

At my recent CPSP meeting I presented this verbatim and got some new insights from the group. I’m going to shorten it a bit just to make it easier to read.

This happened quite some time ago and when my colleagues asked why I brought it up I responded that it deals with things that I still deal with today: self-care, tiredness, and burnout.

The patient in this visit, Mrs. S, is 67 years old and has been on hospice now for a few months. She has a history of alcoholism and is on hospice for chronic pain and malnutrition. She is extremely thin and emaciated even though she eats fairly well. She smokes regularly 3-4 times a day. She is a widow and has children but they are not involved with her and she does not want them contacted. Mrs. S is Roman Catholic but has not attended church in some time. She maintains her own prayer practices and she says that she finds these comforting. She almost always presents herself as happy and content unless she is in pain, and even then she tends to minimize her pain. Her pain is regularly 8 out of 10. She is very friendly but not always open regarding her own feelings, family and past. She tends to use humor to divert attention and make light of her situation. She is frequently in bed as this is most comfortable for her. Continue reading