Self-care for healthcare professionals in palliative care

Resilience can protect against emotional exhaustion and modulate negative effects related to trauma, burnout and compassion fatigueDobson, 2021 Zanatta, 2020. To build resilience, manage stress and prevent burnout, one’s own healthcare requires attention.

Self-awareness is one of the most important aspects of self-care and includes awareness of one’s own emotional and psychological reactions to stressful situations, the pressures of clinical practice, and the potential impact of these on oneself and others.

Create personal strategies to prevent and respond to signs of stress; self-care measures that can help are summarised in Self-care measures to build resilience and prevent burnout in healthcare professionals in palliative care.

Table 1. Self-care measures to build resilience and prevent burnout in healthcare professionals in palliative care
Education, training and skills development
Seek opportunities for skills development through training, mentorship and supervision to ensure adequate preparation for the role.
Self-awareness and realistic expectations
Understand emotional reactions to difficult situations and recognise early signs of stress and seek support early. Develop realistic expectations of the support it is possible to provide to patients. Maintain appropriate professional boundaries.
Peer and professional support
Nurture relationships with co-workers—informal support among colleagues is vital. Identify mentors and colleagues who can be trusted with discussions about feelings and difficult situations. Create regular opportunities to reflect on practice with an appropriate colleague (eg via professional supervision).
Workload and work–life balance
Where possible: Limit workload to appropriate levels. Set realistic limits on work hours and availability. Take regular annual leave and make time for exercise, alternative interests and hobbies. Vary work to enhance satisfaction and intellectual stimulation. Maintain a routine that includes adequate rest, sleep and nutrition.
Stress management practices
massage, yoga, mindfulness meditation, physical activity, listening to music, relaxation techniques, journaling

Be alert to the professional boundaries that define roles, responsibilities and relationships with patients, especially the extent of involvement with patients and their families. This includes sticking to usual working hours and shifts (including after-hours rosters). Boundaries help healthcare professionals cope with the proximity to suffering that providing palliative care can often entail. Volunteer staff may be especially vulnerable to such stress when not supported by clear guidelines or boundaries to their roles.

Reluctance to admit to difficulties is a common problem among healthcare professionals, but recognising early signs of stress or burnout and knowing when to seek support is essential.

Note: Reluctance to admit to difficulties is a common problem among healthcare professionals, but recognising early signs of stress and knowing when to seek support is essential.

Seek out available support for personal difficulties or concerns about burnout in the workplace (eg mentors, supervisors, trusted colleagues, professional support programs), or consult a healthcare provider.

Seek support from a colleague to discuss difficulties experienced in the care of patients (or their families or carers). Examples of difficulties include conflict in the relationship with a patient, or frustration with lack of progress, or inability to adequately manage a patient’s symptoms. In some cases, it may be useful to seek another clinician’s advice through review of the patient, or to refer.

Further information on self-care for health professionals working in palliative care, as well as a self-care planning tool can be found in the Self-Care Matters resource provided by Palliative Care Australia.