Compassion Fatigue Solutions

International Telehealth Palliative Care Symposium - April 27-29th, 2010

Topics include:

-So Many Patients Die After We Get Close to Them: How do we heal ourselves?
-Best Practices for Palliative Pain and Symptom Management: How can I confidently change from dosing for cure to dosing for palliative care? What can I do when access to high-level care is limited?
-Who Cares? What People Near the End of Life Say About Caring
-Maintaining Hope and Trust: How can I be honest with a patient about their prognosis?
-Managing Delirium for a Peaceful End of Life Journey
-Traditional Healing among the Inupiaq: Importance of Caring for the Body, Mind, Spirit

To register or for more information phone: (907) 729-1900 or email: palliativesymposium@anthc.org

Leading Edge Seminars: Gabor Maté, Janina Fisher and John Ortiz in a small classroom environment... but not all at once!

The Master Class Series is a way for prominent speakers to further share their research, work and insights with you at a level of complexity that is usually not possible with larger audiences. This is a rare opportunity for more one-on-one exchanges and learning with experts and your peers. Learn in an intimate and collaborative group setting:

Smaller group (maximum 35-40 participants)

Customized seminar content based on questions and case studies submitted in advance by YOU. More time for questions and detailed follow up on issues arising from discussion. Bring your toughest cases and questions to the class.

Upon registration, Master Class participants are invited to submit case studies and questions (articles, notes, video clips and audio files are all welcome) at least two weeks before the date of the class for the speaker's consideration. Cases will be chosen by each Master Class instructor.

New Study looking at Compassion Fatigue in Public Defenders

"The Wisconsin State Public Defender is participating in a study of compassion fatigue on lawyers and support staff. The State Bar of Wisconsin Lawyers Assistance Program (WisLAP) will use the results to develop training materials and techniques to benefit lawyers and law office staff across practice areas and environments. The results of this initiative will be shared with legal professionals in Wisconsin and across the nation. [...]

The study is being conducted by Dr. Andrew Levin, medical director of the Westchester Jewish Community Services, Westchester, N.Y., and Linda Albert, State Bar of Wisconsin WisLAP coordinator. Quoted from Karle Lester of State Bar of Wisconsin

I'm on March Break with my kids this week so I'll just write briefly.

I am happy to report that the 5/30 challenge has been a raging success with my kids. My daughter asked me for a bowl of grapes yesterday at the usual "cheese and cracker" time of the day and said to me "you know, I'm actually starting to actually like eating fruit mom!" music to my ears. We were skiing this weekend and my son got an apple at the snack shack along with his, ahem, poutine. Ok it's not perfect but it seems that it has injected an awareness that was not there before. Plus, I never actually promised them anything if they completed the challenge, I just said "here's what you're supposed to be doing, at a minimum, let's track it for a while ok?" and they were off to the races.

As we move into Spring, I suggest taking stock of your basic self care needs: healthy eating, getting enough sleep, having non-trauma related hobbies and leisure activities, exercising 30 minutes a day, having an activity that replenishes you, going on a media fast for a week, resting each day for a little while. How are you doing on these? If you're not sure where to start, I suggest going back through my blog archives and reading through to see if something strikes your fancy. I also suggest not going at it alone - enlist a friend with whom to share your self care goal, someone who will cheer you on and keep you accountable in a gentle way.

Finally, start small: make one self care goal for Spring and stick to just that one goal and don't beat yourself up about the rest.

...Yes, from the tasty snack, which means I have lots of different things to write about and also means that I ate way too much salty food last night, watching the Oscars. I feel like a block of salt today. ugh. What was I thinking?

First of all, thank you to all the participants who took part in last week's Compassion Fatigue Train the Trainer workshop. I met twenty wonderful people and I think we all enjoyed having the opportunity to slow down and get a chance to talk to each other for two days (and be incredibly well fed, to boot). You were all very much in my thoughts as I visualised each of you making your way back home, either close to Kingston or all the way East. Thank you for your willingness to share in the way that you did, to take risks and to offer us, in turn, the gift of the wisdom of your experiences.

