Caring for Yourself in the Face of Compassion Fatigue

Compassion is “sympathetic pity and concern for the sufferings or misfortunes of others,” and it is felt, often deeply, by those in the nursing profession.

Compassion is defined as “sympathetic pity and concern for the sufferings or misfortunes of others,” and it is felt, often deeply, by those in the nursing profession. But at what cost?

Burnout—the feeling of being physical, mental, and emotional exhausted—is an all too common job hazard that impacts a large percentage of nurses, as well as other healthcare professionals. While the numbers vary across studies and from year to year, an estimated 36% to 70% of nurses have reported symptoms of burnout and those numbers are on the rise.

Compassion fatigue is a part of burnout—it is part of the emotionally exhausting part of burnout. The term itself was coined by Carla Joinson in 1992, when she observed that nurses dealing with repeated heartache had lost their “ability to nurture.” While compassion fatigue can develop in any care relationship where empathy is present, it is common in nurses who work in pediatrics, oncology, intensive care, emergency services, and hospice, and those who experience chronic or prolonged exposure to trauma.

Caring for yourself—especially while caring for others—is essential to combat compassion fatigue. Here are some tips on how to do so.

Practice Self-Compassion

Suffering from compassion fatigue and burnout is not a personal flaw. They are job hazards, and you are not a lesser person for succumbing to them. Remind yourself of this often. Be gentle and understanding with yourself, not hyper-critical. You are only human and you are doing the best you can.

Incorporate Self-Care and Mindfulness

Put yourself first. You cannot care for others, if you are not caring for yourself. Begin to practice meditation or yoga, keep a gratitude journal, take time to just breathe, partake in hobbies you enjoy outside of work, never take your work home with you, eat healthy meals, and make sure you are getting enough sleep each night.

Ask for Help

There is no shame in seeking help, if you cannot overcome compassion fatigue on your own. Discuss your concerns with your team and superiors. Any institution worth working for will have protocols in place for fostering good mental health for their employees. And beyond that, if needed, counseling is also an option. Sometimes, just confiding your burdens in another, and not carrying them alone, is all you really need to begin feeling better.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

White Coats As Superhero Capes: Med Students Swoop In To Save Health Care

While doctors have traditionally been branded a mostly conservative group, there is growing evidence that young doctors-to-be are leaning leftward and interested in activism.

Rachel Bluth, Kaiser Health News

Each wall of the library reading room at the New York Academy of Medicine is lined with tall wooden bookshelves holding leather-bound medical tomes. Atop the shelves perch busts — seemingly all white, all male — lit by two large brass chandeliers. Floor-to-ceiling windows overlook New York City’s Central Park and Fifth Avenue.

This setting, which speaks to medicine’s staid past, recently became the backdrop for plotting medicine’s future.

On a gray Sunday in September, 150 medical and nursing students dragged themselves in before 9 a.m. to learn how to meld their chosen professional careers with societal and political activism.

“As doctors, we will have this tremendous opportunity to talk to people every day,” said Miriam Callahan, a second-year student at Columbia University medical school. “We’ll have the ability to organize with them, to bring people together.”

While doctors have traditionally been branded a mostly conservative group, there is growing evidence that young doctors-to-be are leaning leftward. This year, the American Medical Association student caucus persuaded the organization to drop its decades-long opposition to single-payer health care and instead study the concept, for example.

The conference at the academy, which was organized by medical students and sponsored by the New York City Department of Health’s Center for Health Equity along with four New York medical schools, sought to help students navigate that path. It featured a panel discussion and speeches by public health workers and doctors, including Dr. Abdul El-Sayed, a physician who mounted an unsuccessful progressive campaign this year for governor of Michigan.

Dressed in blazers and dress shirts reflecting their professional identity, some also donned Planned Parenthood Buttons or Democratic Socialists of America pins. The agenda had a clear progressive bent, with workshops on LGBTQ+ health, gun violence, abortion access and criminal justice reform.

