Self-Care is Ethical Practice

Caregivers tend to be so focused on helping others that they don’t dedicate enough time and resources for their personal care.  Some feel guilty or selfish when their focus is turned toward themselves.  Self-care for the caregiver should be viewed as a professional ethical obligation and not as an option.  When a caregiver is not adequately taking care of his/her needs it can put the client/patient at risk.  Good self-care practices can help the caregiver to perform the responsibilities of his/her position optimally and with increased compassion.

Most professional code of ethics include statements regarding “impairment” and some address caregiver “self-care” more directly.  The Green Cross Academy of Traumatology has comprehensive Standards of Self-Care Guidelines that are designed for professional caregivers (to view CLICK HERE).  This code states that the purpose of the guidelines is twofold:  “First, do not harm to yourself in the line of duty when helping/treating others.  Second, attend to your physical, social, emotional, and spiritual needs as a way of ensuring high quality services to those who look to you for support as a human being”.  (www.greencross.org/)

Most code of ethics begin with the principle of “first, do not harm” as it relates to the client/patient.  While this is a must, it is also imperative that we maintain a dual focus on the client/patient and ourselves while doing our caregiving work to ensure optimal service, to uphold the integrity of our professions and to maintain personal well-being.  Ethical errors are more likely to occur when the caregiver experiences symptoms of compassion fatigue and/or burnout.  Self-care has been identified as the greatest protection against experiencing secondary trauma symptoms because it increases caregiver resiliency.

Increased attention given to the subject of self-care by professional associations is helpful in creating awareness regarding its importance.  A good example of this is the statement made by National Association of Social Workers in NASW Social Work Speaks, 2011 – 2014.  “Professional self-care is an essential underpinning to best practice in the profession of Social Work ….. Self-care has relevance to all social workers in the setting with which they practice ….. NASW supports the practice of professional self-care for social workers as a means of maintaining their competence, strengthening the profession and preserving the integrity of their work with clients.”

Compassion fatigue is linked to ethical errors, therefore it stands to reason that it is unethical to neglect self-care.  Self-care is the responsibility of each professional.  The benefits of practicing effective self-care are far-reaching and can impact everyone you come into contact with.  Self-care is ethical practice!

 

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What is Self-Care?

A focus on self-care is becoming increasingly important as the demands within caregiving professions seem to be intensifying.  Self-care is any activity of an individual that is done with the intention of improving or maintaining wellness.  Professional self-care can be defined as the incorporation of skills and strategies by caregivers to preserve their personal, familial, emotional and spiritual needs while serving the needs of their clients (Newell & MacNeil, 2010).

Categories for self-care can include 1) physical:  body work, exercise, adequate sleep, nutrition:  2) psychological:  effective relaxation time, contact with nature, forms of creative expression, balance between work and recreation;  3) social/interpersonal:  supportive relationships and knowing when/how to obtain help;  and 4) professional:  balancing work and home life, setting boundaries and limits, and getting help/support through peers, role models, and supervisors (Charles Figley interview, 2005).

Self-care has been identified as the greatest strategy to prevent or reduce the undesirable effects of Compassion Fatigue, Secondary Traumatic Stress, Vicarious Traumatization and Burnout.  Professional caregivers are at much higher risk than other professionals of experiencing compassion fatigue due to the nature of our work (Radey & Figley, 2007).

Compassion is a very important element in the success of a caregiver engaging clients in direct practice work.  In order to gain the trust of the clients we mush develop a positive working relationship and be able to empathize with the client.  “Sometimes our hearts go out to the clients to the point where we feel their pain and suffering, which can lead to mental, physical and emotional fatigue” (Radey & Figley, 2007).  Chronic exposure to others’ traumatic events is also a factor that puts caregivers at higher risk of experiencing compassion fatigue.  Compassion fatigue can lead to burnout, a condition of emotional, physical, psychological, and spiritual exhaustion that results from practicing with people who are vulnerable or suffering (Newell & MacNeil, 2010).

Citations

Compassion fatigue:  An expert interview with Charles R. Figley, (2005).  Retrieved 4/15/14 from http://www.medscape.com/viewarticle/513615.

Newell, J., & MacNeil, ., (2010).  Professional burnout, vicarious trauma, secondary traumatic stress, and compassion fatigue:  a review of theoretical terms, risk factors and preventative methods for clinicians and researchers.  Best Practices in Mental Health 6(2), 57-68.

Radey, M., & Figley, C., (2007).  The social psychology of compassion.  Clinical Social Work Journal 35(1), 207-214.

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Secondary Trauma and Self-Care

Maintaining high levels of compassion and empathy required by caregiving professionals can be difficult, given the intensity and high demands of the work.  Professional caregivers, including but not limited to:  mental health professionals, medical practitioners, first responders and animal caregivers are exposed to the traumas of the clients they serve.  This indirect exposure to graphic material can be through hearing the stories told by clients/patients or by assisting them during or immediately following a trauma, such as during a life threatening emergency or in the emergency room, for example.

Research has been done to verify that caregivers are at high risk of experiencing symptoms of secondary trauma.  Professional caregivers studied include, but are not limited to:  social workers, child welfare workers, substance abuse counselors, domestic/sexual violence social workers, emergency room nurses, hospice nurses, juvenile justice education workers, firefighters and chaplains working following the events of 9/11 in New York City.

Self-Care has been identified, through research, as the greatest prevention of experiencing the negative effects of secondary trauma.  It is the intention of Self-Care Specialists to provide progressive training for professional caregivers that creates awareness regarding secondary trauma injuries and to teach effective stress management tools as prevention.  It is important for professional caregivers to take optimal care of themselves in order to maintain resiliency and the ability to provide superior service to those clients who trust and rely upon us to assist with their needs.

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