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Herman & Wallace Blog

Our care is as important as our patients

This post is part two of Nari Clemon's series on practitioner burnout, compassion fatigue, and the story of a pelvic rehab therapist who struggled to care for herself while caring for patients. Read part one here.

There is a point where caring so much and wanting to help becomes counter-productive to us, until we burn out. We can develop true compassion fatigue. Compassion fatigue makes us feel apathetic, spent, and sometimes even jaded or cranky. But, how do we turn that caring off in time? Our compassion is what led us to this field in the first place.

That day, I talked to my colleague and close friend, whom I was teaching with, Jen VandeVegte. Jen and I both felt that conversation was a wake-up call. We talked about seeing this same scenario at our courses: so many amazing therapists getting spent, and our best therapists getting burnt out. People were coming back with enhanced skills course after course, but many of them were looking weary and tired...

In the prior years, Jen and I were both trying to be mindful and intentional. But, it hadn’t been enough in our own lives. I remember thinking, “I’m mindful I’m getting drained and there is a creeping sensation of fatigue as I am working with this patient. Now what?” There seemed to be some pitfalls many of us were getting trapped in. We noticed there were certain patients who drained us more: when the role was therapist as hero and patient as victim. There were themes of not being able to leave the patient stories at work, finding ourselves laughing less, being less adventurous. There also seemed to be a link with empathy. Those of us who were more empathic carried burdens differently than our more concrete minded peers.

For myself, I had to hit bottom to learn how to climb back out. It got to the point where I didn’t honestly want to go to my thriving private practice and treat patients. I was treating more and more complex patients and leaving work drained, despite having a repertoire of advanced skills. I remember consulting with many people trying to understand how to stop this process of my patients’ illnesses and moods bleeding into my space and my body. People told me all kinds of things: “Imagine wearing gloves that are impenetrable”, “Picture a plexiglass box around yourself”, or “Just decide it is a one way flow.” None if it worked for me. I studied Reiki and worked with therapists. Still, I was so spent after treating patients. When I moved from Indiana to Portland, I took a whole year off of work with a singular mission: get healthy and figure out how to stay that way in my work. There was no book on this. There were some crazy stories and consults that made me realize I was heading in the wrong direction, and I finally learned the key concepts that changed my life.

And oddly enough, my great friend, Jen, also had to transform. We talked honestly and shared our failures, fears and successes as we learned. We committed to being real and honest about what parts of us were stuck in old, unhelpful paradigms. Some of these were playing the hero, feeling like there should not be limits on our compassion, not holding boundaries with what was ours to own, facing difficult things within ourselves, learning how to deeply own the space in our own bodies, and accepting that as intuitive, empathic women, we can’t expect ourselves to reproduce a very masculine, directive method of treating that denies so much of who we actually are. We also changed how we dialogued with patients from the outset. We read and researched and learned how to apply a shared responsibility model from the first contact with our patients and how to hold that model during the course of care. We then applied more pain theory and how to educate patients on those aspects of their own recovery to encourage a model of mind-body wellness and responsibility for their own reframing with our guidance. I created a mediation for pelvic health CD, so patients had a clear way to practice these home programs.

Jen and I both found that as we healed and re-framed there was a great freedom and honesty that emerged in our lives and our practices. We would get together to teach Capstone and were filled with gratitude for how much had shifted and that work no longer felt like a burden. Our lives were more balanced and we were physically, mentally and emotionally stronger. We felt like we had found the holy grail of balanced practices.

But, there we stood, teaching so many of our peers who were clearly in the same quicksand that had been plaguing us in the past. Where could our colleagues who were at our series courses go to learn how to do this job and navigate their days differently? How could they feel as good at the end of the day as they did before they saw patients? This was the training many pelvic therapists needed to thrive in this field AND their life, but it had taken us so many years. This was our call to action.

We all take courses on how to help our patients and how to reach those few difficult patients and help them. Yet, as medical professionals, we do not have enough training in how to care for ourselves. At some point, we all need to realize that our care is as important as our patients. Our wellness, physical, mental, and emotional also matter and may actually be necessary to keep helping patients. Enjoying our lives is no less important. It is an investment in your family, your future patients, and yourself to take a few days to peel back and deeply examine the root of why work is so taxing and come up with a clear, individualized plan to take your life, joy and passion back…without leaving pelvic rehab.

We need all of you in this field. We want to help you stay in this field and stay in it well! Please come join us in Boundaries, Self-Care and Meditation for a retreat-like weekend to change the framework of your practice and commit to your own wellness as a provider. Come learn how to shift dynamics from your first interaction with patients and how to hold that space. You are worth it!