Attendees gave each other advice about how to advocate for single-payer, for example. Don’t talk about socialism, focus on the inefficiency and inequality you see, some said. Forget the “decrepit old physicians only worried about money,” their minds will never change, advised others.

Some participants were motivated by a humanitarian streak. Others were galvanized by the conditions they saw at free clinics, where they work as part of their medical education, or by a goal to increase national student engagement on issues like gun violence.

All were struggling with what they perceived as the responsibility that comes with a white coat and grappling with their place in a health care system they saw as broken.

Keven Cabrera, a fourth-year medical student at the Zucker School of Medicine at Hofstra University/Northwell, said this notion became real to him when he and some of his classmates participated this year in the March for Our Lives, a rally against gun violence.

Accustomed to the student position at the bottom of the medical hierarchy, he was taken aback by how much the white coat, even a short one that marks a student instead of a full-fledged attending doctor, afforded him respect in the community.

“We were all surprised by how much our voices counted,” Cabrera said.

Everyone came to the table with the general agreement that health care for all was a moral necessity and abortion access was a fundamental right.

So they discussed how best to move these ideas forward. How do you get better reproductive education into a conservative medical school syllabus? How can you organize other students to protest, call legislators and show up for marches?

In one noisy room after lunch, students crowded around tables where doctors with experience lobbying on behalf of Physicians for a National Health Program led role-playing conversations to demonstrate how best to communicate with congressional staff or state assembly members. They also learned how to use the stories of patients they saw on a daily basis to work within the system to advocate for single-payer health care.

The students fretted — at least a bit — about how activism could help or hinder their professional success. A group sat in a semicircle listening to a doctor tell his story of being arrested at a protest.

Students asked about how civil disobedience could affect their residency placements, or get them marked as agitators within their departments. Then another chimed in: “Would you even want to be in a residency program where they would disqualify you for a protest arrest?”

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Definitions May Vary, but Burnout Is a Problem All the Same

Does defining burnout as a diagnosable condition, such as depression, even matter in regards to treating the problem, or should the focus fall elsewhere?

This month, The Journal of the American Medical Association published two major studies and one searing editorial on physician burnout.

The first study, entitled Prevalence of Burnout Among Physicians, A Systematic Review, is a summary of research to date on the prevalence of physician burnout. In conclusion, the review found, “there was substantial variability in prevalence estimates of burnout among practicing physicians and marked variation in burnout definitions, assessment methods, and study quality.”

The second study, Association of Clinical Specialty with Symptoms of Burnout and Career Choice Regret Among US Resident Physicians, followed doctors-in-training over the course of six years, and kept track of how they felt about their work. In conclusion, the study found that “reported symptoms of burnout occurred in 45.2% of participants and career choice regret in 14.1%.”

The accompanying editorial, Physician Burnout—A Serious Symptom, But of What?, written by Thomas L. Schwenk, MD and Katherine J. Gold, MD, MSW, MS, takes aim at these studies and the problem of burnout as a whole.

“The term burnout has taken on meaning far beyond what is understood about it as an actual diagnosis or even a syndrome. The medical profession has taken a self-reported complaint of unhappiness and dissatisfaction and turned it into a call for action on what is claimed to be a national epidemic that purportedly affects half to two-thirds of practicing physicians,” the editorial reads, in part.

It goes on to say, “There is clearly something important and worrisome happening to physician well-being.”

From where you stand, as a physician, does defining burnout as a diagnosable condition, such as depression, even matter in regards to treating the problem? Or do you believe the focus should fall elsewhere?

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Drama Series with NP Protagonist Heads to Netflix

A new romance drama series with a nurse practitioner at its heart is headed to the small screen, bringing exposure to the NP profession through entertainment.

Netflix has given the green light to a new romance drama series with a nurse practitioner at its heart.

“Virgin River,” a small screen adaptation of a book by the same name, tells the story of Melinda Monroe, an NP who answers an ad to work in the remote California town of Virgin River in an effort to start fresh and leave her past behind. “Virgin River” is the first book in a series of more than twenty Harlequin novels written by Robyn Carr, which have sold, combined, upwards of 13 million copies.

