Professional caregivers' emotional well-being, empowerment and burnout prevention: lessons to be learned from palliative care

Professional caregivers working in palliative care face workplace conditions and experiences that might affect their physical and emotional well-being. Professionals have to cope with dying and death, suffering, ethical issues, and organizational factors in their daily practice. These elements can contribute to the development of work-related problems; such as burnout, compassion fatigue and moral distress, amongst others. First, moral distress refers to feelings of distress, usually related to tensions that occur when moral or ethical decisions have to be made and professionals disagree on the best course of action. Second, compassion fatigue is a slow decrease in compassion over time, usually associated to repeated contact with irresolvable suffering. Finally, burnout is defined as a complex and multidimensional syndrome, encompassing physical and emotional exhaustion, depersonalization and personal and professional dissatisfaction. Although professionals working in palliative care face risk factors for developing these problems, the literature suggests lower levels of burnout in palliative care when compared to other health care settings. It seems that professionals working in palliative care have a set of protective factors and strategies for preventing, coping and promoting, simultaneously, their own individual and team empowerment. Empowerment in the workplace is a complex phenomenon, and a relevant determinant of individual, team and organizations' effectiveness. It involves a sense of control in the workplace, which is manifested in four beliefs concerning the person-work relationship: meaning, competence, self-determination, and impact. The literature expands empowerment's nomological network, suggesting that empowerment in the workplace is an important predictor of professionals' effectiveness, satisfaction and commitment. Considering that professionals who have empowering work environments and perceive positive feelings of empowerment show higher levels of effectiveness at work and lower burnout; what are the lessons that could be learned from palliative care?1 It is our objective to explore these ideas, emphasizing the fact that health professionals' emotional well-being, empowerment and self-effectiveness do not only affect themselves, but it also influences the quality of care provided.