It was a gorgeous sunny weekend in this part of the world. There was much premature celebration of Spring going on in Kingston with many people running outside in, brrr, shorts even though it was only about 5 degrees (we get a bit spring crazy, us Canadians don't we?). My brother - who is also one of my best friends, and his wonderful family were visiting and we took many long walks, talked and ate and and talked some more. There was also a surprise visit from my beloved, gorgeous, super smart, trilingual 23 year old sister Doudou. Doudou is a graduate student in Montreal studying international development. She has lived in Mali, Nicaragua and Kashmir (so far) and is currently planning on returning to Africa and India as soon as her thesis is done. She is very thoughtful and extremely well informed about international aid and the challenges facing developing countries. After three years of living abroad, she is also dealing with reverse culture shock, coming back into our profligate consumer culture.

In Kashmir, Doudou lived for many months with a family that had not one stitch of furniture in their home and very little to eat. Ditto in Nicaragua and in Mali. In Paris, she worked with the homeless for several months. Yesterday, as we were sitting and chatting, she told a story about this wonderful wise homeless man she used to work with and finished by saying "oh, and then one day, he was stabbed 19 times and died. That was really upsetting."

From these experiences, I see, through her eyes, that the world is never going to be quite the same again. There is a richness to what she is learning and a huge passion for the work that is still to come, but, as her older sister, I feel this protective urge to spare her the pain of what she is going to continue seeing. Of course, then, when she starts talking, I realise that she has already seen too much for me to prevent any vicarious trauma from occurring. It has already happened and it is a normal consequence of the work that she has been doing.

One thing that surprises and angers me is that in her preparatory training to deploy to these countries, she did not receive much, if any, VT training from the NGOs. I thought we were doing better than that in this day and age.

Hearing Doudou's stories, I also feel elated to see a young person who is truly a citizen of the world, and who brings a highly knowledgeable perspective to international work. I like to hold on to these encounters to combat the cynicism I sometimes hear from my slightly older friends who often launch into the old litany of "kids these days...." which they follow with a complaint about how entitled, materialistic, self-centered, what have you they perceive kids in their twenties to be. In fact, in my experience, many of the young people I speak to are not spoiled electronic brats who expect immediate gratification for everything. The people I am meeting across the country are really engaged and concerned about the society we live in, the environment, racism and poverty.

I think that sometimes, when we, the older generations, get tired and overwhelmed, we also get defensive and stop being open to the voices of people younger than us.

I, for one, am excited to hear what they have to say.

This wellness challenge is an initiative of heart institute of Montreal. For the next six weeks, you are invited to commit to eating 5 portions of fruit and vegetables per day and exercise for at least 30 minutes daily (these can be three separate 10 minute activities such as climbing the stairs, walking to the grocery store and going for a walk at lunch, or one thirty minute exercise session).

You can make this commitment on your own, with friends or, if you are reading this on or before March 1st, you can enroll in the challenge online

Relevez le défi 5/30! Une initiative de l'institut de cardiologie de Montréal. Pour les 6 prochaines semaines, optez de manger au moins 5 fruits ou légumes par jour et de faire 30 minutes d'activité physique. Vous pouvez vous inscrire sur le site ou relevez votre propre défi au bureau ou avec votre famille! Visitez leur site pour plus d'information.

(Tonight, when they come home, I'm going to challenge my kids and hubby to this and see if they can rise to the challenge. We'll see who wins - full disclosure is that I already do both of these things on most days so I am pretty sure I am going to win but let's see who gets the silver medal in our home!).


Photo from Image: Suat Eman / FreeDigitalPhotos.net

Wow, what a wonderful trip.

A beautiful place and amazing people. I received an incredible welcome in Whitehorse and was treated like royalty...Imagine the re-entry shock when I got home: "ahem, my water bottle is empty...(cue to my family sitting on the couch watching the olympics, ignoring me) ahem...I need to be driven to the store, someone? No? Say what? Do it myself? Oh..."

