I've been working with a lot of teams that seem to be tired, frustrated, blaming/in-fighting, confused, and many of the members have individual health issues and a notable amount of family distress. As a result I'm trying to deconstruct a number of things.
I have to wonder how much of this we've created, are experiencing as a result of the pandemic, and how much of this has always happened and we havn't talked about it. I think we're experiencing a confluence of things as a community of humans who help other humans right now. The things that I am most aware of right now are Moral Injury, Compassion Fatigue and Burn Out.
Story time, it was March 3, 2020 when the director of behavioral health walked in and siad "you are all essential employees, you cannot leave the state and we have to got owork right now to keep everything open." Welp, that was fun. What happened next was the Covid-19 pandemic panic. Everyone in behavioral health worked 12-16 hour days from that moment on. Most, of us have not been able to slow down since the beginning of the pandemic. The entire world was catapult into exaggerated behaviors and coping strategies. To include a 540% increase in alcohol sales, multiple familial deaths, crisis after crisis, client deaths, community loss, economic loses, not to mention the emotional and psychical toll on everyone who stayed available during the crisis; the essential workers, minimum wage to system managers, we are all really tired.
Fast forward, the pandemic winds down, people do not want to work in offices, noone sees each other in the community, businesses are boarded up, and somehow fashion has become congruent with the little house on the prairie. Just sayin.
Everyone who gets into the helping fields nursing, medical, counseling, social work, psychology, peer support and other credentials....every single one enters the field with the intention of caring for others. We take an oath to do no harm. But does the system take an oath not to harm us?
This is where I have to raise the conversation about moral injury. Injuries that happen to us as a result of working in systems that tear us apart emotionally or mentally. Our values are in oposition tot he system we're a part of. For example, going into medicine to be a doctor and caring for people only to find out at the practice you can't see people more than 7 minutes and it has to be as complex and as short as possible. This hurts, it causes injury. You may say, then leave. Welp, your privilege is showing. Some folx cannot leave thie jobs for whatever reason, they can't afford to, they don't know how to, they cannot figure out how to. The reality is that a number of people get held hostage in work situations taht cause moral injury. How about the state employee who goes into the work thinking they can make buracratic changest hat make the systems easier for outsiders. Then you find out that the peple who are charge prefer it to be complicated and difficult to navigate. That causes moral injury.
That's one serious issue. Now what about burn out? I hear this term thrown around all of the time. But what is it? Burn out is ongoing feelings of exhaustion, negative or cynical attitudes toward work and a sense of not doing well or being ineffective. It seems to me that burn out might come from moral injury. It could also be a separate issue or maybe it isn't, maybe its a model for consideration.
Moral Injury > Burn Out > Secondary/ Vicarious Trauma
Some might say well how is this different than secondary trauma? Secondary trauma includes the feeling of being keyed up or on alert as a result of hearing the rtaumatic stroies of others. The Office of Victims of Crimes has created the Vicarious Trauma Toolkit. They suggest that instead of vicarious/ secondary trauma we can move the response to vicarious resilience or transformation. They also assert that compassion fatgue can be shifted to compassion satisfaction.
I'd like to hear your thoughts about this post. I'll be writing the next round shortly, about digesting and using this material in practice!
In gratitude and respect,
Tiffany
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