Burnout and Compassion Fatigue

It’s That Time of Year When Morticians Become Monsters

Funeral directors can crack anytime of the year, but during the winter, it seems our mental state becomes much more vulnerable to suffering from the occupational hazards of burnout, compassion fatigue and depression.  Sure, many of us who live in the colder climates of the world suffer through the winter blues; but for those in funeral service, winter often means more sickness, more death and more stress placed upon our shoulders.

Death runs strong before, during and after the holidays … and then somewhere before the start of spring, it seems he pulls a double shift.  And as those who follow Death’s movements, we too start pulling the double shifts.

After a month or so of pulling long days, we reach a point and suddenly we feel like we have nothing left to give.  So, we push through our exhaustion and it isn’t too long before we morph into stress induced monsters.  Yes, monsters.

Death is wild.  It has no desire to be tamed.  And it’s a capricious boss.  It doesn’t follow a schedule.  It doesn’t listen to our cries for reprieve.  It doesn’t stop when we’re exhausted.  We have no control.

And this lack of control is the problem.  Since death doesn’t hear our complaints, since it can’t be fought and subdued, we funeral directors will often displace our aggression onto ourselves and our families.  And this is where the monster is made.

Pedersen, Gonzales, & Miller write that,

“Displaced aggression is thought to occur when a person who is initially provoked cannot retaliate directly against the source of that provocation and, instead, subsequently aggresses against a seemingly innocent target.”

This “seemingly innocent target” is usually those around us: our spouses, our children, our friends and ourselves.

It’s in these time of burnout that some of us start to drink more heavily; some of us will see our families fall apart before our eyes; and others (like me) will spiral down into deep dark places of depression.  Those in the funeral industry can suffer burnout anytime of the year; but during this time of the year particularly, the road can become very difficult.

Often we don’t realize we’re burnt out until it’s too late.  We’ve been working so hard trying to stay on top of the funerals we’re arranging that we simply don’t have time to reflect and take stock of our personal lives.  Our schedules become so busy that we stop going to the gym, we stop eating healthy, getting enough sleep; and we let our hobbies fall on the wayside.

And out of nowhere our partner leaves us.

Out of nowhere we’re contemplating suicide.

Out of nowhere we’re using a destructive coping mechanism to get through the stress of Death’s spree.

Maybe I’m wrong, but I’ve noticed that the funeral industry doesn’t offer a good support system when it comes to the personal mental and physical health of its workers.  When one of us gets burnt out, there’s rarely someone there to council you.  Maybe I’m wrong, but I don’t see those in funeral service being encouraged to see out professional help from psychologists.

And maybe it’s time to change that.  Maybe it’s time we start recognizing that it happens often in this industry.  Maybe it’s time to start doing something about it.

So, if you’re burnt out right now, let me encourage you: seek help.  It’s not okay for you to be burnt out.  In fact, you’re robbing your family and friends, the people you serve and yourself.  You are NOT strong enough to do this on your own.  It’s time to overcome the monster.

Battling Burnout: How Funeral Directors Find Peace in the Midst Of Chaos

(This article was originally published in the October issue of The Director. Written for ASD – Answering Service for Directors by Jessica Fowler.  Used by permission.  

We — at the Wilde Funeral Home — daily use the answering services of ASD; and our customers, no matter how distraught when they call, are always met with a professional and caring voice.)
Funeral Director Thomas Gale counts ceiling tiles. Each one represents another moment in his life to remember not to take for granted. For nearly 20 years, Gale has been a funeral director at Currie Funeral Home in Kilmarnock, VA, and has learned how to balance his professional and personal life after his own brush with mortality.

Gale remembers lying immobile in a hospital bed during a heart procedure several years ago, his only outlet the ceiling tiles above him. When he counts them now, it is to remind him to take regular breaks, set time aside for hobbies and accept assistance from others.

