HJAR Mar/Apr 2021

Q&A 24 MAR / APR 2021 I  HEALTHCARE JOURNAL OF ARKANSAS   with the nursing home lockdowns, but we got creative there as well and implemented telehealth visits with both patients and families when in-person visits weren’t possible. Is burnout in hospice workers higher than other fields of healthcare? How do you help with staff burnout? BARBARA ROSS It has long been established that end-of-life care for direct-care clinical staff includes high levels of extreme stress. Bearing witness to ongoing illness, decline, death and loss can take its toll without ample support and often leads to burnout and compassion fatigue. It is thought that as many as 65% of hospice and palliative care clinicians suffer some type of burn- out due to the high emotional demands of patient visits, cumbersome documentation requirements and staffing issues. Turnover rates can be high in that many in the field find that a calling to give to those facing end of life is ever taxing and not the cake walk they had imagined; and thus, they leave the field. Ideally, programs are established with these stressors in mind and built into hos- pice agency activities designed to mitigate the emotional effects of working in end-of- life care. Ongoing support, management sensi- tivity and empathy training, with a huge focus on boundaries and self-care, can all help to build safety nets of compassion- ate care for our own staff. Arkansas Hos- pice provides such training for employees, with an ongoing emphasis on staff support and wellness, and reflects its support via staff meetings, services of remembrance, wellness programs, post-death debriefings following complex deaths and disciplined but compassionately led IDG meetings, all of which can pave the way for staff to achieve high levels of job satisfaction with minimal burnout. Day-to-day networking and support by hands-on managers who fully understand the ongoing stressors are a must, just as allowing for ample staff time off to recharge and relax is. The biggest nod is to self-care and wellness, all part of the growing trend in helping the helpers to not only get what they need to succeed, but also to thrive while helping others. There is one school of thought that says our biog- raphy can indeed become our biology, or what we do can indeed make us ill. Thus, intentional efforts to address these issues become primary. What has surprised you by this work? BELL Working in primary care really burned me out in 2006. It seemed it was more paperwork and less patient time. One of the first patients I had in hospice was a man who was born in this 120-year-old house. My first visit, we drank coffee and rode around his farm and looked at his cattle. He told me he was born in this house, and he was going to die in this house. I knew after that visit that I could finally practice the kind of medicine that I had always wanted. I call it slowmedicine — taking your time to know a patient and their family in many dif- ferent aspects: their values, hopes, dreams, failures, what made their life special and the aspirations they have for their family after they die. It is just hard to do that in a 15-min- ute office visit. Will you share a beautiful passing you have witnessed? What made it special? BELL Recently, I took care one of my friends at the end of her life. I got to use my talents