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Safeguard Magazine

Compassionate fatigue

Carers typically work shifts and suffer from fatigue, while some are at risk of compassionate fatigue too. DANNII HARRIS reports from personal experience.

From the age of seven I would go to the Cottage after school and on weekends. The Cottage was part of a rest home where my mother worked. It consisted of twelve residents and two staff, and it operated 24 hours, seven days a week. This was a normal part of my life.

My mother worked at three different caregiving jobs, all different hours of the day, yet not once did she complain. Her predicament was not unusual in this female-dominated sector. The rest home I visited most had elderly residents who had dementia. As a result of their condition, some of the residents would become aggressive and I learnt very quickly to avoid any confrontation.

As I got older my mother taught me the different aspects of the job. The first task I learnt was cleaning, such as washing dishes and doing the laundry. I also learnt how to prepare the food and give residents their meals. I particularly enjoyed engaging with them. On reflection, I realise now how hard my mother worked and how she managed to complete a huge workload within a given time, while raising a family of her own.

FIRST JOB

At the age of 15 I landed my first job as a caregiver. Together with one other staff member, I looked after sixteen residents, many of whom were bedridden and/or had the early stages of dementia. It was a very demanding and tiring job in which I was on my feet the whole time I was at work. There were no lifting hoists and lifting belts were a rarity so we were expected to manually lift the patients, often by ourselves. I soon learnt how to pivot and lift correctly so I didn’t hurt myself.

As with my mother’s jobs, there was never enough time to complete all the tasks required. The other frustrating aspect of the job was that there was never enough time to give the residents my full attention because for every task I had completed there were still two or three more waiting to be done.

SHIFT WORK AND STUDY

When I was almost 19 I changed organisations and moved from caring for elderly residents with dementia to caring for residents with a range of intellectual disabilities. After I was there a while I was promoted to the position of team leader. Although I enjoyed the position, at times it was very challenging. Some of residents’ issues required us to have a great deal of understanding and a high level of maturity.

The job was also quite isolating as I did shift work where I worked in the afternoons during the week and nine hour shifts on the weekends, which meant I was often working alone. The hours of work meant that I would be at home alone during the day as my family were at work, and on weekends I didn’t finish till 6pm so there was little opportunity to go out and socialise.

Not only was I working fulltime, I was also studying fulltime. In short, I had no work-life balance because of my hours of work and if I wanted to plan something I had to take annual leave.

HEALTH IN DECLINE

After a while the excessive pace and emotional strain of work, together with the heavy demands of study, took a toll on my physical and mental health. Unfortunately I didn’t talk to my manager about my predicament and in the end my health had deteriorated. When I returned to work I was much more candid with my managers, who offered support in the form of extra staff and more manageable and suitable hours of work. As a result I was able to complete my dissertation on compassionate fatigue among caregivers as part of my Master’s degree.

Shift work is inevitable in the health sector so it needs to be carefully managed. As I and others know, fatigue is inextricably linked with shift work, but as many of us are finding, compassionate fatigue is also an issue. Compassionate fatigue is not well understood and is under-researched, but what we do know is that it results from the long-term exposure to the suffering of others. The limited research on compassion fatigue has focused on occupations such as nurses, police officers, veterinarians and psychologists.

COMPASSIONATE FATIGUE

The caregivers in the study liked caring for people; many also had family members who they cared for too. However, all the caregivers interviewed experienced fatigue and compassionate fatigue regardless of their grade. Disturbingly, they saw fatigue as a normal part of the job, which is something I can attest to. They also felt that they had a lack of managerial support, with no coping mechanisms to deal with how they were feeling. Overall, they felt their workload had increased over the years and that they had no work life balance.

So how can we reduce the level of fatigue? Educating staff on how to recognise fatigue is important. There needs to be open communication between staff and management in which staff need to be able to approach management and talk about their issues. Including staff in decisions around their health and safety is also crucial and is an integral part of the new Health and Safety at Work Act 2015. Shift work cannot be eliminated but we can change work schedules to ensure staff aren’t finishing late at night and coming back to work early the next day. Physical fatigue can be reduced by ensuring staff are trained in manual handling techniques, and that it is reduced where possible.

Finally, after graduating in 2017 with my master’s degree from AUT, I am now a health and safety manager at Rescare Homes Trust. I am passionate about my work and I am looking forward to making a difference.

Dannii Harris is health and safety manager with Rescare Homes Trust in Auckland.

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