87-Practitioner Burnout, Compassion Fatigue & Moral Injury with Jess Serdikoff RD

Practitioner burnout, compassion fatigue & moral injury is the reality of too many practitioners and coaches.

Practitioner burnout, compassion fatigue & moral injury 

If you feel exhausted and perhaps this is “too hard” or “i’m just not cut out for this career” I hear and I recommend you listen to this interview with Jess.

Jess Serdikoff Romola is a registered dietitian and supervisor helping practitioners say FU to hustle culture to diffuse stress, build confidence, and reconnect with their passions and purpose as a human first, and dietitian second. 

What you’ll learn listening to this episode on practitioner burnout, compassion fatigue & moral injury:

• Why it’s you the problem but the system
• Why moral injury could be the “real” problem
• The parallels between diet culture and hustle culture

Mentioned in the show:

How to Become A Non-Diet Coach Masterclass

Non-Diet Coaching Certification 

Free Resources 

Connect with our guest:

Instagram – Jess Serdikoff

Facebook – Jess Serdikoff

The Empowering Dietitians Grounding Journal

Transcript

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Practitioner Burnout, Compassion Fatigue & Moral Injury with Jess Serdikoff RD

Hey, my dear colleague, welcome back to the podcast. We are halfway through the enrollment for the next cohort of the non diet coaching certification cohort number nine. And We had the virtual class earlier today, how to become a non diet coach. If you want to grab the replay for that. You can go to the link in the show note or how to become a non diet coach on Mr. Google and grab the replay. It’s a totally free class and inside of that class I go through does it mean to become a Non diet coach, what it is and what it’s not, and also the most common mistakes that I see people do when they want to become a professional coach in that particular field.

And I go through exactly what’s in the syllabus and the curriculum of the non diet coaching certification. So if that’s an interest of yours. Go grab that replay, and you can also book a consultation with me once you’ve watched, the class and read the curriculum. If you still have questions, it’ll be my pleasure, to go on a Zoom coffee chat with you to answer

any question that remains for you now, today’s topic is in alignment with the foundation that we set in an online coaching certification, which is safe. coaching. I brought on an expert today to talk to you and to unpack with me compassionate fatigue, moral injury, and burnout for people in our field.

That you are a licensed professional, a provider, practitioner, or coach, and You coach behavior, you quickly realize that what’s behind the behavior of eating, for example, or health, a body image is not a lack of knowledge, it’s emotion, right? It’s people feel terrible and that influence their behavior and people feel anxious and people feel sad.

sad people feel grief because of what happened to them because of the way they’re thinking about themselves. And very quickly when you coach behavioral health situation, you uncover that it’s not about the behavior. It’s about the real problem. And it’s if you don’t know how to. coach at that level, that stuff gets really heavy fast.

And unfortunately, when you’re not equipped professionally as a coach to deal with that, you take it on yourself and you end up with burnout and you end up with fatigue. Compassion fatigue is a real thing. and I want to teach you today how to avoid that. And that’s why I brought Jess Serticoff, a dietitian and a supervisor of dietitian because that’s what she talks about day in and day out with her clients on how to unpack that and how to prevent it, most important.

And we’re also going to talk about hustle culture and how it impacts our practice with our client. Not necessarily from a business standpoint, we’re going to talk about it a little bit, but more about how hustle culture. impacts how we think we should coach. It’s a brilliant episode. save it and come back to it if you feel fatigue and you think you’re on your way to burnout.

So without any further ado, I’ll get my team to roll in podcast.

Stephanie: Welcome to the podcast, Jess.

Jess: Thank you for having me.

Stephanie: I’m so excited about this conversation.

Jess: Me too.

Stephanie: We’ve not talked about that before on my podcast.

Jess: Ooh,

Stephanie: I made a podcast a few years ago around the parallel between hustle culture and diet culture,

Jess: yeah.

Stephanie: but I kind of never talked about it again.

Jess: And this is a beautiful opportunity.

