Caring for cancer patients is challenging work. There can be very few professions that demand so much of their practitioners. It is important that we acknowledge this fact. Every day we are faced with clinical situations that demand both our professional expertise and our personal compassion. All of our patients are confronting a potentially life-threatening disease that, together with our intrusive therapies, very often produces tormenting physical symptoms and devastating psychosocial repercussions. Although our professional training may have prepared us well to master the technical challenges of our work, our professional schools have not prepared us to understand and navigate the human dimensions of our work as healers. Each of us has typically needed to find our own way through to navigating the experiential aspects of our work. Unfortunately, recent research demonstrates that despite our best efforts, the task of caring for cancer patients is exacting a substantial toll on our wellness and is also negatively impacting our ability to provide optimum care for our patients. As wounded healers, we often find ourselves emotionally and physically deplete and therefore unable to meet the needs of our patients, and ourselves. In this regard, recent research reveals a dispirited profession. Suicide rates for physicians are estimated to be as high as six times that of the general public, and 17% of physicians reported their mental health as fair or poor (more than twice the national average) and 46% described their medical practice as very or extremely stressful.1,2,3
This chapter reviews:
(a) some key concepts relating to wellness and stress in clinicians;
(b) recent research on the current state of health care provider wellness;
(c) the impact of health care provider stress and burnout on patient care;
(d) specific strategies to enhance health care provider wellness.
It is important to understand several key concepts as they relate to wellness, that is, wellness, resilience, and burnout.
Although there is currently no universally accepted definition for "wellness," there is a growing consensus that "wellness" is a multidimensional construct that describes a positive state (rather than simply the absence of illness). Dunn4 has defined wellness as "an integrated method of functioning, which is oriented toward maximizing the potential of which the individual is capable. It requires that the individual maintain a continuum of balance and purposeful direction within the environment where he is functioning." Rather than being an "all or nothing" concept (like allopathic disease models), wellness describes a continuum and a movement to optimal well-being and human flourishing. The concept of wellness can sometimes be challenging to allopathic health care professionals who have a medical model that is constructed on a foundation of treating disease, and not supporting positive health. Since allopaths receive almost no training in recognizing and supporting the positive aspects of health, it is not surprising that they ...