“We take better care of our cars than we take care of ourselves,” Gale says. “If you see a blinking red light in your car, you’re going to pull off the road to get it serviced. Yet, we have warning signs go off in our lives all the time, but we keep driving until we have a major crash.”

A funeral home operates on a constant, 24-hour rotation that never sleeps. On a daily basis, funeral directors must deal with economic, operational and emotional stress, as well as the demands of providing compassion to the bereaved. In Funeral Home Customer Service A-Z: Creating Exceptional Experiences for Today’s Families, author Dr. Alan Wolfelt outlines the symptoms of what he calls “funeral director fatigue syndrome.” Known generally as “compassion fatigue”, this syndrome is common among caregivers who focus solely on others without practicing self-care, leading to destructive behaviors. Some common symptoms include:

*Exhaustion and loss of energy 
*Irritability and impatience 
*Cynicism and detachment 
*Physical complaints and depression 
*Isolation from others

While the admirable goal of helping bereaved families may alone seem to justify emotional sacrifices, ultimately we are not helping others effectively when we ignore what we are experiencing within ourselves,” Wolfelt says. “Emotional overload, circumstances surrounding death and caring about the bereaved will unavoidably result in times of funeral director fatigue syndrome.”

Dramatically changing these behavior patterns and adopting positive, healthy habits help these symptoms diminish overtime. While it can be easy for funeral directors to get swept up in the workload, it is often considerably more difficult to allocate free time for leisure. Here are some tips from directors and experts on how to defeat feelings of funeral director burnout:

Family Matters

According to Tim O’Brien, author of A Season for Healing – A Reason for Hope: The Grief & Mourning Guide and Journal, funeral professionals must maintain a near-constant demeanor of strength and self-possession, rarely displaying their emotions.

“Those characteristics are exactly why they need to take time for themselves and practice sound stress management techniques,” O’Brien says. “Yes, they do have to show outward composure and be the steady hand in public. However, they can and should have private time for exploring and expressing emotions. The alternative is often premature death.”

In a recent article for The Director, O’Brien cited irregular hours, interpersonal relationships with employees, limited free time and the often-depressing environment that grief can create as some of the main reasons directors experience compassion fatigue. However, finding a way to strike a balance between professional and personal isn’t as simple for small town funeral homes where the two categories are often one and the same.

Director Stephen Hall grew up in the funeral home business and has worked at the family owned and operated Trefz & Bowser Funeral Home in Hummelstown, PA since he was 12 years old. As an experienced director living in a small town, it is often difficult for Hall to step away from his numerous responsibilities but he has found that the nature of the job offers its own share of rewards as well.

“When my kids were younger, if there was a slow day at the funeral home I was free to attend activities at school because I set my own schedule,” Hall says.

The fine line between personal and professional has always been especially faint for Funeral Director Derek Krentz. He resides at the Gardner Funeral Home in White Salmon, WA with his wife Dominique, also a director, and their children. While Krentz rarely takes vacations, he feels fortunate to work side by side with his wife and still function as a family.

“Its not on common for the kids to do their homework while we’re working. Very often we’re folding memorial folders and laundry at the same time in the middle of the living room floor,” Krentz says. “We rarely go anywhere more than an hour away. You just learn to enjoy being at home.”

Embrace Technological Solutions

In the past, funeral professionals would remain near their firm’s telephone at all times to secure new business and provide families with assistance day or night. Many firms still operate with skeletal staffs, employing only a handful of full-time employees to share the workload. However, in the past decade, new technology and services have emerged that cater to the funeral home industry and help directors conduct business more efficiently.

“With new technology, we’re no longer tethered to a physical location anymore,” Hall says. “Pagers and cell phones have given us the freedom to run our business practically from anywhere.”

Improvements in telecommunications have allowed directors to remain available to families anytime they step out of the office. Whenever Hall has to step out of the office, either for a few minutes or for the evening, he forwards his phone lines to a funeral home exclusive answering service that records detailed messages and contacts Hall for any urgent or first calls.

