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5. Helping Caregivers Cope with Children’s Pain
As a result of caring for children who are ill and in pain, health care providers often experience feelings of stress and burnout. Health care providers are generally caring people who want to help others. Thus, especially when they are constantly dealing with situations which are difficult or impossible to solve, they become stressed and, over time, sometimes less effective. Often the health care provider has experienced multiple losses of patients and has little time or inadequate resources to fully grieve the losses they have experienced. Over time, the unacknowledged sadness, anger, and guilt become compressed and result in cynicism and decreased ability to invest emotionally in patients.
Another feature identified in health care providers working with patients with HIV and pain is feelings of personal limitations and powerlessness to "fix" the situation. In this case, it is helpful for the health care provider to remember the power they do have; the power to provide the medical treatments which are necessary and available, to be with the patient when they are suffering, to provide hope and humor in a potentially devastating situation, and to be a positive factor in the midst of so many negative ones. Working with chronically ill children in pain often leads to powerful bond between the patient and the health care provider. In situations where the family has limited involvement, health care providers often become surrogate family.
One thing health care providers can do to help one another as they help children and families in pain is to create a supportive environment, in which responses to seeing children in pain can be expressed. Expressing these feelings can reduce isolation and normalize the experiences. Support groups for health care providers can also lead to new ways to cope with the stress of work. In these settings, it is often more important to discuss how the health care provider responds to difficult situations and to think about new ways to respond to them, than to discuss in detail the situation itself. The goal should be to express feelings, to see things in a new light, and to develop new skills and strategies for coping. Humor is also a powerful way of coping with stress. Humor, as differentiated from sarcasm, can help the health care provider to view difficult things in a positive or less critical, serious manner and to view painful experiences as a part of life rather than the whole experience of it.
Health care providers may forget that they also have needs which if left unmet will impair their ability to give care to others and themselves, and will shorten the time they are able to be effective in helping others. At times, health care providers must step back and reevaluate how to replenish themselves. The health care provider can evaluate several areas of his life which may be contributing to increased stress. Getting adequate rest is one area to evaluate. Nutrition and diet are also important. Exercise is important to maintain physical health and energy, to improve sleep, and decrease depression, and to allow work to be done with greater energy. At times, caring for children and families can become an overwhelming focus in our lives, and it is at these times the health care provider is most vulnerable. The health care provider needs to shift the focus back to his own life, reestablishing relationships with family and friends, seeking leisure and recreational activities which are fun, and increasing the quality of life overall.
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