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"Being Connected . . . A Key to My Survival"

Michael K. Kearney, MD; Radhule B. Weininger, MD, PhD; Mary L. S. Vachon, RN, PhD; Richard L. Harrison, PhD; Balfour M. Mount, MD

JAMA. 2009;301(11):1155-1164.

Physicians providing end-of-life care are subject to a variety of stresses that may lead to burnout and compassion fatigue at both individual and team levels. Through the story of an oncologist, we discuss the prodromal symptoms and signs leading to burnout and compassion fatigue and present the evidence for prevention. We define and discuss factors that contribute to burnout and compassion fatigue and consider factors that may mitigate burnout. We explore the practice of empathy and discuss an approach for physicians to maximize wellness through self-awareness in the setting of caring for patients with end-stage illness. Finally, we discuss some practical applications of self-care in the workplace.

Author Affiliations: Palliative Care Service, Santa Barbara Cottage Hospital and Visiting Nurse and Hospice Care of Santa Barbara (Dr Kearney), and La Casa de Maria Retreat and Conference Center (Dr Weininger), Santa Barbara, California; Department of Psychiatry and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (Dr Vachon); Counseling Psychology Program, University of British Columbia, Vancouver, Canada (Dr Harrison); and Department of Medicine, McGill University, Montreal, Quebec, Canada (Dr Mount).

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