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CME/CE

Compassion Fatigue and Burnout in Healthcare Providers Caring for Patients With Cancer

  • Authors: Linda Emanuel, MD, PhD; Frank D. Ferris, MD, FAAPHM; Charles F. von Gunten, MD, PhD; Jaime H. Von Roenn, MD
  • CME/CE Released: 12/6/2011
  • THIS ACTIVITY HAS EXPIRED
  • Valid for credit through: 12/6/2012
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Target Audience and Goal Statement

This activity is intended for physicians, nurse practitioners, and physician assistants (particularly those working in the field of oncology, family medicine, general medicine, and geriatrics) in either community or hospital settings, training program directors (particularly of oncology fellowships, palliative medicine fellowships, geriatric fellowships, and family practice residencies), oncology nurses, oncology social workers, palliative care nurses, and therapists treating patients with cancer.

Healthcare providers caring for persons with cancer will learn how to prevent, recognize, and deal with compassion fatigue and burnout in themselves.

Upon completion of this activity, participants will be able to:

  1. Define burnout and compassion fatigue
  2. Recognize associated signs, symptoms, and risk factors
  3. Describe a model for organizational antecedents
  4. Contrast burnout, compassion fatigue, and depression
  5. Identify techniques to decrease burnout and compassion fatigue


Disclosures

As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.


Author(s)

  • Linda Emanuel, MD, PhD

    Author, researcher, educator, previously practicing clinician; Principal, The EPEC Project; Director, Buehler Center on Aging, Heath and Society (where the EPEC Project and its derivatives are housed), Northwestern University Feinberg School of Medicine, Chicago, Illinois

    Disclosures

    Disclosure: Linda Emanuel, MD, PhD, has disclosed no relevant financial relationships.

    Dr. Emanuel does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the US Food and Drug Administration (FDA) for use in the United States.

    Dr. Emanuel does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

  • Frank D. Ferris, MD

    Director, International Programs, Institute for Palliative Medicine at San Diego Hospice, San Diego, California; Professor, Department of Family and Preventative Medicine, University of California School of Medicine, San Diego, California; Co-principal, The EPEC Project

    Disclosures

    Disclosure: Frank D. Ferris, MD, FAAPHM, has disclosed no relevant financial relationships.

    Dr. Ferris does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics not approved by the US Food and Drug Administration (FDA) for use in the United States.

    Dr. Ferris does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

  • Charles F. von Gunten, MD, PhD

    Medical Director, Center for Palliative Studies, San Diego Hospice & Palliative Care, San Diego, California; Associate Clinical Professor, University of California, San Diego, School of Medicine; Co-principal, The EPEC Project; Past Chairman, The American Board of Hospice and Palliative Medicine

    Disclosures

    Disclosure: Charles F. von Gunten, MD, PhD, has disclosed no relevant financial relationships.

    Dr. von Gunten does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the US Food and Drug Administration (FDA) for use in the United States.

    Dr. von Gunten does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

  • Jaime H. Von Roenn, MD

    Medical Director, Palliative Care and Home Hospice Program, Northwestern Memorial Hospital, Chicago, Illinois; Professor of Medicine, Division of Hematology/Oncology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Co-Principal, The EPEC Project; Editor, EPEC-O Curriculum; Editor-in-Chief, The Journal of Supportive Oncology

    Disclosures

    Disclosure: Jamie H. Von Roenn, MD, has disclosed the following relevant financial relationships:
    Served as a director, officer, partner, employee, advisor, consultant, or trustee for: GTx; AstraZeneca
    Received income in an amount equal to or greater than $250 from: GTx; AstraZeneca

Editor(s)

  • Cheryl Arenella, MD, MPH

    Cancer Education Program Specialist, Contractor, National Cancer Institute, Office of Communications and Education, Office of Education and Special Initiatives, Rockville, Maryland

    Disclosures

    Disclosure: Cheryl Arenella, MD, MPH, has disclosed no relevant financial relationships.

CME Reviewer(s)

  • Nafeez Zawahir, MD

    CME Clinical Director, Medscape, LLC

    Disclosures

    Disclosure: Nafeez Zawahir, MD, has disclosed no relevant financial relationships.