Things I learned while I was away:

1) If you live in Whitehorse and your windshield gets cracked by flying gravel, don't bother replacing it. It will only get cracked again (percentage of cracked windshields of cars I was driven in: 99%, pretty strong data I would say.)

2) If you notice, just as you are about to check in for your return flight home, that you have mistakenly booked your flights for March 20th rather than February 20th and are flying through Vancouver, the busiest airport in Canada this weekend, just cross your fingers and pray that somehow the Air Canada guy (ACG) is in a good mood. Plan B, start crying loudly. Luckily, I was just about to start working on Plan B when some miracle happened and ACG got me a seat on all three connecting flights even though they were all overbooked. Thank you ACG.

Today, instead of travelling across the country to give a talk, I am going...across the street to St Mary's of the Lake (isn't that a beautiful name for a hospital? It always makes me think of Arthurian legends for some reason).

I will post something deep and meaningful related to Compassion Fatigue later on this week. For now, I am adjusting to being back home and trying to catch up on life.

Contest winner! I would like to congratulate Mezaun on winning a copy of The Compassion Fatigue Workbook. I will be sending it to you this week.

By Leo Babauta, author of the book "From Zen to Done"
Go see his website: www.zenhabits.net


“Activity conquers cold, but stillness conquers heat.” ~ Lao Tzu

It’s a bias of our culture that stillness is regarded as lazy, as being stuck in inaction, as a negative.

It’s not. It’s an action, and a powerful one.

What’s more, it can change your day, and in doing so change your life.

You’re in the middle of a frazzled day, swamped by work and meetings and emails and interruptions, or hassled by kids and phone calls and errands and chores.

You pause. Stay still for a minute, and breathe. You close your eyes, and find a stillness within yourself. This stillness spreads to the rest of your body, and to your mind. It calms you, centers you, focuses you on what you’re doing right now, not on all you have to do and all that has happened.

The stillness becomes a transformative action.

Stillness can be a powerful answer to the noise of others. It can be a way to push back against the buzz of the world, to take control. It can remind you of what’s important.

How to Practice
Stillness, oddly, doesn’t come naturally to many people. So practice.

1. Start your day in stillness. Whether it’s sitting with a cup of coffee as the world awakes, or sitting on a pillow and focusing on your breath, stillness is a powerful way to start your day. It sets the tone for things to come. Even 5-10 minutes is great.

2. Take regular stillness breaks. Every hour, set an alarm on your computer or phone to go off. Think of it as a bell that rings, reminding you to be still for a minute. During this minute, focus first on your breathing, to bring yourself into the present. Let the worries of the world around you melt away — all that is left is your breath. And then let your focus expand beyond your breath to your other senses, one at a time.

3. When chaos roars, pause. In the middle of a crisis or a noisy day, stop. Be still. Take a deep breath, and focus on that breath coming in, and going out. Find your inner stillness and then let your next action come from that stillness. Focus on that next action only.

Let stillness become your most powerful action. It could change your life.

“Through return to simple living Comes control of desires. In control of desires Stillness is attained. In stillness the world is restored.” ~ Lao Tzu

This free webinar came across my google alerts this morning:

March 3, 2010 - Compassion Fatigue
LCDR Pamela Herbig - Psychiatric Nurse Practitioner, Clinical Nurse Specialist and Director, Uniformed Services University of Health Sciences as Director of the PMH-NP program.

I don't know the organisers or the presenter, but Rocky Mountain Learning seems to be a really interesting agency who specialises in bringing training to folks through webinars and other distance learning modules.

As I gear up to leave my young kids for five days (nearly the longest ever), the idea of doing more and more web-based training is highly appealling to me, let alone the significant cost savings for all involved (no travel, no hotels, etc.)

So, if you're free on March 3, consider signing up for this training and let me know what you think, both of the content and the learning medium.