QUESTION: I am the director of palliative care in a community hospice program. I have 20 staff members reporting to me. All are compassionate, empathetic and highly trained professionals. As you can imagine, our work is very intense and sadness seeps in just about every day. We work as a cohesive team, and I try very hard to be present for all of them in the most supportive way possible. We gather for debriefings following more traumatic cases and cover for each other when a situation hits particularly hard. Do you have any innovative ideas on how I can keep them healthy and engaged in their work? I worry about the high levels of stress and burnout that come with this particular form of caregiving.--Thomas
ANSWER: Congratulations on building and retaining a productive, cohesive team. You have accomplished something many in leadership positions fail to do. As the “caregiver” of your team, making yourself accessible is of the utmost importance. If they sense you are there for them, they will be free to offer your patients and their loved ones the support and attention they need. Charles S. Lauer, former publisher of Modern Healthcare magazine, best-selling author and public speaker, once said: “Leaders don't force people to follow—they invite them on a journey.” Probably the best way to keep colleagues involved and engaged is to be inclusive as they travel the journey with you. As a working director, ask for opinions and ideas, consult with them in your decision-making process, be a transparent communicator, and most important, be an active listener. Humans have four needs in common: to love and be loved, to be safe, to be valued for what they do, and to be validated for who they are. These four needs are particularly prevalent in those in the helping professions who care for others. We look to our caregiving work to provide us with the validation we crave. We need to know we are making a difference. Since humans have several modes of communication, be sure to hit on the top three: Communicate in writing, in action and in words. While it may seem overwhelming with 20 employees, take the time to discern how each one prefers to be addressed. Several might prefer to hear from you via email, others via spoken comments, and others by a pat on the back for work well done. When all is said and done, the workplace environment needs to breed trust, especially in a challenging environment such as yours. For employees, trusting management happens when staff feels it is receiving clear, transparent communications from superiors. For management, trust occurs when the appropriate helpers are hired into the jobs they are trained to do. This process begins in the Human Resources department. Designing questions to weed out negative people is mandatory. The workplace is difficult enough without naysayers adding negativity to the mix. Once the best person is hired, the next step to success is sustainable orientation. Create materials that include your organization’s mission, goals, objectives, expectations, history and vision for the future. Implement an annual commissioning where each employee must renew his or her commitment to the mission of caring for others in the best possible way. In all avenues of health care, there is a new trend forming that compliments the adage that patients come first. In his book, Patients Come Second: Leading Change by Changing the Way You Lead, authors Paul Spiegelman and Britt Berrett state that making a patient a priority is by no means a dated adage. But without caring and cared-for employees, a healthcare organization is incapable of making the patient a priority and incapable of running well as a business. While this may feel counter-intuitive, I believe these authors have hit upon something very important. You sound like a leader who will take their message to heart and continue to create a compassionate, caring environment where patients and their loved ones can feel the peace and tranquility needed during the difficult transitions hospice care requires.
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Patricia Smith is a certified Compassion Fatigue Specialist with 20 years of training experience. As founder of the Compassion Fatigue Awareness Project© (www.compassionfatigue.org), the outreach division of Healthy Caregiving, LLC, she writes, speaks and facilities workshops nationwide in service of those who care for others. She has authored several books including To Weep for a Stranger: Compassion Fatigue in Caregiving, which is available at www.healthycaregiving.com or Amazon.com.
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