“When ASD (Answering Service for Directors) came around it was a god send because their people know the profession. All of our calls are screened so we only have to address important concerns right away. ASD can field a lot of the questions that would have been another phone call for me to make,” Hall says. “Now that they have broadened out with the web connection I can log in to see the activity and if there is anything that needs to be addressed immediately.”

Other organizations work to decrease the time consumed by daily tasks at the funeral home. Life insurance assignment companies expedite insurance payments that can otherwise take months for funeral homes to receive. Many funeral professionals rely on removal services to transport decedents after office hours. Software companies have adopted new technology to speed up the process of death certificate filing, obituary placement, and much more.

Yet there is a still a slight stigma associated with modern funeral home practices and some multi-generational and small town firms continue to employ an older business model based on 24/7 availability. Many funeral home owners avoid hiring extra help or seeking assistance from other companies in an effort to provide families with a more personal touch.

“I’m not that computer savvy so I just prefer sitting down with a family while they’re making arrangements and write it down rather than type it into a computer,” Krentz says. “I just find it more personable.”

As President of the Association of Independent Funeral Homes of Virginia and a director in a small, tight-knit community, Gale knows first hand the pressure placed on directors to uphold traditional values. It is the reason why he still sometimes counts the ceiling tiles above his desk—to remember to never ignore his own needs or take his life for granted.

“I remember the old regime of remaining available all the time,” Gale says. “While you still have to be available, you don’t have to do it all alone.”

Care For Yourself So You Can Care For Others

According to O’Brien, funeral professionals are highly likely to develop compassion fatigue without “professional detachment, a positive attitude in the midst of an apparent negative atmosphere, regular personal time and good dietary, sleep and exercise habits.”

Every person needs an outlet: an activity they enjoy that should never feel like work. For funeral professionals, it is essential to seize any opportunity for personal enjoyment, even if only for a few hours.

“I don’t get away a lot but I’ve learned that when things are slow, go fishing, because you don’t know when the phone is going to ring again,” Krentz says.

Like Kretz, Gale is also an avid fisherman and finds the peace and serenity of being out on the water help him restore his state of mind and return to the funeral home with a clearer perspective. He also believes that surrounding yourself with other community members is invaluable to never losing sight of the reason you do your work.

According to Gale, “You’ll become a better person, a better funeral director and just a better over all servant to the people around you if you can care for yourself.”

A change of scenery is also a vital ingredient for maintaining a balanced lifestyle. Apart from the time spent away, physical space acts as a barrier between the mind and the stress agent, in this case, the funeral home office. No one can consistently give 100 percent day in and day out. Regular breaks provide the rest necessary to renew motivation for returning to work.

Last year, Gale took a vacation to spend time with his family in Virginia Beach, VA. For the first time ever, he wanted to free his mind and pretend for one straight week that the funeral home did not exist. At first, the time apart was excruciating. He spent the first 24 hours fighting the urge to check his messages, unable to break decade-old habits of remaining on top of all business, no matter the time or day.

Eventually, he was able to settle in and truly enjoy his break.

“Even the greatest of engines can’t run all of the time without being serviced,” Gale says.

*****

Jessica Fowler is a freelance writer and Public Relations Specialist for ASD – Answering Service for Director where she has answered calls for funeral homes for more than 8 years. Jessica earned her Degree in Journalism from Temple University in Philadelphia, PA and has written articles for The Director, Mortuary Management and American Funeral Director in addition to local travel publications. She can be reached at jess.fowler@myasd.com.

I Don’t Smile When I Embalm Bodies

Earlier this week a contentious discussion brewed on my Confessions of a Funeral Director Facebook page.  And I’d like to address the topic in my blog’s forum.

The discussion was kick-started when I posted this status:

The second comment on the above status was from a fellow embalmer named Allison, who said this:

Allison’s initial comment eventual prompted this comment from a former embalmer named Kristie.