CNE Reviewer

  • Laurie Scudder, DNP, NP

    Nurse Planner, Medscape, LLC

    Disclosures

    Disclosure: Laurie Scudder, DNP, NP, has disclosed no relevant financial relationships.

Nurse Planner

  • Susan B. Yox, RN, EdD

    Director, Editorial Content; Editor, Medscape Infectious Diseases

    Disclosures

    Disclosure: Susan B. Yox, RN, EdD, has disclosed no relevant financial relationships.


Accreditation Statements

    For Physicians

  • Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    Medscape, LLC designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Medscape, LLC staff have disclosed that they have no relevant financial relationships.

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    For Nurses

  • Medscape, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

    Awarded 0.75 contact hour(s) of continuing nursing education for RNs and APNs; none of these credits is in the area of pharmacology.

    Accreditation of this program does not imply endorsement by either Medscape, LLC or ANCC.

    Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]


Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

  1. Read the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or printed out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. Medscape Education encourages you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of your Medscape homepage.

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CME/CE

Compassion Fatigue and Burnout in Healthcare Providers Caring for Patients With Cancer

Authors: Linda Emanuel, MD, PhD; Frank D. Ferris, MD, FAAPHM; Charles F. von Gunten, MD, PhD; Jaime H. Von Roenn, MDFaculty and Disclosures
THIS ACTIVITY HAS EXPIRED

CME/CE Released: 12/6/2011

Valid for credit through: 12/6/2012

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Editor's Note:

This text has been excerpted and adapted from: Emanuel LL, Ferris FD, von Gunten CF, Von Roenn J, eds. EPEC™-O: Education in Palliative and End-of-life Care for Oncology (Module 15: Cancer Doctors and Burnout), Copyright The EPEC™ Project, Chicago, IL, 2005). The EPEC™-O curriculum was produced by The EPEC™ Project, with major funding provided by the National Cancer Institute, and with supplemental funding provided by the Lance Armstrong Foundation.

Compassion Fatigue and Burnout in Cancer Care

Working as a healthcare provider with patients who have cancer has many rewards. It can also be challenging and stressful. Stressors from work with traumatized patients and families, organizational demands, and managed care can lead to symptoms of stress and burnout that can be manifested both at work and in the home environment. Lifestyle management techniques, changes in managerial environment, and educational interventions may limit the occurrence of burnout and compassion fatigue.

This oncologist is showing evidence of burnout -- anger, exhaustion, and detachment. His coworkers voice concerns.

Burnout

Burnout, a psychological syndrome, is a response to chronic interpersonal stressors on the job.[1] The concept of burnout was first developed in the 1970s.[2]

The 3 key dimensions of this response are:

  • Individual: overwhelming exhaustion; feelings of being overextended and depleted of one's emotional and physical resources;
  • Interpersonal: cynicism (or depersonalization) and detachment from the job. Cynicism refers to a negative, callous, or excessively detached response to various aspects of the job; and
  • Self-evaluative: sense of ineffectiveness and lack of accomplishment -- Ineffectiveness refers to feelings of incompetence and a lack of achievement and productivity at work.

Pines suggests, "The root cause of burnout lies in people's need to believe that their lives are meaningful, and that the things they do -- and consequently they themselves -- are important and significant."[3] Most healthcare professionals who are treated for burnout do not come in saying they are burned out.[4] Typically, they say, "There's something wrong with me. I don't care anymore. Terrible things happen in front of me, and I feel nothing."

Compassion Fatigue

Compassion fatigue is related to, but distinct from, burnout. Figley describes compassion fatigue as "a state experienced by those helping people in distress; it is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it is traumatizing for the helper."[5] Compassion fatigue is conceptualized as consisting of 2 parts: 1) symptoms associated with burnout, such as exhaustion, frustration, anger and depression; and 2) secondary traumatic stress, the negative effects of which may include fear, sleep difficulties, intrusive images, or avoidance of reminders of past traumatic experiences.[6] Healthcare workers are at increased risk for compassion fatigue, especially those involved with highly emotionally charged situations.

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