Many areas of nursing can be stressful, none more so than Oncology and Palliative Care. The emotive nature of working closely with patients and families at one of the most difficult times of their lives can be challenging. While rewarding and satisfying for much of the time, it can be overwhelming and difficult to face at other times.
Prioritising self-care is an important first step for health professionals’ self-care. However, this needs to be taken together with strategies to promote awareness, expression, and planning, as well as compassion for self and others to be effective. 
Self-care includes ways of coping with stress, grief, burnout, compassion fatigue, and ways of being, including the promotion of health and maintenance of wellbeing. 
There is extensive literature about the prevalence of stress in the healthcare workforce. A number of significant risk factors have been identified:
Self-reflection, mindfulness, and meditation are just some of the ways proposed to encourage self-awareness and address stress. Similar to the benefits of plans for optimising patient care, planning for self-care is regarded as beneficial and warranting a systematic approach.  The Palliative Care Australia resource Self-Care Matters provides support and guidance on caring for yourself.
Visit Palliative Care Australia’s website for Self-care Matters tools
Palliative Care Australia
Burnout is a syndrome of emotional exhaustion, depersonalisation and reduced accomplishment which occurs in health workers and others who work in human services. Burnout occurs when the stressors exceed the person’s ability to cope. It is frequently assessed using the Maslach Burnout Inventory, which has been well validated and is widely used in research.
Some markers of burnout are:
The impact of burnout on the healthcare worker, on the quality of the care they can provide, on their workplace and colleagues, and on their family and friends, are potentially highly significant.
Burnout is a significant cause of psychiatric morbidity and of loss of staff.
The feelings triggered when confronted with the suffering of another, coupled with a desire to relieve that suffering is known as compassion. [2,3] This is recognised as central to palliative care. In the context of stress or suffering self-compassion refers to compassion applied to oneself. Although the evidence base is small, there is support for the benefit of self-compassion for hospice and palliative care staff as well as for patients.  These benefits include psychosocial and spiritual well-being. What also needs to be considered is compassion fatigue, which results from the relationships between clinicians and patients and their families.  The absence of self-care strategies has been associated with compassion fatigue.  This ongoing issue for those who work with the dying, with the constant need to form new relationships and then subsequent losses, can contribute to stress and to burnout.
Resilience is the capacity to adapt under stress, and the ability to thrive and find satisfaction from producing good outcomes in difficult situations. The resilient palliative care provider is able to monitor their own levels of distress and identify and deal with potential problems in their practice. There is an evolving literature on resilience and how to promote the qualities that also support professional survival and growth.
Video by Dr Jason Mills
Visit the palliAGED website for practice guidance
Watch the PCC4U learning module video: Expert opinion self-care
Access more Self-Care resources
Last updated 20 August 2021