 

First off, let me say it’s possible for an embalmer to be both 100% for tissue/organ donation and not enjoy the process of preparing a donor.  It’s possible for us to be both professionals and human.  I’m one such funeral director.  I am firmly and unequivocally a supporter of those who choose to find life in a tragic death, and yet when a donor body comes through the morgue door, it’s not Christmas morning.

I know that the best donors are usually young and they usually die from tragic (not necessarily violent) circumstances that leave their body in decent condition to be harvested.

I have immense respect for families who — in the midst of incredible tragedy and darkness — find a way to overcome their pain and chose life by allowing for the harvesting of a body they love so dearly.  This act of donation is one of the few genuinely unselfish acts to be found in humanity.

Yet, while I recognize the intense moral beauty and life saving value of organ donation, I’m less than excited to embalm and prepare a donor’s bodies.

Each funeral home and funeral director is different.  Some funeral homes are large enough to have shift work; still others are large enough to employ full-time embalmers, who basically embalm body after body all day.  Some funeral homes have secretaries, prearrangement directors, at-need directors, full-time pick-up people, etc., etc.  But for many of us small firms, we play role of embalmer, secretary, pick-up/livery person, funeral director, at-need director and pre-need director.  We’re on call 24/7 and rarely have an uninterrupted holiday.

Our personal lives are not just blurred with our professional lives, they become one and the same, often resulting in sad endings.  Divorce.  Depression.  Burnout.

Our pay doesn’t always justify what this profession takes from us.  According to the BLS, the average embalmer makes $45,060, which isn’t bad until you consider that the salary often comes at the expense of our souls.  I’ve worked 20 hour days.  I’ve worked 100 hour weeks.  Most months I get two days off.  This month, my weekend off happens to be this weekend and with the snow coming, I may have to work the plow on one of my “days off.”  And when I am home, it’s hard to get comfortable as I’m one phone call away from going back to work.

I was up until 12 midnight writing this post and then at 3:30 AM I was called into work.  I won’t be finished work until roughly 5:30 PM.

Here’s a picture of me at the nursing home at 4:40 this morning.  The smile is real … the nurses were making fun of me for taking the photo.

And although this isn’t about me and the burdens I carry, I will say that my experience isn’t exceptional.  The at-need demand, emotional and long hours take their toll on us as people.

So, when the heart is donated and I have to raise six arteries instead of one, I don’t smile.

When there’s bone donation, I don’t look forward to moving the Styrofoam rods around to make the appendages look natural.

When skin is grafted, I don’t smile when I’m cleaning the seepage off the floor.

When I get various liquids on myself because of the intrinsic messy nature of donor bodies, my face doesn’t crack a grin.

Unless I’m listening to stand-up comedy on the morgue’s radio, I don’t embalm bodies with a smile.

I appreciate Kristie’s assertion that she has never thought about complaining when preparing a body.  And I appreciate that she always sees it as an honor.  I will be the first to admit that Kristie is probably a better person and funeral director than I am.  Maybe her suggestion to Allison (that Allison should find another profession) applies to me as well.

But, I, in contrast to Kristie, think it does us funeral directors well to be honest.  Maybe not in a public forum like I’m doing now, but we need to recognize that we’re both professionals and human.  We love to serve you, but there’s times when we too need to be helped.  We need to fight that perception that to be a professional means being an unfeeling robot.  We need to ask for help, sometimes we need to seek counselling.  If you’re a funeral director and you don’t embalm donor bodies with a smile, it’s okay.

 

 

Are You Suffering from Compassion Fatigue?

 

If you think you are suffering from Compassion Fatigue, Burnout or Secondary Trama, THIS TEST IS VERY IMPORTANT! If you’re like me, you may think you’re suffering, but you won’t reach out for help until you have an objective voice confirming your own perceptions.   This test is that secondary voice!  If you “fail”, it’s time for you to consider seeking professional care!

