Soul

Care

Kerryn Lawley

Lee-Anne Madsen

Compassionate Beds

https://www.youtube.com/watch?v=wkf-WxMZVP8

Companioning the Dying

Means being with their suffering

We cannot take the journey of dying for another

“Passage to death reminds us of the passage to life at the time

of birth”

Willingness to walk with and learn from the people that we are

working with

Soul is discovered in the quality of what you experience when

you are deeply present to others

Sense of soul

Anchoring yourself in truth and integrity

Murray, 2015 ;Wolfelt,2005

Cultivating presence in the midst of

suffering

Be yourself (Unconditional positive regard)

Empathise don’t sympathise

Show human kindness (details matter)

Keep it simple (have confidence in the healing power

of human presence)

Be still in your presence

What is most important right here, right now?

Longaker,1998

Wolfelt,2005

Self care in the

Helping Professions

What causes strain on workers?

The worker becomes traumatised by

being constantly involved

Empathy (particularly affective empathy)

and exposure

Over identification

Martyr complex

Threats to assumptive world and safety

Emotional Labour

Care =organisation + physical/medical care + emotional labour

Notion that you should get over it

It’s your job!

You chose to do it

Don’t get involved

You are a professional

You’ll get used to it

Warning Signs of Compassion Fatigue in Staff

Exhaustion

Reduced ability to feel

sympathy and empathy

Anger and irritability

Increased use of alcohol and

drugs

Dread of working with

certain clients

Diminished sense of

enjoyment of career

Disruption to world view

Heightened anxiety or

irrational fears

Intrusive imagery or

dissociation

Hypersensitivity or

insensitivity to emotional

material

Difficulty separating work life

from personal life

Absenteeism

Impaired ability to make decisions and

care for clients

Problems with intimacy and

in personal relationships

Developed by Christina Clarke, MS, HS-BCP, Coordinator of Continuing Medical Education and

faculty, Wake Forest School of Medicine, Northwest AHEC

Finding a balance: caring for oneself while

caring for others

Stress caused by internal factors such as:

Previous or current life circumstances

Personal death experience

Too much investment in patients without

sufficient replenishment over too long a

time

Concern that the work was not done well

Our pain as carers may be our most important

asset as a professional

Therapeutic use of self. We are our primary tool in

the care of the dying person

There is no us and them we will all die and we will

all lose people we love

We need to think of ourselves in terms of our

relationship with the suffering of others

There is a need for awareness of our own feelings

in palliative care and the ability to hold them

aside

Self awareness

Self awareness is the key to effective engagement, management of stress and prevention of burnout

Strategies

Not taking a patient’s needs and suffering as one’s own

Attention to care giver grief - regardless of work or cultural

setting health care professionals need to find ways of

experiencing and expressing their grief

Social supports are necessary inside one’s professional

circles where one can share the emotional experience with

those who understand the quality of the connections that

are formed as well as both the emotional fulfilment and

drain that comes with this type of work

Whole person care also means whole person practitioner

care

Rothschild,2006; Ray et al, 2013

Strategies

Individual counselling

Explore own relationship with death

Emotional: meditation, journaling, good outside social

supports

Spiritual well being: activities such as spending time in

nature or through engaging in own spiritual practice

Life affirming ways of being

Connection with own community

Remember your child-like self

Rothschild,2006

Self care in Palliative

Care = Care of your

soul

“I DESERVE TO LEAD A JOYFUL, WHOLE LIFE”

“MY WORK DOES NOT DEFINE ME”

“I MUST LISTEN TO MY INNER VOICE”

“I SHOULD EXPRESS THE PERSONAL ME IN BOTH MY

WORK AND PLAY?”

“I AM A SPIRITUAL BEING”

Getting in touch with your Values

“Clarifying what is

most important,

deep in your heart;

what sort of person

you want to be;

what is significant

and meaningful to

you; and what you

stand for in this life.”Harris, 2006

What do Values have to do with self

care and self compassion?

Enriching, relaxing, inspiring, fun and enjoyable, strengthen

frame of mind and build resilience

Things that provide you with love and joy, “refill your cup”

If we can identify our values and the tasks and activities that

are connected to these values we can access these as

strategies to enhance the way we live, we can better protect

ourselves against feelings of burnout, foster self compassion

and build resilience.

Noticing that we have distanced ourselves from some of our values may make us more aware of what our triggers might

be or times that we are more vulnerable.

3 main elements of self

compassion:• SELF KINDNESS

• A SENSE OF COMMON HUMANITY

• MINDFULNESS

Funk et al, 2017

This is the work that we do

Karla's video, aged care nursing

How do we keep our own

lives enriched so that we

can enrich the lives of

others?

