Monday, 24 August 2015

Avoiding Carer Burnout

If you are working in a profession which involves you giving emotional support to others you may well suffer from burnout. The end result of burning out of giving can lead to you feeling depleted physically, emotionally and mentally. It is avoidable through good time management and focusing on your own self care.  This is not to say that you wont have times where you just can't give or care any more.  This will happen. That's when you need to have a break. Unfortunately for many of us our work is casual which doesn't include paid holidays. Perhaps this is why burnout has become so prevalent in the caring professions recently. Regular breaks are as good as a holiday and focusing on yourself rather than your clients might be a good start.  It's very easy to lose that focus.

I remember how hurt I was when I had been working for a young woman for three years and then got another job somewhere else.  Our paths crossed some years later. The young woman smiled at me, I could see that she had no recollection of who I was.  I had seen this young woman nearly every day for 6 hours a day for three years. I was just one of a faceless army of support workers she had, had in her 30 years of life. People coming and going being close then never seeing them again.

That old cognitive bias lead me to believe that somehow I had been special in her life because she had been special in mine, I could never forget her. This is an example of why you should always put yourself first and everyone else after you.  I think most people working in caring professions will realize the importance of prioritizing your own needs yet surprisingly there is a very high burnout rate in these professions due to the fact that we can't seem to walk the walk as far as self care goes. As with everything practicing skills makes us better at them. Self care is a skill us carers need to practice.

Inlets and Outlets are one of my favourite ways to consider my energy and mental health.  I think we all have heard about outlets these are places where we vent  our frustrations in healthy ways such as going to the gym, running, painting any activity the expends energy and feelings is an outlet.  We let out emotions. Inlets are activities that regenerate our strengths things that we put into ourselves like meditation, going for a massage, being spoiled by our partners or friends these are activities in which we receive something usually nurturing toward ourselves. Strangely, I've noticed that people who work in caring professions are very good at giving and not so good at receiving.  I've seen some nursing colleagues positively squirm at the idea of allowing themselves a day of self care or letting their partner do something for them or even ask for help.  I'm not sure about the origins of why this is a problem for us givers to switch roles to be takers.  It would make an interesting topic to research that is for sure.

In the medical field there's a bit of elitism regarding how hard you can push yourself.  There's a culture of "we all did it tough, you're going to do it tough too".  Doctors and nurses working without adequate sleep is often seen as a badge that is worn with pride. It's such an unhealthy approach to work of any kind.  In my opinion when in the caring professions where life and death decisions are being made it seems the height of stupidity to be operating without adequate sleep and nutrition.

When I first started working as an Assistant In Nursing I encountered this horrid attitude.  I spoke to my father about it and said I'm afraid I'm going to make a mistake because I'm so tired.  He said next time they say something along the lines of "We use to do it much harder, what's wrong with you, simply say we used to live in caves too".  I tried it  and it worked.

Standing up against a culture of work until you drop is hard.  The way I see it is; if that's how they want to work that's fine for them.  If they want to do four shifts in a row and go around with their chest puffed out then that's fine.  Let them feel better than me they obviously have a lot riding on it. I love myself and I care enough about my clients to be aware of my personal boundaries  to know what I can do to perform my best.  I certainly cannot do four shifts back to back and do a good job. I lost a job because I chose not to do those kind of shifts every week. I was happy to lose that job.

Life is in fact not short, with any luck, the average life expectancy has increased a lot.  Its not unusual for people to live well into their late 80's and early 90's these days. The decisions you make now will last through your lifetime.  If you push yourself too hard you will hurt yourself. There are lifelong consequences such as, having an emotional and mental breakdown. It's a well known fact now that shift workers life expectancy is shorter than those who work within normal hours.  That might be all about pushing the limits in these professions. Pushing past your limitations isn't what I would call a good thing, extending your limits gradually, learning about personal boundaries and extending your capabilities through training, education and mentorship these things are fine. Smashing your head up against your limitations, denying your body food and rest, not such a smart move.

These things not only impact on you, they impact on important people to you, your family and friends.  These people are generally the people who have your best interest at heart. If you asked them if they wanted you to work four shifts in a row back to back I'm pretty sure they would not hesitate in telling you that it's a dumb idea. It's not selfish to prioritise yourself its sensible. Stand up for yourself because nobody else is going to. The organisations that you work for are interested in what you can do for them and even the nicest places are busy filling shifts and you are not the main priority.

