appendix d  Burnout among AIDS Care Workers---How to Spot it, How to Avoid it

CHAPTERS: Introduction  1 The Extent of the Nightmare  2 What's so Special about a Virus?  3 When Cells Start to Die  4 How People Become Infected  5 Questions People Ask  6 Condoms Are Unsafe  7 Moral Dilemas 8 Wrath or Reaping?  9 Some Life and Death Issues  10 When Church Members Need Help  11 Others Need Help Too  12 Saving Lives  13 Needle and Condom Distribution?  14 Special Issues in Poorer Nations  15 A Ten Point Plan for the Government  16 A Global Christian Challenge  Appendix B  Appendix C  Appendix D 

• Latest AIDS statistics, AIDS information - Africa AIDS Crisis - History of AIDS - AIDS epidemic, India, Asia, Eastern Europe, Central Europe, Russia, America, China
• AIDS research - causes of AIDS - AIDS treatment - retroviruses - protease inhibitors - cure? Antiretroviral therapy for HIV
• HIV transmission, AIDS risk factors and HIV window period
• What is AIDS? - HIV symptoms - AIDS symtoms - symptoms early HIV infection - early signs infection
• How reliable are condoms?  HIV dating - reducing HIV transmission
• Life and death issues - HIV medicine
• AIDS FAQ - vaccine, treatment, AIDS testing, Africa, China, Children, workplace discrimination, AIDS myths, origin of AIDS
• Moral dilemmas - euthanasia and AIDS treatments
• AIDS and the church - when church members need help
• Community care - treatment, adults, children, orphans
• AIDS education - AIDS awareness in youth and schools
• HIV Prevention - needle exchange program and condom distribution
• AIDS in Africa and HIV in Africa, HIV infected surgeons
• Ten point AIDS management plan for governments
• A global Christian challenge - church response to AIDS
• Guidelines for best practice in running HIV / AIDS programmes in developing countries (Africa / India / Asia)

Note:  This chapter of The Truth about AIDS by Dr Patrick Dixon is the original text as published by Kingsway in 1994 and may be reproduced with acknowledgment.  Search this book.

`Burnout' is a loose term used to describe what happens to some people in the caring profession when they have given out too much for too long, have become too drained and have been lacking support, quality time off and opportunity for understanding.

It starts when a warm caring person begins to distance himself or herself from people, in order to gain protection from further suffering. The person may become profoundly depressed, bursting into tears for little apparent reason, taking time off work, sleeping badly, not coping at all. Over-involvement is another danger sign. When a volunteer is asked to go in from 10.30 to 12.30 to help with housework, but regularly stays at the home until 11.00 pm, I would say that volunteer is a good candidate for burnout.

Now there are times when we all switch off. But if I burst into tears at the scene of a major car accident I would not be much use as a doctor. As a medical student I used to faint at the sight of blood and sometimes I still do, but I have to harden myself in order to get a job done. Nor are we emotionally capable of identifying fully with every person's suffering. Jesus was able to---and is able to now---but we are more limited. Dame Cicely Saunders, founder of St Christopher's Hospice, once said that the most important thing you can ever give your patient is your tears and the knowledge that you will miss him when he is gone. That is true. Tears are a part of my life as a member of a home care team and a part of my life as a leader of a church. If we cannot laugh and don't know how to cry, then what are we made of? The shortest verse in the Bible is this: `Jesus wept.' He was grief-stricken.

However, there are times when I need someone to point out danger areas. I remember when working at St Joseph's Hospice in Hackney, I was looking after a young woman who had shown great courage over many months with pain that was sometimes very hard to relieve. After much suffering she developed a pneumonia. I prescribed antibiotics and was confronted by the ward sister whom I respected enormously. She felt strongly that I had made the wrong decision. I backed down only after the intervention of a senior medical colleague. Eventually I realised that I was too emotionally involved with this patient to be capable of any rational decisions regarding her treatment.

The patient was a very strong character who had often been hard for us to care for, but over time I grew fond of her. Having wished sometimes that her suffering would end, I now found myself unable to let go and let her die.

In actual fact, as in so many of these things, I do not think antibiotics would have made any difference---she was very near death and deteriorating rapidly. I found the whole thing very distressing. Now if that sort of thing was happening two or three times a week, you can see that in a month or two I would become emotional jelly. Should I have not cared about her? Not at all. But let us care for each other, care for the caregivers, listen to each other, protect each other and share the load.

Support teams crack up and pack up with monotonous regularity due to lack of care and personality clashes. Together we can avoid these things.

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