Week 10: Professional Experiences: First Responders, Health Care Workers, Death Care Workers

Question 1

First Responders

Answer 1

Emergency Medical Technicians (EMTs), paramedics, police, firefighters.

Question 2

Health Care Workers

Answer 2

Physicians, nurses, health care aides (nursing homes), residential care aides, social workers, personal support workers (PSWs).

Question 3

Stressors & Enrichment from Caregiving

Answer 3

-Increased exposure to death, and sometimes traumatic death, as a part of work, can lead to mental health concerns including stress, burnout, PTSD, and compassion fatigue.
-Many who work with dying people, or otherwise provide care to others report being personally enriched by their work.

Question 4

Compassion satisfaction

Answer 4

being personally enriched, feeling gratified from providing care to others, joy experienced from helping others.

Question 5

Primary Trauma

Answer 5

direct exposure to traumatic events.

Question 6

Secondary trauma (vicarious trauma)

Answer 6

exposure to the suffering of others.
-Informing family and friends of a death, exposure to the grief of the bereaved loved ones of patients.

Question 7

Post-Traumatic Stress Disorder (PTSD)

Answer 7

Categories of symptoms:
1) Re-experiencing (repeated unwanted memories, repeated unpleasant dreams, flashbacks)
2) Avoidance (of reminders of the traumatic event)
3) Emotional numbing
4) Arousal (trouble sleeping, irritability)
Associated with elevated risk of substance abuse, family violence, and suicide.
More likely with repeated exposure to death, particularly with traumatic and tragic deaths.

Question 8

Former Lt.-Gen. Romeo Dallaire

Answer 8

-Force commander of UN intervention in Rwanda from 1993-1994
-Received orders not to intervene as genocide took place (1994).
-800,000 people were killed in 100 days
-Became a public face of PTSD in Canada after suffering untreated for many years.

Question 9

Cumulative stress/ trauma

Answer 9

repeated exposure to death, traumatic incidents increases likelihood of PTSD.

Question 10

Burnout

Answer 10

feeling emotionally drained or depleted; loss of motivation, interest, commitment, empathy; loss of personal sense of achievement in work.
-Emotional exhaustion
-Depersonalization (feeling detached from work, loss of motivation), cynicism.
-Feelings of inefficacy (feeling hopeless, feeling like a failure).
-Arises from workplace conditions

Question 11

Burnout

Answer 11

feeling emotionally drained or depleted; loss of motivation, interest, commitment, empathy; loss of personal sense of achievement in work.
-Emotional exhaustion
-Depersonalization (feeling detached from work, loss of motivation), cynicism.
-Feelings of inefficacy (feeling hopeless, feeling like a failure).
-Arises from workplace conditions

Question 12

Moral Distress

Answer 12

when healthcare workers feel conflicted or distressed about the ethics of providing care that may be futile, unnecessary, or harmful to a patient.
-Feel unable to provide the best care. Leads to feelings of guilt.

Question 13

Moral Distress

Answer 13

when healthcare workers feel conflicted or distressed about the ethics of providing care that may be futile, unnecessary, or harmful to a patient.
-Feel unable to provide the best care. Leads to feelings of guilt.

Question 14

Compassion Fatigue

Answer 14

-When health care workers lose compassion and empathy for clients over time as a result of ongoing [long-term] stress at work
-Can be related to increases in workload, decreased funding, staffing, pressures caused by an ongoing crisis like Covid-19.
-Arises from contact with people experiencing trauma (emotions of others).
-Secondary trauma + burnout= compassion fatigue.

Question 15

Gendered Expectations and Emotional Vulnerability

Answer 15

-Emotional vulnerability is frequently associated with weakness, perceived as ‘unprofessional’
-Leads to stigmatization of grief and stress in traditionally male-dominated professions.
-Pressure to ‘be strong’ leads to isolation, disenfranchised grief
-Seeking help can be stigmatized when you are supposed to be the ‘strong’ caregiver.

Question 16

PTSD and First Responders

Answer 16

-Stress associated with repeated exposure to violent and traumatic deaths, decision-making, risking self.
-First responders experience PTSD at 2 times the rate of general population
-Estimated that up to 22% of paramedics will develop PTSD.
Estimated that 70,000 Canadian first responders have experienced PTSD in their lifetimes.
-The role as ‘helper’ or ‘protector’ limits likelihood of seeking out own help.

Question 17

PTSD and First Responders

Answer 17

-Stress associated with repeated exposure to violent and traumatic deaths, decision-making, risking self.
-First responders experience PTSD at 2 times the rate of general population
-Estimated that up to 22% of paramedics will develop PTSD.
Estimated that 70,000 Canadian first responders have experienced PTSD in their lifetimes.
-The role as ‘helper’ or ‘protector’ limits likelihood of seeking out own help.

Question 18

Health Care Workers & COVID-19

Answer 18

-In spring 2020, serve burnout was experienced by 30-40% of Canadian healthcare professionals, by spring 2021, rates were over 60%
-Nurses and younger professionals working with in ICU’s, COVID-19 units, hospitals, emergency departments experienced higher rates.
-Higher risk for PTSD, burnout and compassion fatigue due to multiple and ongoing occupational stressors including short-staffing, long hours, shortages of PPE, higher exposure to rates of death and dying.
-Limited ability to provide sufficient care (due to shortages of space, personnel) can lead to moral distress
-Feelings of guilt, stress related to inability to match personal values with actions
-Working with insufficient resources.

Question 19

Consequences of Burnout in Healthcare

Answer 19

-Associated with diminished safety
-Diminished quality of care
-Mental health problems, diminished quality of life for healthcare workers
-Staff shortages

Question 20

Death Care Workers

Answer 20

-Death care workers also report experiencing compassion fatigue due to high demands, long hours, intensity of the work with families.
-Possibly heightened during COVID-19
-“Often funeral directors are the forgotten ones. We deal with the most difficult situations and scenarios on a daily basis. We are dealing with everyone else’s grief. We are not immune to grief ourselves and distress at some of the situations that we come across”
-Secondary trauma.

Question 21

Seeking Help

Answer 21

-Respondents all professions describe that being able to talk, be vulnerable after a difficult incident is crucial for coping.
-Efforts are being made to normalize mental health struggles, emphasize self-care, and provide access to mental health supports in numerous professions
-Social need to de-stigmatize vulnerability
-Need for structural change; provision of sufficient funding, resources.

Question 22

Cultivating mindfulness and practicing self-care has been shown to reduce burnout.

Answer 22

-When you walk home from work, pay attention to the sensation of contact between your feet and the ground.
-Keep a folder in your email of ‘nice things’ that people have said about you or your work.
-Develop a ‘role-shedding ritual’ at the end of the day.
-Reward yourself for the completion of a task
-When feeling overwhelmed, go outside or look out the window and notice something in nature. Give it your full attention for a few minutes.