The general rule is that after awhile people learn what you are capable of and if you do a great job at work, your clients will report back to your employer how wonderful you are and everyone will be happy. If you do your best job when you are at work it reflects well on the organisation you work for and you become an asset to them. It then becomes in their best interest to stick within your boundaries and not ask you to do more than you are capable of.

I intend to live into my 90's I want to be a fit healthy 90 year old, break the mold of shift workers dying young.  I hope that you join me in advocating for self care starting with yourself. Love is grand and we should first start by loving ourselves.  I was thinking about how I could  define the role of all people who care for others and this is what I came up with. An important sentence in the overall life story of others. We are important but we are only part of a person's story.  It's up to us to make our role as carers an important part of our own story and not the whole story.

Saturday, 15 August 2015

Caring for Others

Last week I wrote about caring for yourself, loving yourself and accepting who you are warts and all. This week I'm going to be writing about caring for others. I have a few years experience in the area of caring on a professional level and a few more years experience in caring for others personally. Giving to others can be a very rewarding thing.  If we all asked ourselves what we could do to support and care for others in an altruistic manner then the world would, I'm sure, be a better place. Altruism is the key to all genuine giving and unfortunately it's rarely the reason why people enter into caring professions or stay in them.  Organisations I have worked for have never used the word or the sentiment of altruistic giving of care in their "Mission Statements".  Being able to give to others in an altruistic manner requires intelligence, compassion, acceptance and the power to let go of power. It requires the reward of giving to be about seeing another person take the power over their own life or circumstance. It requires the giver to let go and be happy to give without feeling the need to be told thank you or to feel the warm fuzzy of gratitude from another person. It's getting the warm fuzzy feeling and the sentiment of gratitude to come from yourself not the other person.

I've had many conversations with fellow support workers, bosses and even friends who start off the process of giving and then find themselves angry, frustrated and feeling under valued because the recipient of their thoughtful, loving actions didn't respond with gratitude sometimes the person has been gruff or rude to them.  This lack of response from the recipient doesn't surprise me, its really humiliating to have to have someone in your home doing your housework for you, seeing you naked in the shower, seeing all your personal stuff around the house and seeing you vulnerable.  They do all of the stuff you wish you could do. The support workers are buzzing around, chatting to you then they leave and there you are still stuck in your wheelchair.

I don't expect a thank you for what I do. I just do it, I do the best job that I can in the most dignified way I can. I'm getting paid for what I do and that's my reward. My bonus reward comes from doing the job well and if I can shine a bit of light and happiness to my clients then thats great.  If I can get a laugh or a smile or lighten the atmosphere then that's even better.  I enjoy meeting these people I work with and hearing their stories, I like doing my job.  I like caring for people. I do the same for my friends. I like to hear what's troubling my friends, I like to help them in whatever way I can, maybe not giving them a shower but in other ways, sure. I do the giving for them. To see their happy faces is my reward.  I don't need a thank you.

It does happen that I work for people who are so sad, so angry, so depleted of any humanity that they just can't accept the care they receive.  Then its my job to hear all about it. To wear the complaint that I know they are going to make about me when I'm gone. When this happens I know that it's about what is going on for them and nothing to do with me.  They don't want to be grateful they don't want to say thank you and in fact they want to hurt me in whatever way they can because they are so angry at the world.  They can't lash out at the circumstances around them so they lash out at the support worker who has come to clean their house or who has come to give them a shower or take them shopping. Nothing I can do is going to be good enough for these people.

These people are career wreckers and they are relentless. They won't stop until they see that you've been sacked.  I'm really good at picking up on who these people are and I usually only do one shift with them and make sure I never go back. I always end the shift by saying "Thank you for having me in your home. I do hope things improve for you".  As I walk away I am relieved, I feel sad that these people have reached this point and I know that I am not responsible for their feelings. I wait for the call from my work which will be the complaint.   Luckily I work at amazing organisation, Care Agency Services that know and value me enough to realise that these complaints are usually lies and support me by keeping me employed. The gentle way in which the staff in the office deliver these complaints is much appreciated by me, it can't be easy. This has not always been the case, other organisations have dragged me over the coals and punished me by reducing my hours and some have been verbally abusive. In the forefront of my mind I am saying to myself.  All I can do is my best, I've done my best. Who owns the problem here? The other people. It is just wonderful working for a place where I don't feel alone when complaints are made. That my version of events is believed. This is a gift to me.

