By Rabbi Nadia Siritsky
In Conjectures of a Guilty Bystander, Thomas Merton wrote, “There is a pervasive form of contemporary violence to which the idealist most easily succumbs: activism and overwork. The rush and pressure of modern life are a form, perhaps the most common form, of its innate violence. To allow oneself to be carried away by a multitude of conflicting concerns, to surrender to too many demands, to commit oneself to too many projects, to want to help everyone in everything, is to succumb to the violence of our times. The frenzy of our activism neutralizes our work for peace. It destroys our own inner capacity for peace. It destroys the fruitfulness of our own work, because it kills the root of inner wisdom which makes work fruitful.”
These wise words present a challenge for those of us working in healthcare, especially in the emergency department. The very definition of working in such a setting is to want to help everyone, and to be thrust in the midst of an array of conflicting concerns, all of which are urgent, and many of which are the direct result of the violence of our times.
Compassion fatigue and vicarious trauma are often the consequence of working in healthcare, but they can be particularly challenging for those working in the Emergency Department. The pace and the acuity contribute to this, as does the sad reality that most emergency responders only see the patient at their worst, and rarely get to see them healed and recovered. This contributes to a lack of compassion satisfaction, which Beth Hudnall Stamm identifies in her research as a mitigating factor.
Burnout, while common for healthcare providers, can lead to a variety of other concerns, ranging from staff retention issues and patient experience challenges, to safety concerns due to forgetfulness and even health problems. As such, addressing staff compassion fatigue and burnout is critical.
The pastoral challenge is to enter the emergency department and not succumb to the chaos and violence that pervades that space, to be present with providers and to help them to reconnect to Merton’s “root of inner wisdom which makes work fruitful.” Carving out space for caregivers to debrief and reflect upon meaning and purpose is the primary goal. Meaning-making is the key to developing the capacity to find compassion satisfaction.
Dr. Viktor Frankl taught, “Life is never made unbearable by circumstances, but only by lack of meaning and purpose.” While it may seem difficult to schedule or prioritize, pastoral care and support for staff working in emergency departments must be a top priority. Helping staff carve out time to reflect upon the meaning and purpose of their work will help them to derive greater satisfaction, which in turn will ensure improved patient care.
Leviticus enjoins us to love our neighbor as we love ourselves. This means that it is not selfish to schedule time for rest and reflection on the emergency department’s to-do list. Even if it is simply taking a moment to pause and breathe at the beginning and the end of a shift; or ensuring that the chaplain’s rounds include emergency department staff, not only patients; or taking a moment to pause in silence when a patient dies — each of those moments can become anchoring moments that can root caregivers during stormy times.
Rabbi Nadia Siritsky, MSSW, BCC, is vice president of mission at Jewish Hospital in Louisville, KY.