SCALE N = 27
1 2 3 4 5
STRONGLY
DISAGREE
DISAGREE NEUTRAL AGREE STRONGLY
AGREE
1. You know your strengths, how to use them to help, support colleagues, care for patients.
26 of 27 scored 4 or 5
2. You know your weaknesses, how to deal with them to protect yourself, family, colleagues, and patients.
23 of 27 scored 4 or 5
3. You can say “No!” without feeling guilty, making an excuse why not, or becoming defensive.
15 of 27 scored 4 or 5
2

SCALE N = 27
1 2 3 4 5
STRONGLY
DISAGREE
DISAGREE NEUTRAL AGREE STRONGLY
AGREE
4. You know how to do good citizen in world.
“self-care” , take care of family, be effective co-worker/colleague, perform job at highest level, and be contributing
21 of 27 scored 4 or 5
5. If you experience stressful/disturbing incident at work, you know how to
“Self-Debrief” to process event, learn and grow, so you will not experience long-term personal/professional harm.
15 of 27 scored 4 or 5
3

SCALE N = 27
In the list below, please check box of any statement that describes how you have felt in the past several months, since the beginning of 2015.
Hypervigilance & exaggerated startle response – being on guard & jumpy.
4 of 27 checked this box
Irritability or angry outbursts.
15 of 27 checked this box
Nightmares & trouble falling or staying asleep.
9 of 27 checked this box
4

SCALE N = 27
In the list below, please check box of any statement that describes how you have felt in the past several months, since the beginning of 2015.
Emotional numbness, lack of interest in activities & difficulty feeling love & joy.
9 of 27 checked this box
Avoiding thoughts & situations that are reminders of a traumatic event.
9 of 27 checked this box
5

SCALE N = 27
In the list below, please check box of any statement that describes how you have felt in the past several months, since the beginning of 2015.
5 Common Symptoms of Post-Traumatic Stress Disorder (PTSD)
Important notes: Of the 27 Pre-Evaluations completed May 14 th :
6 checked 3 of the 5 Common Symptoms of PTSD
2 checked 4 of the 5 Common Symptoms of PTSD
1 checked all 5 Common Symptoms of PTSD
6

Started today’s Session with same Evaluation questions as 5/14.
DNE and I wanted to see how much progress you each feel you have made in past 8 weeks.
Question (honest answer, please): How many of you have used
ANY of the handouts you received on May 14 th to help you address some issues that are most pressing/distressing right now.
If so, which handouts did you find most helpful?
7


Multiple losses, anticipatory, unresolved grief

“The development of negative professional attitudes and behaviors as a result of job strain. Work Environments can cause job strain when the worker experiences frustration, powerlessness, and an inability to achieve work goals.”

(Puchalski & Ferrell, 2010)
“… is a response to the work environment and not to the consequences of caring for people who are suffering.”
(Puchalski & Ferrell, 2010)

Feeling inadequate due to inability to alleviate others’ suffering
(Bright, 1996; Hooyman & Kramer, 2006; Vachon, 2000.)



(Nevidjon, 2004; Vachon, 2010; Ferrell & Coyle, 2010)


Recognize stress as an occupational hazard of trauma work

Accept your reactions as normal responses to specialized work

•
Limit exposure to trauma material
Books-conferences-discussions-movies
(Pizanti, 2006)


Develop supportive environment for discussing own reactions to work

Build a network of professional connections

Consider personal counseling to work through issues

Make use of the COH EAP – Employee Assistance
Program
(Pizanti, 2006)


Develop supportive environment for discussing own reactions to loss

Work within supportive organization

Set and maintain clear boundaries on therapeutic relationships
(Pizanti, 2006)

Processing a Death ~ Sample Priming Questions





How did you find out the person died? Were you there or did someone call you?
If you were present, when he or she died, what was that experience like?
Can you identify ways in which this death brought up some experiences of loss from your past?
How has dealing with losses in the past prepared you to deal with the losses you face now? In what ways do you feel illprepared?
What good memories do you have of the person who died?
Think or write a bit about one of those good memories.
(Nichols, 2012)

Spiritual care of Nurses
 Identify self-violence, suffering or injury
 Empower nurses to care for themselves & others
 Promote spiritual, psychological and physical abundance - not scarcity
(Pizanti, 2006)

Explore your own beliefs and values *
Think of a time when you faced a major life transition, change or loss. How did it affect you spiritually? How did your spirituality affect the experience? Did you discover spiritual strength during that time? How did you want to be supported spiritually?
*From “Offering Spiritual Support For Family or Friends” http://www.caringinfo.org/UserFiles/File/faith_brochure.pdf


Take time to laugh, have fun, socialize with co-workers

But not about work

Seek spiritual renewal in your life

Worship – prayer – Scripture + + + (Sacred text)

Emphasize self-care and self-nurturing activities
(Pizanti, 2006)


Take sabbaticals from trauma work – if possible

Take mental health breaks purposefully
(Pizanti, 2006)


Develop hobbies, sports and creative interests

Develop restful, meditative activities

Yoga, music, reading, gardening…

Nurture supportive relationships and roles for yourself outside work
(Pizanti, 2006)


Use nature as a healing force in life

Guard against addictive behaviors

Be rested, fit and eat well

Set clear boundaries between home and work
• Use clothing/rituals to mark change from work to leisure
(Pizanti, 2006)


Nurture a sense of joy, grace, beauty, love and connection in life

Seek out experiences which instill comfort and hope

Connect with community and friends +++
(Pizanti, 2006)

Your presence and compassionate, listening ear are the two most important tools you bring to any intervention.
(Stanley, 2002)
Compassionate Presence = A Way of Being
(Nichols, 2012)
21


Compassionate presence and follow-up

Reflective listening/query about important life
 events—spirituality as connection
Support patient sources of spiritual strength and
 note in chart
Connect patient to community resources

Referral to chaplain or other spiritual care professional
(Puchalski, 2014)

626.256.4673 Ext. 85781
Pager 626.423.0023

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Questions as a Practical Tool for Spiritual Assessment. Am Fam Phy 63(1):81-88, 2001.
Bright, R. (1996) Grief and Powerlessness: Helping People Regain Control of Their Lives
(165-167). London: Kingsley.
,
Ferrell, B. R., & Coyle, N. (Eds.). (2010).
NY: Oxford University Press.
Textbook of palliative nursing (3rd ed.). New York,
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Awareness and Self-Care. Archstone Foundation Grant Teleconference, March 4, 2012.
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Puchalski, C., & Romer A.L. (2000). Taking a spiritual history allows clinicians to understand patients more fully. Journal of Palliative Medicine, 3 (1), 129-137.
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