To provide care for others really requires this kind of ability to be confident in how you provide that care and to be able to do the care from a place of selflessness.  I don't expect my children to say thank you when I care for them because I know that they are thankful, I don't really need to hear the words. I don't expect my friends to be thankful I already know that they are, I don't need a card in the mail to express their thanks. I don't expect my clients to say thank you, most times it's just understood that care is provided for obvious reasons and the thanks is not necessary.  More importantly I've cared for them from a place of love and selflessness that is altruistic their improved life is my reward I don't need to have a card or hear the words, although most of my family, friends, clients and my bosses do say thank you, there's really no need. I'm happy to do what I can. If you have your nose out of joint because you didn't get a thank you, maybe you should ask yourself why you embarked on that act in the first place. Are you burnt out, this is a common condition or place for people in caring professions to end up. There are specific steps you can take to avoid burnout which I will discuss next week.

Until next Sunday enjoy the art of giving in an altruistic manner and spread the love :)

Saturday, 8 August 2015

Honesty with the Most Important Person

I was reminded this week about how important it is to be honest with the most important person in your life, that person is you. Nobody is perfect however, badly we may want to be.  The most important relationship you will ever has is the one that you have with yourself.  Being self aware isn't crucial to life however, I think it really is crucial to self development both professional and personal. I know that sometimes this is like fumbling around in the dark not really knowing what is wrong but knowing that something is really wrong.  Sometimes it's glaringly obvious to everyone else and yet you are unable to see it in yourself.  At other times you know that you are going in the wrong direction or are being less than honest with yourself yet you lack the emotional energy or will to do anything about it.  For other people self awareness is so far off their personal radar they have not one single clue and blame everyone else in their lives for the things that are going wrong.

How do we become self aware? How do we know we are not just beating ourselves up? How do we know that other people aren't just being mean when they make a criticism? Are our instincts good or are they so far off base that it's unbelievable? Do you catch your family and friends rolling their eyes in disbelief? There's really three parts to ourself image.  First of all there's the part that we project to others, this would include how we are at work or how we behave with strangers. Secondly, there's the person that we would like to be and that's our fantastical image that we present to ourselves an example of this might be thinking you are a wonderful human being but in fact are pretty cruel to the people around you or you think you are a faultless parent.There is no such thing as a faultless parent by the way just ask my kids. Thirdly, the person that you actually are, and this is the person that you really should get to know. It might not be a bad idea to really fall madly and deeply in love with that person.  That would be unconditional love. The love where you accept that you are perfectly imperfect and are still a lovable human.

Being open to criticism is hard, particularly hard for some of us.  Its an area you can work on.  I'm currently and in fact always working on this area.  This doesn't mean that you have to take onboard everything people say about you but, it's important to be a bit self reflective regarding criticisms. Every criticism you receive holds some value to you. If you are having difficulty accepting criticism this might stem from your childhood experience of criticism or you may have a fragile self esteem where criticism of any kind feels like a personal attack.  Its helpful to me to step back and ask myself is this criticism an accurate reflection of what I am projecting to this person? Is this assessment accurate in other ways? How could I improve how I express myself so I am projecting a more authentic version of myself?  Its really important that you fully believe the person who is criticizing you because their assessment holds an important key to your own self development and understanding of how others perceive you. It's equally important that your perception of yourself doesn't alter too much. There is a real danger of developing into a person who is suffering from the need to please disease. Your self esteem and self confidence can really suffer if you take criticism too seriously.

I'm always being criticised for being a smartass.  This assessment is an accurate assessment of me. I am a smartass, I don't perceive it as a negative thing, my sons pointed out the positive elements of smartass behave to me years ago.  Being a smartass and a woman can have negative connotations that I just don't want to bore you with today. As it turns out being a smartass is an attribute I have passed onto my children.  We are in fact a family of smartasses and our smartassery is the source of great humour and jocularity.  I would go so far as saying that our smartassness forms the backbone of our family culture.  If I tried to change this about myself I would be flirting with need to please disease and nobody should go there.  I do find arenas where my smartassness is fully appreciated for what it is  for example close friends and family members. I hold back on the smartassery where it's appropriate. At work I do a lot of thinking smartass things but not saying them out loud.  There are times that you have to ask yourself who has the problem here?  If it turns out that its the person giving the criticism that has the problem that's something for them to work on.  You can happily go on with your life and let that guy work on his own issues. If it's someone you love and you think they are ready to receive information about themselves then go ahead and gently mention something to them.