There’s a difference between burnout and compassion fatigue.  Burnout in the workplace is a more general term that relates to anybody in a stressful situation, while compassion fatigue is a phenomena that specifically relates to those of us who are professional caregivers.

Being that funeral directors are susceptible to compassion fatigue AND have an uncontrolled work environment, we are especially vulnerable to burnout, as well as secondary trama. I’ve bordered compassion fatigue and burnout a couple times as an undertaker, and sometimes I’ve crossed the line into the danger zone where dark depression and self-infliction reside.

And I’ve often wondered if there’s a way to define whether or not a caregiver (such as a funeral director, nurse, doctor, etc.) is indeed suffering from compassion fatigue and/or burnout.

Here’s a test I found.

It’s long. And if you want to complete it, it might take about 15 minutes.  Probably the easiest way to take it is to print out this entire article by using the “Print” button at the bottom. If you “fail” the test, seek help.

PROFESSIONAL QUALITY OF LIFE SCALE (PROQOL) COMPASSION SATISFACTION AND COMPASSION FATIGUE (PROQOL) VERSION 5 (2009)

When you [help] people you have direct contact with their lives. As you may have found, your compassion for those you [help] can affect you in positive and negative ways. Below are some questions about your experiences, both positive and negative, as a [helper]. Consider each of the following questions about you and your current work situation.

Select the number that honestly reflects how frequently you experienced these things in the last 30 days.

1=Never  2=Rarely  3=Sometimes  4=Often  5=Very Often

1. I am happy.

2. I am preoccupied with more than one person I [help].

3. I get satisfaction from being able to [help] people.

4. I feel connected to others.

5. I jump or am startled by unexpected sounds.

6. I feel invigorated after working with those I [help].

7. I find it difficult to separate my personal life from my life as a [helper].

8. I am not as productive at work because I am losing sleep over traumatic experiences of a person I [help].

9. I think that I might have been affected by the traumatic stress of those I [help].

10. I feel trapped by my job as a [helper].

11. Because of my [helping], I have felt “on edge” about various things.

12. I like my work as a [helper].

13. I feel depressed because of the traumatic experiences of the people I [help].

14. I feel as though I am experiencing the trauma of someone I have [helped].

15. I have beliefs that sustain me.

16. I am pleased with how I am able to keep up with [helping] techniques and protocols.

17. I am the person I always wanted to be.

18. My work makes me feel satisfied.

19. I feel worn out because of my work as a [helper].

20. I have happy thoughts and feelings about those I [help] and how I could help them.

21. I feel overwhelmed because my case [work] load seems endless.

22. I believe I can make a difference through my work.

23. I avoid certain activities or situations because they remind me of frightening experiences of the people I [help].

24. I am proud of what I can do to [help].

25. As a result of my [helping], I have intrusive, frightening thoughts.

26. I feel “bogged down” by the system.

27. I have thoughts that I am a “success” as a [helper].

28. I can’t recall important parts of my work with trauma victims.

29. I am a very caring person.

30. I am happy that I chose to do this work.

SCREENING

Based on your responses, place your personal scores below. If you have any concerns, you should discuss them with a physical or mental health care professional.

COMPASSION SATISFACTION

Compassion satisfaction is about the pleasure you derive from being able to do your work well.  For example, you may feel like it is a pleasure to help others through your work. You may feel positively about your

colleagues or your ability to contribute to the work setting or even the greater good of society. Higher scores

on this scale represent a greater satisfaction related to your ability to be an effective caregiver in your job.

Test Results Scale for Compassion Satisfaction

3.  ____   6.  ___   12.  ____  16.  ____  18.  ____  20.  ____  22.  ____  24.  ____  27.  ____  30.  ____  Total: _____

The sum of my Compassion Satisfaction questions:

22 or less 43 or less =  Low // Between 23 and 41 = Average // 42 or more = High

BURNOUT

Most people have an intuitive idea of what burnout is.  From the research perspective, burnout is one of the elements of Compassion Fatigue (CF). It is associated with feelings of hopelessness and difficulties in dealing

with work or in doing your job effectively. These negative feelings usually have a gradual onset. They can

reflect the feeling that your efforts make no difference, or they can be associated with a very high workload or

a non-supportive work environment. Higher scores on this scale mean that you are at higher risk for burnout.