Representation matters, and though it may seem like a small win to some, this series is definitely a victory in terms of exposure for the NP profession.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

New Legislation Arms Advanced Practitioners in the Fight Against Opioids

More than 115 Americans die every day from opioid-related causes. The SUPPORT for Patients and Communities Act, which passed in the House last week, aims to stop that.

The U.S. opioid epidemic is a grave and serious crisis. Each day, more than 115 Americans die of opioid-related causes. A new “opioid package” passed in the U.S. House of Representatives last week, however, is taking aim at combatting the crisis.

H.R. 6, also known as the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act of 2018 is seen as a compromise between the House and Senate, which previously passed their own separate opioid abuse prevention packages. The SUPPORT for Patients and Communities Act, as it’s being called, is expected to be considered by the Senate in the coming days and then be sent to the President’s desk to be signed into law.

One of the major provisions of the SUPPORT for Patients and Communities Act applies directly to advanced practitioners:

“Enable clinical nurse specialists, certified nurse midwives, and certified registered nurse anesthetists to prescribe buprenorphine; and make the buprenorphine prescribing authority for physician assistants and nurse practitioners permanent. In addition, H.R. 6 will permit a waivered-practitioner to immediately start treating 100 patients at a time with buprenorphine (skipping the initial 30 patient cap) if the practitioner has board certification in addiction medicine or addiction psychiatry; or if practitioner provides MAT in a qualified practice setting. Medications, such as buprenorphine, in combination with counseling and behavioral therapies, provide a whole-patient approach to the treatment of opioid use disorder (H.R. 3692)”

Both the AANP and AAPA consider this legislation a win.

“With this agreement, Congress has reaffirmed the power of America’s 248,000 NPs to fight and win the battle against opioid addiction. The legislation permanently authorizes NPs to prescribe Medication-Assisted Treatments (MATs), further expanding patient access to these critical treatments—prescribed and managed by NPs,” AANP President Joyce Knestrick, Ph.D., C-FNP, APRN, FAANP said in a statement released last week.

Jonathan E. Sobel, DMSc, MBA, PA-C, DFAAPA, FAPACVS, president and chair of the AAPA Board of Directors, echoed that sentiment in his statement, saying, “AAPA applauds Congress for including this crucial provision as part of comprehensive legislation aimed at stemming the tide of the U.S. opioid epidemic.”

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

12 Grants Awarded to Fund New Treatments of Rare Diseases

A third of the new awards aim to accelerate cancer research, and another 25% of the new awards fund studies evaluating drug products for rare endocrine disorders.

The U.S. Food and Drug Administration announced this week that it has awarded 12 new clinical trial research to enhance the development of medical products for patients with rare diseases. The grants, which total more than $18 million over the next four years, were awarded to principal investigators from academia and industry across the United States through the Orphan Products Clinical Trials Grants Program.

The awarded grants include:

