A Three-Year Experience in Self Care Resilience for Palliative Care Fellows, Nurse Practitioners and Physician Assistants (761)

Abstract

1.Describe the importance of life-long self care in the practice of Hospice and Palliative Care, particularly as it relates to the ACGME Core Competency of Professionalism.2.Explore art, music, writing, physical exercise, counseling, and other modalities as a means of self care and expression for Hospice and Palliative Care providers.3.Design a self-care program for their home institutions, to promote self care, professionalism and team building, using our experiences at the University of Alabama at Birmingham. In the field of Hospice and Palliative Care, the risks of compassion fatigue and burnout are high. Consequences of these problems include compromised patient care, relational difficulties with patients, patients' families and clinical staff, and difficulties with personal life. Prevention through appropriate self-care is critical. Self-care should be modeled and taught for all providers, and it is a key component of the ACGME Core Competency of Professionalism. Identify risk factors for compassion fatigue and burnout among palliative care fellows and other team members. Teach strategies to mitigate these stressors, to promote self care, professionalism and team building. We instituted a program of self-care for the Palliative Care fellows, nurse practitioners (NPs) and physician assistants (PAs) in our program over the past three years. Fellows complete a reflective journaling exercise at the beginning of the academic year, identifying potential stressors and appropriate/inappropriate coping strategies to mitigate these stressors if/when they arise. Fellows, NPs, and PAs then have three opportunities over the course of the year to be relieved of their clinical duties for a half-day and to participate in off-site, guided self-care activities, including: visiting the local Fine Arts Museum to better understand the integration of art and medicine, working with music therapists to explore music as a positive coping mechanism, practicing yoga with a certified instructor to help relieve stress, experiencing self-expression with a certified art therapist, and learning from a licensed counselor the concepts and importance of self-care. Illustrative qualitative comments gathered from three years of evaluations will be highlighted. Specifically, participants endorsed commitment to self-care and improved professionalism and team-building. Self-care is imperative and can be taught through appropriate educational programs.