Nina Gaby

Essays, art, and healthcare

“May I never see in the patient anything but another creature in pain.” Oath of Maimonides 1135-1204: Trauma Informed Care and Compassion Fatigue, Is there a connection?

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What is to give light must endure burning.”
Viktor Frankl 1905-1997

It is National Nurse’s Week and I am preparing a presentation for our nursing staff on the phenomenon of vicarious traumatization, the subject I tackled in my last blog and most recent essay “Don’t Touch the Mustard; Notes on Being in Lockdown With my Daughter.”

Vicarious trauma is a contagion, it is what happens to nurses and other caregivers who spend time helping others move through illness and crisis. We absorb the pain that surrounds us. Its sister, compassion fatigue, is the “debilitating weariness brought about by the repetitive, empathic responses to the pain and suffering of others” (LaRowe 2005) and “very much the landscape for today’s professional” (Showalter 2010).

My hypothesis for this presentation is this-If we look at trauma differently, will we respond differently? I am briefly commenting on this in honor of nurses everywhere who risk burnout, fatal weariness, and with concern for our healthcare system which suffers from the turnover that this fatigue costs all of us.

Trauma Informed Care

“A thorough understanding of the profound neurological, biological, psychological and social effects of trauma and violence on the individual” (Jennings 2004).

“Trauma is a disease of disconnection.”
Bessel van de Kolk Lecture, October 2011

Traditional treatment demands “compliance,” how would it be different to ask for “collaboration?” Would a change in a power differential actually ease the burden on the caregiver? Or is the potential for connection threatening? This is a question begging far more time and energy than is possible for this caregiver and blogger right now.

Can symptoms be looked at as adaptive rather than destructive? Normal responses to abnormal experiences?

For traumatized patients, all behaviors were directed towards survival. Over time they may have become “dysfunctional” with high incidence of substance abuse, psychiatric symptoms, and repetition compulsion. If we intervene with a clear understanding that these symptoms were lifesaving behaviors, we can respectfully help suggest alternatives. The same alternatives that might help any one of us.

Should we say- what happened to the patient rather than what is wrong with the patient? If we practice this with others, might it be easier to look at ourselves with more compassion?

Viktor Frankl also suggests that we honestly assess whether in the same situation might we do the same thing that we see our patients doing? This would go far in reducing the ‘us and them’ mentality that often gets in our way.

And then there is humor. Wish I had more time. Suffice to say it is the rare situation, with patient or colleague, that doesn’t get a whole lot better with humor. Or food. Another subject for another blog.

I need to get this on Powerpoint. In the spirit of collaboration, I will use more questions than answers. And bring lunch.

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3 thoughts on ““May I never see in the patient anything but another creature in pain.” Oath of Maimonides 1135-1204: Trauma Informed Care and Compassion Fatigue, Is there a connection?

  1. Nina-great post. If you haven’t already heard about these two books, I highly recommend reading them: The Boy Who Was Raised as a Dog, and Born to Love, both by Dr. Bruce Perry. He runs that Child Trauma Institute in Texas, here is his website: http://childtrauma.org/ Hope all is well! Donna Head “There is a destiny that makes us brothers, No one goes his way alone, All that we send into the lives of others, Comes back into our own.” —Edwin Markham (1852-1940), poet

    Mrs. Donna Head-Literacy Specialist Webster Thomas High School Willink Middle School

  2. Nina-enjoy your posts! If you haven’t already seen/read these books, they are remarkable:
    The Boy Who Was Raised as a Dog, and Born to Love-both by Dr. Bruce Perry, head of the Child Trauma Institute in Texas.
    Hope all is well!
    Donna Head

  3. I was surprised that you actually wrote this. My apologies, that sounded rather off.
    All things considered, I have already been on this site before and this page
    astounded myself… Considerably! Remember to write more information on
    “May I never see in the patient anything but another creature in pain.
    ” Oath of Maimonides 1135-1204: Trauma Informed Care
    and Compassion Fatigue, Is there a connection? | Nina Gaby or probably look at short native indian legends on
    the other hand? Thank you reading this. Best wishes

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