By Rod Myerscough, PhD

We have developed a number of initiatives that we believe are creating the conditions that support good self-care. Fundamental to these efforts is the clarification of our core values so that, in the words of Parker Palmer, our “soul and role” are congruent. That is, when we know our personal, core values and our jobs conform to them, we believe that we will be effective and able to sustain a long and satisfying career.

For example, we have offered a two year training course in “The Sacred Art of Living and Dying”. This training involved four two-day retreats over two years accompanied by monthly meetings in small, four-to-six person study support groups to advance the work and learning identified in the retreats. It was designed to help the participants clarify their core values, become attentive to patients’ interpersonal and spiritual needs at the end of life, and to integrate these into their actual day to day work.

We also provided several courses of mindfulness training, a modified version of the popular eight week program, Mindfulness Based Stress Reduction (MBSR) described in Jon Kabat-Zinn’s book, Full Catastrophe Living. In it we placed special emphasis on meditation training and MBSR’s Seven Foundational Attitudes of Mindfulness (Non-Judging, Patience, Beginners Mind, Trust, Non-Striving, Acceptance, and Letting Go). We believe that when we practice these attitudes it is highly unlikely (if not outright impossible) for compassion fatigue to develop. The practice of mindfulness is uniquely situated to advance and support the goal of congruent “soul and role”.

We have also utilized poetry to advance the goals of self-care. W.H. Auden observed that “What the poet says has never been said before, but, once he has said it, his readers recognize its validity for themselves.” We partnered with Kent State University’s Wick Poetry Center to have poetry workshops in which members of the Palliative Care Team discuss a selected poem and then write one of their own. These discussions and the poetry that has emerged have been remarkably powerful experiences for the way they move the practitioners away from their usual clinical way of observing the world to one more informed by the heart’s vision. Additionally, a poem is read at the start or the end of team meetings. The poems selected are chosen because of their capacity to stimulate reflection and to help the team members see the world and themselves in a way that they would not otherwise do and, in Auden’s words, “…recognize its validity for themselves.”

The intention behind all of these efforts is the maintenance and, if necessary, the restoration of the practitioner’s sense of competency and wholeness. Our self-care strategy assumes that we already have all that we need, although it is certainly possible to forget this and to become lost and burned out. Our hope is that these and other initiatives will prevent compassion fatigue, promote good patient care, and allow practitioners to have long-lasting and meaningful careers in Palliative Care.

For more on Summa’s Palliative Care and Hospice Services, visit AAHPM’s Profiles in Innovation.