  • Alkeus Pharmaceuticals, Inc. (Cambridge, Massachusetts), Leonide Saad, phase 2 study of ALK-001 for the treatment of Stargardt disease – $1.75 million over four years
  • Arizona State University-Tempe Campus (Tempe, Arizona), Keith Lindor, phase 2 study of oral vancomycin for the treatment of primary sclerosing cholangitis – $2 million over four years
  • Cedars-Sinai Medical Center (Los Angeles), Shlomo Melmed, phase 2 study of seliciclib for the treatment of Cushing disease – $2 million over four years
  • Columbia University of New York (New York), Yvonne Saenger, phase 1 study of talimogene laherparepvec for the treatment for advanced pancreatic cancer – $750,000 over three years
  • Emory University (Atlanta), Eric Sorscher, phase 1/2 study of Ad/PNP fludarabine for the treatment of head and neck squamous cell carcinoma – $1.5 million over three years
  • Fibrocell Technologies, Inc. (Exton, Pennsylvania), John Maslowski, phase 1/2 study of gene-modified ex-vivo autologous fibroblasts for the treatment of dystrophic epidermolysis bullosa – $1.5 million over four years
  • Johns Hopkins University (Baltimore), Amy Dezern, phase 1/2 study of CD8-reduced T cells for the treatment of myelodysplastic syndrome or acute myeloid leukemia – $750,000 over three years
  • Oncolmmune, Inc. (Rockville, Maryland) Yang Liu, phase 2b study of CD24Fc for the prevention of graft versus host disease – $2 million over four years
  • Patagonia Pharmaceuticals, LLC (Woodcliff Lake, New Jersey), Zachary Rome, phase 2 study of PAT-001 (isotretinoin) for the treatment of congenital ichthyosis – $1.5 million over three years
  • The General Hospital Corporation (Boston), Stephanie Seminara, phase 2 study of kisspeptin for the treatment of dopamine agonist intolerant hyperprolactinemia – $1.4 million over four years
  • University of Minnesota (Minneapolis), Kyriakie Sarafoglou, phase 2a study of subcutaneous hydrocortisone infusion pump for the treatment of congenital adrenal hyperplasia – $1.4 million over three years
  • University of North Carolina at Chapel Hill (Chapel Hill, North Carolina), Matthew Laughon, phase 2 study of sildenafil for the prevention of bronchopulmonary dysplasia – $2 million over four years

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Majority of Patients Review Healthcare Experiences Online

51% of Americans surveyed said they share their personal healthcare experiences online via social media and review sites, such as Yelp, Google, and Facebook.

More and more, patients are consulting online reviews via sites such as Yelp and Google when determining which healthcare facility and provider to use, and are sharing their healthcare experiences online, as well, according to a new survey from Binary Fountain.

The results of the second annual Healthcare Consumer Insight & Digital Engagement Survey, released this week, indicate that:

  • 95% of the surveyed respondents find online ratings and reviews “somewhat” to “very” reliable.
  • Of the 95%, 100% of respondents between the ages of 18-24 and 97% of respondents between the ages of 25-34 find online ratings and reviews “somewhat” to “very” reliable.
  • 70% of Americans say online ratings and review sites have influenced their decision in selecting a physician.
  • 51% of Americans said they share their personal healthcare experiences online via social media and review sites, which is a 65% increase from the previous year.
  • Millennials are most likely to share their physician or hospital experiences online, with 70% saying they have done so.
  • 68% of Americans aged 18-24 said they have shared their healthcare experiences online, which is a staggering 94% increase over last year.
  • Facebook is the most used method of sharing healthcare experiences for ages 25-54.
  • Patients between the ages of 18-24 indicated that Google is their preferred online platform to share their healthcare experiences.

Have you Googled your facility lately?

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

The Delicate Nature of Caring for Sexual Assault Patients

An American is sexually assaulted every 98 seconds. No matter your specialty, the odds are high you will treat a victim. Keep these things in mind, when you do.

This week, the hashtag #BelieveSurvivors has trended heavily across all forms of social media, due in part to the claims of sexual assault levied against Supreme Court nominee Brett Kavanaugh.

Politics aside, as a nurse, there is a strong likelihood you will encounter sexual assault patients during the course of your career, given that an American is sexually assaulted every 98 seconds, according to the U.S. Department of Justice. That prevalence means that even if you aren’t a forensic nurse examiner or don’t work in emergency or psych, it is important that you be equipped with an understanding of how to handle the unique emotional aspects of sexual violence, as well as a practical approach to caring for the victim.