Test Results Scale for Burnout:

*1.  ____   *4.  ____   8.  ____  10.  ____  *15.  ____  *17.  ____  19.  ____  21.  ____  26.  ____  *29.  ____

Reverse the scores for those that are starred. 0=0, 1=5, 2=4, 3=3, 4=2, 5=1

Total: ____

22 or less = Low // Between 23 and 41 = Average // 42 or more = High

SECONDARY TRAUMA

The second component of Compassion Fatigue (CF) is secondary traumatic stress (STS). It is about your work related, secondary exposure to extremely or traumatically stressful events. Developing problems due to exposure to other’s trauma is somewhat rare but does happen to many people who care for those who have experienced extremely or traumatically stressful events. For example, you may repeatedly hear stories about the traumatic things that happen to other people, commonly called Vicarious Traumatization. If your work puts you directly in the path of danger, for example, field work in a war or area of civil violence, this is not secondary exposure; your exposure is primary. However, if you are exposed to others’ traumatic events as a result of your work, for example, as a therapist or an emergency worker, this is secondary exposure. The symptoms of STS are usually rapid in onset and associated with a particular event. They may include being afraid, having difficulty sleeping, having images of the upsetting event pop into your mind, or avoiding things that remind you of the event.

Test Results Scale for Secondary Trama

2.  ____  5.  ____  7.  ____  9.  ____  11.  ____  13.  ____  14.  ____  23.  ____  25.  ____  28.  ____     Total: _____

22 or less = Low // Between 23 and 41 = Average // 42 or more =High

IF YOU WANT MORE ANALYSIS OF YOUR SCORE, CLICK HERE: PROFESSIONAL QUALITY OF LIFE SCALE (PROQOL) COMPASSION SATISFACTION AND COMPASSION FATIGUE (PROQOL) VERSION 5 (2009)

My Job Proposed and I Said “No”

It’s been 30 straight days since I’ve had a day off.

Work has never hurt me.  Good work is fuel to the body and soul.  And the funeral business is good work.  It is meeting needs that only you – as funeral director – can meet.  It’s easing an otherwise impossible task for the bereaved.  It’s so good that many directors marry this business.  It’s easy to marry this business.

To commit to it as your first love.  It’s easy to pledge your heart to this one thing and no other.

It’s easy to let your own family take second in your priority list.

It’s easy to allow your personal life to get swallowed up by the voracious appetite of death care.

Like many other businesses, if you don’t marry it, it begs.  It begs for your attention.  Your time.  It begs for your heart.  It begs for your soul.  It begs for you to miss your kid’s games.  It begs of you to skip the date night with your special someone.  It begs you to miss church.

This business will take you and romance you into believing that you … YOU are THE ONE … the only one who can meet the needs of the family.

And I’m afraid that one day I’ll give up and concede.  I’ve been in this business for 10 years now and if feels like it’s becoming less and less “what I do” and more and more “who I am.”

And I have nothing against committing to a job for a lifetime; my problem is having my sense of freedom erode day by day.  The more I become embedded, the harder it will become to “get out” … if I should ever choose to “get out.”  Will I eventually marry this business and sacrifice my dreams to earn a Ph.D.?  Will I become like so many others and just let this business take my soul?

It’s not the hard work, the late hours, the fact that I didn’t get done working until 1 AM this morning … it’s the fact that it’s slowly eating away at me.  I’m becoming this business and this business is becoming me.

I love caring for families, helping them walk through the valley of the shadow.  I enjoy putting my heart into this business, but I won’t give it my soul.

I haven’t married it.  I won’t marry it.  I won’t let it define me.

And this is why:

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