Compassion Fatigue Solutions

I am posting a bit late this week - I was in Toronto yesterday, attending Dr. Gabor Maté's workshop on stress. I will write more on this later as it was a very rich day of learning and Dr Maté deserves his very own post.

Last week, I had the privilege of sharing the podium with Dr David Kuhl at a conference hosted by the Elizabeth Bruyere Continuing Care Centre in Ottawa. Dr Kuhl is both a physician and a psychologist and he is the director of the Centre of Practitioner Renewal (CPR) at Providence Care in Vancouver. The CPR was created several years ago to offer support to staff members of the hospitals of the Providence Care network. At the CPR, Dr Kuhl and his colleagues offer counselling and education to health care workers and carry out research related to compassion fatigue and helper wellness. They work with individuals and also with entire teams to try and improve staff relationships and enhance the quality of care.

Dr Kuhl is a very erudite and skillful presenter and his session was inspiring and illuminating. I really appreciated the focus he puts on teams and the challenges they are facing in health care.

Conference participants had many questions for us about organizational challenges and expressed their frustration at the current state of affairs in health care. Their anger and exasperation towards the system was expressed strongly throughout the day. This is not an isolated case: I have the opportunity to meet hundreds of health care professionals each month from across the country and the evidence is overwhelming: physicians, nurses, allied health professionals and hospital managers are struggling. Health care workers all over Canada describe having to do more with less resources and trying to deliver quality of care when staffing has been cut beyond what is realistic. Last week, one nurse told me about mandatory overtime where nurses are not allowed to say no when the hospital calls. She talked about nurses who work in remote communities who get a knock at their door when they don't answer their phone - in order to force them to come to work.

Taking a step back, how can quality patient care be delivered when you have been coerced to come to work for an additional shift? It simply does not make sense.

What happens, of course, is that we all suffer, patients and health care workers alike: we turn on our colleagues, we resent any extra time off they take (I call it the "must be nice phenomenon"), we blame our managers whom, we feel, "don't understand". Perhaps that is sometimes true, but I meet with different managers weekly and they say they feel like "the peanut butter in the sandwich", squeezed between upper management, ministry demands, staff needs and concerns and patient care. A very difficult position.

So, what to do about all this? Sometimes we can try going the advocacy route, protesting to the upper echelon in various ways, not voting for a government that doesn't value health care workers (and also doesn't believe in a restorative justice system, but I digress). But sometimes we feel that we do not have a voice. We feel stuck.

In my opinion, to find our voice within this deeply flawed system, we need to gain a better understanding of organizational health. This is what my esteemed colleague Dr Pat Fisher does. Dr Fisher is an organizational psychologist as well as a trauma specialist and she has spent the last two decades working within our system. She has developed an approach to diagnosing and enhancing organizational health and the results are very convincing: a year after her interventions, agencies report a significant improvement in decreased absenteeism, productivity, decreased job stress and employee wellness. Pat has developed the 4 tier, 12 factor model of organizational health. I invite you to go read more on her important work.