The environment we oncology social workers work in has become increasingly stressful, much of the infrastructure to nourish our professional selves has faded, and we are asked to be ever more innovative, doing more with less. We have played a major role in defining standards for measuring the levels of distress in our patients. What has been given less attention is the distress levels that we as professionals experience, working in this often hostile environment, and the kind of active participation it takes to apply self-care as well as participate in improvements within the system.

Compassion for our fellow beings lies at the root of our work, and we are familiar with the professional training and reflection to give it a place where we can transform it into professional effectiveness. But little to nothing is mentioned about occupational health and self-care; at least there is no strategic or evidence-based approach. Perhaps some institutions are better than others, and within AOSW the Annual Conference and peer support and consultation fill some of the gaps.

Self-Care in Social Work
By Kathleen Cox and Sue Steiner
NASW Press, 2013
ISBN: 0871014440
The National Association of Social Work (NASW) set up a Workforce Study in 2006 and started to examine work-related stressors in social work. From the research thus far, it appears that it oftentimes isn’t clients’ issues that cause the distress social workers experience, but the work environment itself. In the fall of 2013, NASW published Self-Care in Social Work by two professional social workers, Kathleen Cox and Sue Steiner. The book aims at a large audience, from social work students to practitioners, supervisors and administrators. Making clear distinctions between the various kinds of work-related stress, the book is filled with many strategies for self-care, based on an integrated bio-physical-social model. Each chapter provides a section to be used for reflection and awareness in the daily practice setting. The chapter on “Workplace Wellness” is especially revealing as it attempts to present a balanced approach between employers’ and employees’ responsibilities to create and sustain a safe working environment. Although much more needs to be explored, I suggest this book is a must-read for all social workers (and the NASW website invites discussion). Like the many discussions and brainstorming around distress and standards of care in oncology social work, a dialogue within AOSW about the occupational hazards could add much substance to our field and start an approach to develop tools and strategies to lessen occupational hazards and improve (emotional) safety.

The Compassion Fatigue Workbook
By Françoise Mathieu
Routledge, Taylor and Francis Group, 2012
ISBN: 0415897904
In her book, Francoise Mathieu highlights the costs and benefits of compassionate caring in our work. Many of the ideas presented come out of trauma psychology and the work Charles Figley presented in the late ‘80s about compassion fatigue and (later) compassion satisfaction. Mathieu’s book is filled with various self-assessment tools and can be used alone or within group supervision to deal with compassion fatigue, vicarious traumatization and burnout. This book also clearly distinguishes the organizational elements of burnout stemming from a poor fit between organizational and workers’ needs, and the more personal elements of compassion fatigue and resilience. The book is filled with many examples and the instructions are easy to follow. The tools to measure compassion fatigue and burnout are easy to apply, and the book offers a range of self-care techniques, all well documented and backed up by research.

Exposure to Stress—Occupational Hazards in Hospitals
CDC & National Institute for Occupational Safety & Health, 2008
In 2008 the Centers for Disease Control and Prevention came out with a report called “Exposure to Stress—Occupational Hazards in Hospitals.” This report is available on the Internet. It summarizes sources of occupational stress, identifies adverse health effects of occupational stress and presents organizational work practices to reduce these. Tending to our occupational health and personal well-being should never be a luxury but a basic necessity to safeguard ourselves and our ability to contribute to our own psychosocial well-being, a prerequisite to being effective in our work with patients. I advocate creating a more substantial body of knowledge about the various systems-related occupational hazards and develop strategies for the changes that are so much needed. I believe we are underestimating the impact we could have, but it does require a more disciplined approach to research and borrowing from other disciplines such as organizational psychology.

The political process surrounding health care tends to clutter and mask the underlying occupational issues of the health care delivery system. As oncology social workers, used to keeping hope alive in difficult situations, and bringing much systems oriented knowledge to the table, we might find new, organizationally oriented roles that can contribute toward a positive change within our work environments and play a major role in the changes that will need to take place as the Affordable Health Care Act further unfolds.