Caregivers At Risk Of Burnout

Dawn Filisky spent half her nursing career in emergency care at MetroHealth, Cuyahoga County’s main hospital for the uninsured and a Level One trauma center.

FILISKY: I saw things from simple toothache all the way to people coming in who had had cardiac arrest, to gun shots and the stabbings, to horrible car accidents to a mom that's about to deliver and the baby gets born as they're practically coming through the door.

This work takes a toll.

FILISKY: We had a bad car accident where 2 young people were killed and the parents had beat the helicopter to the emergency department…I don't know how to describe these cries from family members when they get horrible news...The doors are closed, they're talking to the family member, but you kind of just hear this wail that comes out of the room and you just know that it's very this moment where their whole world has just kind of collapsed. Their whole life is just completely changed now. Sometimes those sounds or those images kind of stick with you.

It can be like this day after day. Caregivers are part of one trauma then another then another.

FILISKY: You have this moment, and then quickly there's a whole department that still needs to be taken care of so there's not a lot of time to sit with that and process through it or really be with it. It's just kind of like wow this is really horrible and wow there's a bunch of other stuff going on that we've got to get to.

CLEGG: For anyone that is in a position calling upon their ability to empathize with somebody that's going through a really difficult time, unless we sort of refill our tanks, we can run out of gas.

Dr. Kathy Clegg is a faculty member at the Gestalt Institute in Cleveland and a psychiatrist at University Hospitals.

She says that when caregivers put out more energy and support than they receive, it can result in chronic exhaustion.

This affects their ability to take care of patients, and it can lead to anxiety, hopelessness, depression, social withdrawal, and burnout.

It is an emotional shut-down.

There are warning signs, says Clegg:

CLEGG: It's getting harder and harder to get out of bed in the morning or I dread going to work, and I used to love my job.

She says it's crucial to recognize signs like this, and make changes.

Caregivers must step back and take care of themselves.

FILISKY: So I had to kind of make a decision and realize that something was going on.

Dawn Filisky was at the end of her rope, tired all the time and shunning anything social.

Relief came from training herself to be more aware of her needs.

FILISKY: It was about learning to replenish—yeah, really replenish—myself.

Experts suggest those experiencing signs of fatigue or burnout set boundaries with patients and not take on their emotional burdens.

It can also help to take short breaks, develop relaxation rituals like stretching or meditating, get a good sleep and eat a healthy diet, and set aside time for activities that have nothing to do with work.

Administrative policies also can have a large hand in causing burnout: low staffing, unpredictable scheduling, and poor training, all contribute to poor employee health and morale.

More than 40 percent of nurses show signs of burnout, according to a 2001 study in the journal Health Affairs.

It's an issue that more people are recognizing.

Several recent studies have documented the effects of burnout, and a few states have already adopted minimum nurse to patient ratios.

The research is very clear: satisfied, engaged caregivers stay at their jobs longer, live healthier lives, and ultimately, take better care of their patients.

Anne Glausser, 90.3

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