Self-Care for Psychosocial and Palliative Care Clinicians: Stakeholder-Informed Recommendations for Medical Education and Clinical Training

Abstract

Background

Despite overwhelming evidence for work-related stress and burnout, health care clinicians receive little training in self-care.

Objectives

We explored training and current self-care satisfaction of psychosocial and palliative care clinicians.

Design

Forty-one psychosocial and palliative care clinicians (18 physicians, 16 social workers, and 7 others [nurse practitioners, psychologists, pharmacists, and physician assistants]) who care for adult oncology patients at a large U.S. academic cancer center, completed an online survey about well-being, including their prior training, current satisfaction, and barriers to self-care.

Results

This cross-sectional mixed-methods study found that clinicians felt that their graduate training did not prepare them very well to look after themselves in their professional roles (m = 1.71 [SD = 1.25]), where zero corresponded to “not well at all” and 4 to “extremely well.” Open-ended responses highlighted potential gaps in self-care training: (1) Institutional support; (2) Information and education; (3) Self-care techniques and support; (4) Expectations; and (5) Managing boundaries. Clinicians rated their satisfaction with their current self-care practices as “moderately satisfied” (m = 2.10 [SD = 0.92]). Participants also noted barriers to self-care: (1) Time; (2) Competing demands and priorities between work and home; (3) Work culture, including pace and load; (4) Energy, motivation, and awareness; and (5) New methods and tools.

Conclusions

The findings highlight gaps in clinical education and training about self-care practices for health care clinicians, especially for those who care for seriously ill and dying patients. We discuss training implications and propose possible interventions, to strengthen the existing models of self-care for health care clinicians.