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Upcoming Continuing Education Courses

Boundaries, Self-Care, and Meditation - Remote Course

Sep 12, 2020 - Oct 11, 2020
Location: Replacement Remote Course

Pelvic Floor Level 2A - Atlanta, GA (Postponed)

Sep 25, 2020 - Sep 27, 2020
Location: Emory Healthcare

Nutrition Perspectives for the Pelvic Rehab Therapist - Winfield, IL (Postponed)

Sep 25, 2020 - Sep 27, 2020
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Low Pressure Fitness for Pelvic Floor Care - Houston, TX (Postponed)

Sep 25, 2020 - Sep 27, 2020
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Sacral Nerve Manual Assessment and Treatment - Vancouver, WA (Postponed)

Sep 25, 2020 - Sep 27, 2020
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Pelvic Floor Level 1 - Mequon, WI Satellite Location

Sep 26, 2020 - Sep 27, 2020
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Pelvic Floor Level 1 - Atlanta, GA (Postponed)

Sep 26, 2020 - Sep 27, 2020
Location: Emory Healthcare

Coccydynia and Painful Sitting - Philadelphia, PA (Postponed)

Sep 26, 2020 - Sep 27, 2020
Location: Core 3 Physical Therapy

Nutrition Perspectives for the Pelvic Rehab Therapist - Remote Course (SOLD OUT)

Sep 26, 2020 - Sep 27, 2020
Location: Replacement Remote Course

Pelvic Floor Level 1 - Milwaukee, WI (Postponed)

Sep 26, 2020 - Sep 27, 2020
Location: Aurora Medical Center

Pelvic Floor Level 1 - Columbia, SC (Postponed)

Sep 26, 2020 - Sep 27, 2020
Location: Columbia Rehabilitation Clinic

Pelvic Floor Level 1 - Self-Hosted

Sep 26, 2020 - Sep 27, 2020
Location: Self-Hosted Course

Pelvic Floor Level 1 - Decatur, GA Satellite Location (SOLD OUT)

Sep 26, 2020 - Sep 27, 2020
Location: Emory Healthcare

Pelvic Floor Level 1 - Columbia, SC Satellite Location (SOLD OUT)

Sep 26, 2020 - Sep 27, 2020
Location: Columbia Rehabilitation Clinic

Pelvic Floor Level 1 - Minnetonka, MN Satellite Location (SOLD OUT)

Sep 26, 2020 - Sep 27, 2020
Location: Viverant

Pelvic Floor Level 1 - Marietta, GA Satellite Location

Sep 26, 2020 - Sep 27, 2020
Location: Southern Pelvic Health

Pelvic Floor Level 1 - Satellite Lab Course

Sep 26, 2020 - Sep 27, 2020
Location: Replacement Remote Course

Pelvic Floor Level 1 - Orland Park, IL Satellite Location

Sep 26, 2020 - Sep 27, 2020
Location: Palos Community Hospital

Pelvic Floor Level 1 - Columbus, OH Satellite Location

Sep 26, 2020 - Sep 27, 2020
Location: Fitness Matters

Pelvic Floor Level 1 - Colorado Springs, CO Satellite Location (SOLD OUT)

Sep 26, 2020 - Sep 27, 2020
Location: Strive Physical Therapy

Pelvic Floor Level 1 - Torrance, CA Satellite Location

Sep 26, 2020 - Sep 27, 2020
Location: Women's Advantage Inc

Pelvic Floor Level 1 - Kenosha, WI Satellite Location (Sold Out)

Sep 26, 2020 - Sep 27, 2020
Location: Aurora Health Care

Pelvic Floor Level 1 - Lansing, MI Satellite Location

Sep 26, 2020 - Sep 27, 2020
Location: Physical Therapy Services of Lansing

Mobilization of Visceral Fascia: The Urinary System - Phoenix, AZ (Postponed)

Oct 2, 2020 - Oct 4, 2020
Location: Banner Physical Therapy and Rehabilitation

Mobilization of Visceral Fascia: The Urinary System - Medford, OR Satellite Location

Oct 2, 2020 - Oct 4, 2020
Location: Asante Rogue Valley Medical Center

Mobilization of Visceral Fascia: The Urinary System - Self-Hosted

Oct 2, 2020 - Oct 4, 2020
Location: Self-Hosted Course

Mobilization of Visceral Fascia: The Urinary System - San Diego, CA Satellite Location

Oct 2, 2020 - Oct 4, 2020
Location: FunctionSmart Physical Therapy

Mobilization of Visceral Fascia: The Urinary System - Colorado Springs, CO Satellite Location

Oct 2, 2020 - Oct 4, 2020
Location: Manual Edge Physiotherapy

Mobilization of Visceral Fascia: The Urinary System - Fairlawn, NJ Satellite Location

Oct 2, 2020 - Oct 4, 2020
Location: Bella Physical Therapy