Grieving the loss of your patients in a

residential aged care facility

Longer term relationships

Families knew the nurses really well and vice versa

Ward family

When nurses feel they are giving good end of life care

they can deal with loss positively upon the death of the

older person

Being alongside chronic sorrow

Highlighted needs of nursing assistants who often are in

the frontline

Gannon and Dowling, 2011

Beck et al, 2011

Compassion Identity

Compassion fatigue can be mitigated by developing a

strong sense of who you are in the work place

Who you want to be in the work place

Allows for resilience – the positive capacity of people to

cope with stress and adversity by recognising when

attention is needed to care for self in the work place

Recognition of the self in the work place

Serves as a warning system

Allows for compassion for patients and self (Just like me

this person is suffering)

Corso, 2012

The 5 invitations

Don’t wait

Bring your whole self to the experience

Welcome everything, push away nothing

Find a place to rest in the middle of things

Cultivate a don’t know mind (be curious)

Ostaseski, 2017

Slow down at the frangipani

speed bumps and meet the

baby chickens

Someone deeply Listens to you by John FoxWhen someone deeply listens to you

it is like holding out a dented cupyou’ve had since childhoodand watching it fill up with

cold, fresh water.When it balances on top of the brim,

you are understood.When it overflows and touches your skin,

you are loved.When someone deeply listens to you,

the room where you staystarts a new life

and the place where you wroteyour first poem

begins to glow in your mind’s eye.It is as if gold has been discovered!

When someone deeply listens to you,your bare feet are on the earth

and a beloved land that seemed distantis now at home within you.

— John Fox

References

Beck,I.,Tornquist,A.,Brostrom,L.,Edberg, A (2010) “Having to focus on doing rather than

being - nurse assistants’ experience of palliative care in municipal residential care settings,

International Journal Of Nursing Studies, December

Block,S and Billings,J (2005) “Learning from the dying”, The New England Journal Of

Medicine, September 25

Corso,V (2012) “Oncology nurse as wounded healer: developing a compassion identity”,

Clinical Journal of cology Nursing, Vol. 16, No. 5

Funk, L., Peters, S.,Roger (2017)”The emotional Labour of personal grief in palliative care:

balancing caring and professional identities”, Qualitative Health

research,DOI:10.1177/1049732317729139

Gannon,M.,Dowling,M(2010)”Nurses experience of loss on the death of older persons in

long term residential care: findings from an interpretative phenomenological study “in

International Journal Of Older People Nursing, Sept 21

Halifax,J (2008) Being With Dying, Shambhala Publications

Harris, R. (2013). ACT Mindfully [website]. Accessed from

https://www.actmindfully.com.au/

Kauffman,J and Jordan,M(2013)The Essential Guide To Life After Bereavement, Jessica

Kingsley Publishers,UK

Kimble, P.,Bamford-Wade,A (2013) “ The Journey of discovering compassionate listening”,

Journal Of Holistic Nursing, Vol. 31. No. 4

Longaker,C (1998) Facing Death and Finding Hope, Main Street Books; First Edition ,

London

Murray, Judith (2015) Death. In Jennifer Fitzgerald and Gerard Byrne (Ed.), Psychosocial

dimensions of medicine (pp. 235-247) Melbourne, VIC, Australia: IP Communications.

References

Ostaseski,F (2017)The Five Invitations, Bluebird,UK Raab, K (2014) “Mindfulness, self-

compassion, and empathy among health care professionals: A review of the literature”.

Journal of Health Care Chaplaincy

Ray, S., Wong, C., White, D., Heaslip,K(2013)”Compassion satisfaction, work life conditions,

and burnout among frontline mental health care professionals”. Traumatology Vol. 19.

Rothschild,B (2002) “The mind and body of vicarious traumatisation: Help for the Helper”.

Psychotherapy In Australia, Vol. 8. No. 2. February

Rothschild,B (2006) Help For the Helper, W.W Norton& Company, New York

Slocum,S.,Hemsworth,D.,Chan,W.,Carson,A.,Kazanjian,A(2011) “Understanding compassion

satisfaction, Compassion fatigue and burnout: a survey of the hospital palliative care

workforce”, Palliative Medicine, Vol.27. No. 2

Wagman,M.,Geiger,J.,Shockley,C.,Segal,A (2015) “The role of empathy in burnout,

compassion satisfaction, and secondary traumatic stress among social workers”, doi:10.

1093/sw.swv014, National Association of Social Workers

Wolfelt,A (2005) Companioning the Bereaved: A Soulful Guide for Counsellors and Care

Givers, Companion Press, U:K

Wolfelt, A Grief Words Web Site Http: griefwords.comindex.cgi?

Wolter,D(2007)Losing the Clouds, Gaining the Sky, Wisdom Publications

Whyte,D (2008)The Heart Aroused, Management Books,Uk