I recently read a criticism of one counsellor to another counsellor which went something like this "What are doing therapy for yourself on your clients are you?".  Something along those lines. This is not a very nice way to point out your reality to a person.  Another way to say this could have been "sounds like you've been really hurt before, are you completely over that?" or you could say "It's sometimes not helpful to clients when you self disclose about things like this." you could say "When I read that article I got the feeling that you had a lot of current pain going on that might harm your clients'.  No matter how you say things that are critical in nature you run the risk of the person becoming defensive and missing the important point.  One thing is certain when delivering criticism take the smartass button off because the other thing that is 100% guaranteed is that you are not perfect yourself.  If the person does become defensive which by the way is a normal response just apologize and give them some space to think about it. Don't get into a right fight nothing is achieved in those conversations not for you or for the other person. I find that accepting that I packaged the criticism ineffectively and dropping it like it's hot is the best approach for me. You might find a better way to handle defensiveness and if you have share it with me.

Sunday, 2 August 2015

Protection not Paranoia

I have been considering what to write about this week.  I was working with a young family last week who asked me a question in relation to teaching their disabled children how to protect themselves against sexual predators.  This is a very serious topic for everyone actually.  These young parents were right to have concerns for their non-verbal children who are particularly vulnerable.  There's a fine line that we tread as parents to instill protections for our children without making the kids feel paranoid and overly cautious. There are a few things that are important issues to cover.

Education and Information are power  if your child is armed with information this gives them power. Pedaphiles are more likely to choose victims based on the increased likelihood that they will be able to continue the abuse.  A child who is educated and likely to tell increases the chances that the perpetrator will be caught.  There are plenty of children's stories out there these days that are aimed at educating young children in an age appropriate sensitive way.  Here are a couple of websites to start you off on your search for information: Protection and Power are key elements for kids.

Don't perpetuate myths when telling your kids about sexual abuse as the above video mentions sexual abuse is usually perpetrated by someone known to the child.  The idea of Stranger Danger is outdated and completely incorrect.  This adds another layer to the issue that is that you may be getting groomed as well as your child.  We have this image of bad guys being some evil looking fellow or lady however, the truth is that baddies come in all kinds of packages.  Sexual predators are likely to be smooth talking and charming. Its really important that we let go of the bad guy image fed to us in the media and childhood stories. This will enable our children and ourselves to be alert to follow our instincts.

Giving our children a few options in relation to telling someone if they have been abused is good.  Kids know what information will hurt their parents, most kids don't want to hurt their mum and dad. Having a couple of alternative people to tell is also a good idea.  For example an aunt, uncle or grandparent. A family doctor or counsellor is a good idea as well because, these people are once removed from you and might serve as a person to help your child tell you if they have been abused. Make sure that the alternative person is trustworthy and safe.  Its important that a discussion takes place between you and that person before you present this person as an alternate trusted person to your child.  This discussion should be between you and the other person and not involve the child. It maybe too confronting for that person to hear about a traumatic situation like child abuse.  It really is important to discuss these kinds of issues by asking the questions "would you feel comfortable if my child came to you and told you they had been abused? What kind of feelings would this provoke in you will you be able to put those feelings aside until my child has received all the support they require? What kind of support do you need to be my childs alternate support person?" Its important that your child has a few people that they can talk to comfortably about this and other life traumas. As parents we want to be that person but the truth is that we can't always be there and we do need our children to feel supported by more than just us.

Educating your child about personal boundaries is really important. Respecting those personal boundaries is equally important. Its one thing to buy a book about personal boundaries and tell your child they are the boss of their bodies.  It's another thing entirely to have your offered cuddle rejected or your kiss on the cheek rejected.  Its really important to walk the walk.  When your child says I don't want Grandma hugging me you have to support that choice. This will not go down well and you have to be prepared for that storm so that your child feels supported. It might be a good idea to word up your family and friends that you are working on teaching your child how to protect themselves and to expect some rejection as the child finds a balance in relation to having this power.  People generally overuse power when they first get it then settle down as time goes by.  I'm sure everyone has experienced a colleague who has just got a promotion letting the power go to their heads.  The same kind of thing happens when a child is given power.

I do hope this blog has helped a few people with this tricky yet essential topic of discussion. Luckily we are living in an age where Education and Information are around.  Spare a thought for the kids who were brought up in the era where children were seen and not heard.

References

Dara Deborah et al "Advances is Child Abuse Prevention Knowledge: The perspective of new leadership"

Burkhardt & Rotatori "Treatment and Prevention of Childhood Sexual Abuse"

Oats "The Spectrum of Child Abuse: Assessment, Treatment and Prevention".