A new wellness module offered through ASN’s website aims to promote balanced mental health among people who work in dialysis facilities. It conveys that feelings of compassion fatigue experienced during the ongoing COVID-19 pandemic are understandable and offers resources and strategies on how to cope and move forward.
“We’re just beginning to see the mental health fallout of COVID,” said Daniel Cukor, PhD, a coauthor of the new module and director of behavioral health at the Rogosin Institute in New York. There’s a great shift happening now in hesitancy over returning to work in the general population, he said, which is extending into the nephrology community. “Some of that is burnout, people feeling really overwhelmed with healthcare responsibilities at their job. Many people have been through challenging times over the last year and a half, and they’re re-evaluating whether they have the desire to continue doing that type of work.”
The module, “Pursuing Mental Wellness: The Impact of COVID-19 on Dialysis Facility Staff,” features seven lessons offered via text and videos to help clinicians identify compassion fatigue and how it can appear in healthcare settings. It also offers tips, strategies, and resources that individuals and organizations can use to foster resilience. Some nephrologists and their colleagues also share information about how they remained positive and overcame pandemic fatigue, such as by practicing gratitude and spending time outdoors. One nephrology fellow said his program director purchased jewelry made by a kidney transplant recipient to serve as a morale booster.
Compassion fatigue is different from traditional burnout, said nephrologist Matthew Sinclair, MD, a coauthor of the module, medical instructor at Duke University School of Medicine, and a staff physician with the Durham Veterans Administration Medical Center in North Carolina. It’s more of a posttraumatic stress disorder-type response to the ongoing pressure of working in a high-acuity environment, he said. Symptoms include emotional, mental, or physical exhaustion; a reduced sense of meaning in work; and decreased interaction with others.
People who work in dialysis centers already had ongoing stressors, Sinclair said. Patients receive years of ongoing care, often from the same personnel, and are dependent on staff for treatment. Nephrologists have multiple responsibilities, and non-physicians spend the bulk of their time directly in the clinics.
The COVID-19 pandemic then compounded these issues, with dialysis clinic staffs often having to set up separate shifts for COVID-19-positive patients, working extra hard to prevent the spread of COVID-19, and worrying about contracting the virus themselves or bringing it home to their families.
ASN and the authors wanted to emphasize to the dialysis community that these feelings are being experienced by a lot of people, Sinclair said. “This isn’t just focused on one particular provider or aspect of health care—the lessons could be widely applicable to anybody who takes care of patients during COVID,” he said.
“For people who are going through some of these experiences of feeling burnt out, disengaged from their work, and not as empathetically connected to their patients, I hope this will be a first stop that they can go to begin to get some resources to understand what’s going on inside and link that to get professional mental health help if warranted,” Cukor said. “We don’t want good people leaving healthcare just because they’re feeling burdened and overwhelmed at the moment….We want those people to be able to build up their reserves and re-engage in a healthful way with our patient community.”
Other coauthors of the wellness module are Vineeta Kumar, MD; Jeffrey Silberzweig, MD; and Felicia Speed, LMSW, PhD. To review the free course, see https://rise.articulate.com/share/ciYQC-LTODyPV591tbL7EoLAI4eelbmd#/.
Steps you can take to combat compassion fatigue
Take time off from work.
Identify things that are truly important or valuable in your life.
Find new hobbies or interests unrelated to medicine.
Talk to a family member, friend, colleague, or mental health professional.
Exercise, and eat well.
Get sufficient sleep.