Intentional self-care for Palliative Care Professionals
A blog post written by Jonathan Ramachenderan
Self-care was never anything that I valued until I couldn’t bring myself to work anymore.
Burnt out and depressed and anxious about my future as a doctor, I wasn’t sure how I was going to get through.
I’d given everything to medicine and to my career.
I was ambitious but caring, diligent and never relenting. And since starting, I hadn’t allowed myself a quiet moment or space for intentional rest. Sure, there were holidays and weekends, but the rest was never purposeful. Simply time between work commitments, numbing my emotions and guilty thoughts and adopting the mentality of “on to the next”.
And then finally, my body said, no more.
Like a fool, this was the second time I had burnt myself out in two and half years. It certainly was not an achievement to be proud of. It had all caught up with me.
The lack of rest and physical care. The unfinished business of grief and less than ideal patient encounters that I had yet to make peace with. The guilt from mistakes that battled with my false sense of perfectionism. And a relentless schedule that eventually wore down my spirit and connection to what mattered to me.
And so, I asked for help and received the advice that changed my life.
“Jonathan, your health and energy, matter too. No one works like that and ends up in one piece at the end of their career”.
My mentor and psychiatrist friend was right, and so the work of intentional self-care began.
I loved my work, but my patients were sick, and their suffering and plight often lived on in my thoughts and the grief of losing them, lingered in my heart.
We find meaning in life through our connections and contribution. Family and a desire to live fully — these were the things that were most valuable to me, and so I built my self-care around them.
With time, I created space in my life to care for my emotions, often bruised by the suffering that my team and I encountered. I found reflective writing helpful and the silence of the morning life-giving as I processed my lingering thoughts and swirling emotions. I benefited too from Professional Supervision and regular debriefing with my supervisor and mentor. The structure suited me, there was always something to examine or unpack. But most of all, I created space in my life for rest — quarantined time for boredom, play and creativity.
Compounded over time, these things made a difference. It became the rhythm of our family life.
My heart still broke at times for the patients who I met, but my spirit remained strong. And there were stretches of work that tested me and pushed me to my physical limits. But we all have signs that our lives may be making us tired — signals from our body to slow down and replenish ourselves. And as we intentionally create space for silence and reflection, we begin to understand that self-care begins with self-awareness.
When young Emily died, it hit our team and me particularly hard. We loved and cherished the time we had caring for her and it meant the world to be involved in her life. And as I reflected on Emily’s life and death I realised that whilst it hurt, grief had a purpose — it allowed us to grow.
Palliative care work that is untroubled and without personal challenge never leads to personal growth or gratitude for what we have. It doesn't lead to a deepening of our love for those closest or the strengthening of the bonds within our team.
Intentional self-care provides cushioning for all the blows that we sustain through our work and life. Good self-care is the backbone of every dynamic Palliative Care team. Not one of us is invincible but together our self-care is cumulative and benefits one another. Self-care is wisdom and it is everything when we decide to wade out each morning into a sea of suffering.
My encouragement to you is to create space for self-reflection each day. Self-reflection begins the process of own unique self-care – examining your needs and what is meaningful to you. This helps to establish a rhythm, a collection of actions that help to fill your cup and strengthen your spirit. Because if we cannot care for ourselves, we will not be able to provide care for others.
Live intentionally.
Dr. Jonathan Ramachenderan
Palliative Care Senior Medical Practitioner & GP Anaesthetist
FRACGP Dip Derm GAICD ClinDipPallMed