Week 4- interprofessional team approach/ self care

Question 1

who should always be at the table

Answer 1

patient and family
every situation is different

Question 3

what are boundaries

Answer 3

invisible lines in relationships that help you to distinguish where your values & beliefs end and someone else’s begin

Question 4

Establishing/maintaining therapeutic boundaries can (4)

Answer 4

• allow us to care deeply but still think clearly and wisely
• Decrease the occurrences of compassion fatigue
• helps us remember our role as an “intimate stranger” not family or friend
• Help us to focus on whose needs you are trying to meet and whose emotions you are feeling

Question 5

Signs that professional boundaries are not clear (3)

Answer 5

• You experience extreme emotions
• You feel ownership for the dying people you are caring for
• You try to take control

Question 6

good boundaries (5)

Answer 6

• Able to listen, might not agree but can provide support
• Can still cry, show emotions but its not about us.
• Share personal information within reason, things that can help build a connection and relationship not if it puts us at risk or is to influence
• “you are in good hands, I’ve told them about how you want your care” you dint have ownership, instilling confidence in other members of the care team.
• Don’t respond to social media

Question 7

what is very important throughout career

Answer 7

Talk to a supervisor, colleague or counsellor if in a situation where boundaries seem blurred

Question 8

providing care for the dying can (4)

The good things

Answer 8

• Amplify your enjoyment in life
• Increase appreciation of the little things
• Help you identify and prioritize what is important
• Provide strength and determination to face life’s little challenges

Question 9

compassion fatigue

Answer 9

A profound physical, biological and social exhaustion and dysfunction from repeated exposure to emotional events

Question 10

3 stressors unique to palliative care nurses:

Answer 10

1. Personal factors: our own personal beliefs, distractions, inadequate preparation or training
2. Patient or caregiver: rapid decline in their health, non-compliant
3. Work environment: no one available to help, short staffed.

Question 11

indicators of compassion fatigue (4)

Answer 11

• Apathy (don’t care as much)
• making assumptions
• not engaging as much
• no longer seeing individuals,

Question 12

antecedents of CF (3)

Answer 12

• ability to experience compassion and empathy
• exposure to suffering
• repeated exposure to stressors

Question 13

consequences of CF (5)

LBBM D

Answer 13

• loss of ability to feel compassion and empathy
• burnout
• breakdown
• disinterest
• moral distress

Question 14

attributes of CF

(5)

Answer 14

emotional: empathy imbalance
professiona/intellectual: diminished performance
Physical: increased complaints
Social: inability to share in suffering
Spiritual: poor judgment

Question 15

empirical referents of compassion fatigue

Answer 15

• irritation, depression, anxiety, self doubt
• poor performance, calling out, mistakes, inability to concentrate
• HA, nausea, chest pain, exhaustion, sleep loss, malaise, poor endurance
• difficulty in maintaining relationships
• inability to provide judgement, lacks awareness

Question 16

5 domains identified as elements of compassion fatigue

Answer 16

emotional and psychological, intellectual and professional, physical, social, and spiritual.

Question 17

moral distress

Answer 17

The impact and toll on a HCP’s wellbeing when they are prevented from providing the best course of action or care from a moral/ethical perspective

Question 18

implications of moral distress at 3 levels

Answer 18

1. Direct Provider: Erosion of sense of self, ethics & standards, burnout,
2. Care recipient: diminished quality of care via avoidance
3. Organization: Quality of care & retention

Question 19

emotional responses to burnout

Answer 19

• feelings of powerlessness or being overwhelmed
• fear, disgust, discouragement
• depression
• anxiety
• bitterness, cynicism, resentment
• shock
• dismay
• burnout

Question 20

spiritual responses to moral distress

5 FDDDL

Answer 20

• faith crisis
• dampened moral sensitivity
• deterioration of moral integrity
• disconnection from work or community
• loss of self worth

Question 21

behavioral responses to moral distress

Answer 21

• impaired thinking
• nightmares
• lashing out at others
• addictive behaviors
• controlling behaviors
• defensiveness
• avoidance
• agitation
• shaming others

Question 22

physical responses to moral distress

Answer 22

• heart palpitations
• GI disturbances
• insomnia
• HA or other pain symptoms
• fatigue
• hyperactivity unplanned weight gain or loss
• susceptibility to illness

Question 23

reframe experiences of moral distress as

Answer 23

opportunities for growth, empowerment & increased moral resilience

Question 24

Moral distress is indicative of

Answer 24

moral consciousness, not moral failure!

Question 25

benefits of ethics education

Answer 25

evidence that nurses that have had this are more confident in addressing ethical issues, and use resources

Question 26

What can nurses do to address moral distress?

Answer 26

- recognize the symptoms of moral distress - reflect on and be curious about ethical aspects of clinical situations - reconnect to your original purpose and intention for being a nurse - commit to your personal wellbeing - support and restore your moral integrity learn to listen to your intuition and somatic responses - develop ethical competence - speak up about your ethical concerns take principled action

Question 27

vicarious trauma

Answer 27

▪ The emotional residue of exposure to traumatic stories and experiences of others

Question 28

vicarious trauma pre readings