While every sexual assault patient you encounter will be inherently different from the next, keep these things in mind, as you provide them with care:

  • Check Your Judgment at the Door: It is not your place to assign blame, especially not upon the victim. The task of assigning blame comes later; that is a legal process. No matter the physical or mental state your patient appears to be in—be they male or female or drunk or in a state of undress or crying hysterically—it is not your place to criticize them in any way. It is your place to help them and give them the care they need in a safe environment, free of skepticism, while documenting everything from injuries sustained to their mental state in an unbiased manner. Be mindful of your tone, actions, and facial expressions, and most importantly, listen to the patient.
  • The Victim Comes First: The comfort of the sexually assaulted patient should be paramount. Consult with the patient to conclude whether or not a gender preference of caregiver exists, and respect those wishes, if so. It is your responsibility to advocate for the patient’s needs, and this may require a level of patience and a time commitment your other patients do not demand of you.
  • Be Compassionate: As a nurse, compassion likely courses through your veins, and in this instance, that is a very good thing. Above all else, allow your humanity to shine through, while maintaining your professionalism. Believe them, empathize with them, put yourself in their shoes—after all, given the statistics, they could very well be you.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Could Medical Scribes Be A Cure to Physician Burnout?

While there is no easy cure-all for burnout, the results of a new study indicate that utilizing medical scribes to assist with EHR documentation could help.

Time-consuming EHR documentation is a burden that is consistently found to be linked to increased physician documentation workload, and, in turn, physician burnout. Could the use of medical scribes alleviate that burden for physicians, improve productivity and patient communication, and enhance job satisfaction among physicians. A study published this month in JAMA Internal Medicine aimed to find out the answer to that question, and their conclusion is a resounding yes.

The 12-month crossover study randomly assigned eighteen primary care physicians to start the first three-month period of the study with or without scribes, and then had alternated exposure to scribes every three months over the course of the year. At the end of each study period, physicians completed a survey. Meanwhile, the researchers also surveyed patients of participating primary care physicians after scribed clinic visits.

Findings indicated that compared with periods that were not scribed, scribed periods were linked to less self-reported after-hours EHR documentation by physicians (<1 hour per day). Scribed physicians also self-reported that they spent more than 75% of the visit interacting with the patient and less than 25% of the visit on a computer. Patients also reported encouragingly in regards to the presence of medical scribes, with 61% of surveyed patients saying that scribes had a positive bearing on their visits and only 2.4% of them indicating a negative bearing.

While there is no easy cure-all for burnout, the results of this study certainly indicate that there are ways to help lessen the burdens thrust upon physicians by EHRs, and one of those is the utilization of medical scribes.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Majority of Physicians Pessimistic about the Future of Medicine, New Report Finds

The results of the sixth biennial Survey of America’s Physicians have been released, and the findings can only be described as startling.

The Physicians Foundation has released the results of their sixth biennial Survey of America’s Physicians, and the findings are startling.

The survey “took the pulse” of nearly 9,000 U.S. physicians across the country, and examined, at its heart, what they think about the current state of the medical profession.

Over all, the findings indicate being a physician is an evolving medical profession, which continues to struggle with issues of burnout and low morale, despite more physicians now working fewer hours and seeing fewer patients.

Below are some key findings from the report:

  • 62% of physicians are pessimistic about the future of medicine.
  • 55% of physicians describe their morale as somewhat or very negative, which is consistent with findings in previous years.
  • 78% of physicians sometimes, often or always experience feelings of burnout.
  • 80% of physicians are at full capacity or are overextended.
  • 49% of physicians would not recommend medicine as a career to their children.
  • 46% plan to change career paths.
  • 46% of physicians indicate relations between physicians and hospitals are somewhat or mostly negative.
  • Physicians indicated patient relationships are their greatest source of professional satisfaction, while EHRs are their greatest source of professional dissatisfaction.

The survey also includes a portion where physicians are welcome to write in their own comments. Some of those highlighted in the report include:

  • “I could not in good conscience recommend medicine to a young person. It isn’t a profession anymore, it’s a business enterprise. If I had wanted to be a businessman, I’d have taken a less demanding path.”
  • “I am no longer a professional, I am an employee and treated with less respect and consideration than previously.”
  • “As a physician in her late 40’s, I have unfortunately seen the practice of medicine evolve from caring for the patient to caring for the administrator. The focus is on ticking off boxes rather than improving the health of the individual or community.”

Do you think the numbers and comments highlighted here accurately portray the overall sentiment of physicians today?

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.