Building Resilience for Military Health Professionals

U.S. Navy photo by Mass Communication Specialist 1st Class Monique Hilley

Many of our warriors depend on behavioral health professionals to help them cope with stressors that occur during their military service. Treating and supporting these brave men and women can be extremely satisfying, and most individuals who choose this line of work find it to be very rewarding.

Nevertheless, over time, working as a mental health professional — particularly with those who have endured traumatic experiences — can become increasingly stressful and can at times lead to some common stress reactions. In fact, these reactions are seen among military and civilian providers, rescue workers and disaster responders.^{1 [1]} If you or a co-worker are experiencing difficulties due to the cumulative stress (sometimes called compassion fatigue) of this challenging work, the information below can be used to build resilience through proactive self-care and stress management.

Common Stress Reactions in Health Professionals

Civilian and military health professionals alike may work closely with trauma survivors. And although some individuals will not experience lasting stress from this challenging work, some may manifest the effects of stress in the following ways:^{2 [2]}

• Nervousness and anxiety, including heightened vigilance about safety
• Anger and irritability
• Mood swings or emotional outbursts
• Lowered self-esteem and feelings of helplessness
• Feeling cynical, jaded or less able to trust others
• Difficulty concentrating
• Withdrawal from others
• Trouble sleeping because of nightmares related to patients’ traumatic experiences
• Depression or suicidal ideation

These common reactions to stress can simply be the way that the body and mind naturally cope with difficult psychological situations.^{3 [3]} If you are experiencing any of these signs, you can use the self-care strategies outlined below to bolster your resilience and maintain peak functioning.

Self-Care Strategies for Resilience

Ignoring manifestations of the stress that can sometimes result from working with trauma survivors can lead to more serious issues. While every individual’s self-care needs are different, the following strategies can be used to build resilience by those who work with trauma survivors:^{2, [2]4 [4]}

• Focus on the positive impact of your work. Those who provide treatment for trauma survivors in our nation’s military and military families offer an extremely valuable service that has a real, positive impact on warriors’ lives. Focus on the powerful impact your efforts have on the service members in your care. Under stress you may be more likely to focus on the cases that have not gone well and may minimize the positive outcomes of your work.
• Talk to your colleagues for support. Telling your story to other health professionals in a similar line of work — and listening to theirs as well — can help you feel less isolated. You can connect with others at the Real Warriors Health Professionals Message Boards [5] or by finding support groups for stress and other psychological health issues through Mental Health America [6] or the Substance Abuse and Mental Health Services Administration [7].
• Set boundaries for yourself. Establish limits at home and at work to conserve energy, regroup and keep things in perspective. Take advantage of your breaks from clinical work and do something that you find comforting, fun or relaxing.
• Stay physically fit. Eat well, get enough sleep, avoid misusing drugs or alcohol, stay hydrated and exercise regularly. Depriving your body of its biological needs can put you at risk and may also compromise your ability to care for your patients.
• Reduce everyday stressors. Limit your exposure to news reports, practice deep breathing [8] several times a day, make your personal workplace comfortable and write about those things that are causing you stress.
• Avoid comparing yourself with others. Everyone reacts differently to exposure to others’ traumas. For example, some health professionals may feel the need to talk openly about their exposure to trauma, while others may need time to decompress alone. It is important to recognize and respect these differences.
• Be patient with yourself. If you are coping with stress, be patient with yourself. If these stress reactions don’t get better after a period of time, you might even consider stopping or temporarily changing your assignment if you feel you need to.
• Find tools for resilience. To access free, confidential resources to support your resilience, contact one of the trained consultants at the DCoE Outreach Center [9] by logging on to Real Warriors Live Chat [10] or calling 866-966-1020, 24 hours a day, seven days a week.

Building Resilience within your Unit or Team

In addition to the self-care strategies above, units and teams as a whole can use the following strategies to prevent stress and support the group’s collective resilience:^{5 [11]}

• Team support. Institute a buddy system for keeping an eye out for each other, creating a positive atmosphere of support and defining a process for clinical support, consultation and supervision.
• Stress management plan. Educate staff about coping and intervention strategies.
• Effective organizational structure. Establish a clear chain of command with accessible managers, as well as staff who are trained and qualified according to written role descriptions for each assignment.
• Clear purpose and goals. Set well-defined treatment strategies appropriate to different assignment settings, including orientation and ongoing, relevant training for all health professionals on staff.
• Administrative controls. Plan for reasonable time limits on shifts, rotations between high- and low-stress tasks and regularly scheduled breaks.

Reaching Out is a Sign of Strength

Not all military health professionals will experience stress reactions when working with survivors of trauma, but those who do can access resources for support through the DCoE Outreach Center [9] if their symptoms become serious enough to significantly impact job functioning. These more severe stress reactions are commonly referred to as “compassion fatigue,” a state of physical and emotional exhaustion resulting from prolonged clinical work focused on trauma.^{1 [1]}

Although the strategies for self-care and team resilience outlined above can help you mitigate the effects of common stress reactions, it is important to reach out for professional support if you, or someone you know, are experiencing compassion fatigue.

Sources

¹ [12]"Working with Trauma Survivors: What workers need to know [13]," National Center for Post-Traumatic Stress Disorder. Last accessed Dec. 29, 2011.
² [14]“Coping with Compassion Fatigue [15],” Military OneSource. Last accessed Dec. 29, 2011.
³ [16]Quigley, Samantha L. “Caregivers Learn About ‘Compassion Fatigue [17]',” American Forces Press Service. Published on Jan. 25, 2008.
⁴ [18]“Stress Management for Health Care Providers [19],” [PDF 50KB] Center for the Study of Traumatic Stress. Last accessed Dec. 29, 2011.
⁵ [20]“Mental Health Response to Mass Violence And Terrorism: A Field Guide [21],” [PDF 2.3MB] Substance Abuse and Mental Health Services Administration, Department of Health and Human Services and Department of Justice. Published on Sept. 16, 2005.