Protective practices will:
- Help compartmentalise work from the rest of life – identify ways to leave the job behind
- Clarify and support staff in establishing professional boundaries
- Promote emotional and physical health
- Include regular self-care techniques for managing stress.
Protective skills in dealing with complex interactions will:
- Support providers who are dealing with the difficult patient / family
- Reduce conflict over goals of care
- Reduce conflict within team
- Often use humour.
Protective service arrangements will:
- Have a process for actively managing distress and dysfunction in staff members
- Create opportunities for debriefing
- Focus on effective teamwork
- Promote areas of work autonomy for staff, and recognise achievements
- Promote a workplace culture which supports a balance between home and work life, and actively encourage staff to set appropriate limits on expectations
- Provide access to confidential supportive services.
The medical culture, in particular, tends to reward behaviours which are not consistent with good self-care. This is increasingly being challenged in the medical literature (See self care information in relation to medical practitioners). Instead, experienced clinicians should take every opportunity to model good self-care practices, as well as mentoring more junior staff, and explicitly teaching self-care skills.
Self-care plans
The concept of an individualised self-care plan for palliative care providers is discussed in the article by Sally Hill-Jones, A self-care plan for hospice workers. Am. J Hospice and Pall Med 2005; 22, 125-128. It focuses on four self-care domains:
- Physical
- Emotional / cognitive
- Relational and
- Spiritual.
The plan encourages a systematic approach to identifying warning signs of stress and burnout in each area, and the development of protective practices. This process has not yet been formally validated, but has the potential to either be used by individuals or incorporated into mentoring and supervision relationships within palliative care teams.
The isolated practitioner
Practitioners who work in isolation from others or are not part of a palliative care team may find it more difficult to meet their own needs for self-care. The self-care plan and other resources listed in the Self-care resources section may be helpful for people in this situation.
It is also important for isolated practitioners to identify potential mentors and people with whom they can debrief.
This page was created on 09 May 2006 and is scheduled for review in May 2008
This page is currently under review.
Last updated 26 May 2008