Issue link: https://viewer.e-digitaledition.com/i/894235
The Emotional Demands •ADAPTED FROM A PRESENTATION GIVEN BY KEVIN F. DIETER, MD, FA AHPM, AND LUCILLE MARCHAND, MD, BSN, FA AHPM, AT THE AMERICAN ACADEMY OF HOSPICE AND PALLIATIVE MEDICINE ANNUAL ASSEMBLY.- BURNOUT, COMPASSION FATIGUE and hopelessness are serious issues impact- ing palliative care physicians and other medical specialists serving terminally ill patients. Compassion, resiliency and hope are innate qualities doctors possess that can be nurtured through mindfulness, con- templation and self-reflective practices to help mitigate these undesirable conditions. Palliative care is demanding. In a recent study, for instance, 62 percent of palliative care physicians surveyed reported symp- toms of burnout brought about through compassion fatigue. Without the nurturance of the same innate qualities that give hospice and pal- liative care doctors the deep satisfaction and meaning inherent in their chosen profession, they can become increasingly vulnerable to emotional exhaustion. Finding the meaning in this demand- ing clinical specialty nurtures resiliency. Being in touch with one's commitment to service can be a protective mechanism that helps a physician process and cope with the emotional demands of the job. Compassion is nurtured through pres- ence, empathy, acknowledging and caring for emotions, shared decision-making, and being willing to relieve su€ering. These can be achieved through breath work, mindfulness, debriefing with team members, and taking actions to relieve suffering through symptom control, attentive listening and allowing patients to share their stories. It is essential for palliative care doctors to take time for introspection and to ask themselves the following questions: + What conditions disconnect the pal- liative care physician from the innate qualities that called him or her to the chosen f ield of hospice a nd pa llia- tive medicine? + What is the nature of one's calling to palliative care service? + What activities or practices can be used to sustain the physician during emotionally challenging times? + H o w c a n t h e p h y s i c i a n a t t e n d t o s e l f - c a r e w h e n e m o t i o n s feel overwhelming? The arts and humanities provide a safe space for physicians' emotions to be expressed and understood. Incorporating practices involving narrative medicine, mindfulness, and self-ref lection can help physicians specializing in end-of- life care to connect with their deepest selves and with others, so that resiliency, compassion and hopefulness are their predominant state of being. Dr. Kevin Dieter is Medical Director of Hospice of the Western Reserve in Cleveland , OH. Dr. Lucille Marchand is the Stuart J. Farber, MD and Annalu Farber Endowed Professor in Palliative Care Education in the Department of Family Medicine, the Section Chief of Palliative Care, and the Director of the Palliative Care Program — University of Washington Medical Center, at the Unive rsity of Wa shington School of Medicine in Seattle. ■ M D N E W S .C O M /// M D N E W S C L E V E L A N D /A K R O N / C A N T O N 2 017 S P E C I A L C L I N I C A L S E C T I O N : C A N C E R ❰❰❰❰❰ 1 1