Jess: So First, I think that burnout. Is becoming a bit of a buzzword, especially in the health care field, especially in our kind of like Harry post pandemic world. However, you want to look at it, it often gets boiled down into an individual capacity problem. You know, I’m not handling things. Well, I need to take better care of myself.

Jess: I’m burnt out and a lot of the solutions are therefore focused on. More self care, more resilience, you know, what can we be doing as individuals? And I find that to be a At best gross oversimplification of what’s really going on. and we’re really glossing over some of these more systemic problems that are contributing to burnout and other related phenomenon field.

Stephanie: So what are those things we don’t talk about, but we need to talk about?

Jess: Well, when you look at some of the research, particularly with burnout amongst healthcare professionals, and you look at the different factors that researchers associate with burnout, they tend to list external versus internal factors. First of all, the external factor list is Much longer than the internal 1 and the internal factors that they list, including your own capacity, your time management, things like that.

Jess: a lot of those are also societally conditioned and the reason we’re struggling with them. Individually or internally is because of the system that we’re working in. So, the, the biggest thing that I really like to drive home when I’m talking about burnout is that this is not like a you problem that we really need to be talking about.

Jess: We need to be talking about how our health care system, how our coaching system really, how our society is set up.

Stephanie: Yeah, and I’m gonna, by all means, you can use me as an example, but I’ve burned out when I was in the corporate world. I was in the classic sales structure, corporate world burned out. Didn’t listen to myself, just crashed and burned. But right now in this second phase of my life in the coaching world, I’m starting to feel hired, not physically, not as much, but I’m starting to feel tired because there’s too much access to me.

Stephanie: If that makes any sense, does that, is that part of your view on the problem?

Jess: Absolutely. So think about just the way that our society functions. We’re kind of always on. And I see a lot of practitioners who I work specifically with dietitians. So I work primarily in that area, where they’re kind of sold this message of like, quit your clinical job and go into private practice to fix your burnout.

Jess: And so, We’re seeing a lot more dietitians that are leaving and working for themselves and starting coaching businesses and starting, you know, private practices and they’re realizing my burnout isn’t going away and it’s because. There are pros and cons to working for someone else, but one of the things is when you are working yourself, there aren’t inherent boundaries and there are certain expectations, the way that you’ve set up your coaching packages, the way that you’ve set things up, that there is a lot of access to you, whether that is access to email, access to social media, access to messaging, whatever it is, and you don’t have the space to be a person outside of your work.

Stephanie: Bang on, because when I was in, I’ll call it classical practice, it was like one hour appointment in and out. That’s it. Now, the way the coaching industry has imagined the services, it’s like, it’s the coaching session, then it’s the group coaching session, and then it’s the Facebook group.

Jess: And we have to really question if the way that we’re doing business is truly right for us. And if it is, we have to make it work for us, and if it’s not, are we just copying and pasting what someone else told us we had to do? Are we still living according to someone else’s view of what is quote unquote right?

Stephanie: I think it’s, that, that is, because what I just described to you as the structure is what our formatted to be.

Jess: And we get these kind of gold standard things, whether it comes to how you launch a new service or how you conduct your packages or what you charge or how you talk about what you charge, there is kind of this pervasive messaging that there is one correct or best way to do it. And so we wind up being these like. Round pegs trying to fit ourselves into a square hole or vice versa, and it doesn’t feel like it’s working. We wind up feeling more and more disconnected from ourselves, and that’s not going to help us, and it’s not going to help the people we’re trying to serve.

Stephanie: It’s very interesting because this morning I was coaching a group of professionals and we had this conversation.

Stephanie: Where we were talking about how these, like, Facebook group on top of the 101 may not actually be helping our clients. Because they’re not learning to live on their own. They’re like always leaning in to the group and the group coaching and this. And it’s almost like a co dependency thing.

Jess: and are times and places for that, where we have a little bit more handholding, a little bit more of that immersive experience, and that can be appropriate. And then there are also times where we have to be able to trust ourselves too, and go off and trust ourselves. Try something and see if it works, and if it doesn’t, then we do have a landing pad, a support system, a call at some point, but that we don’t, I don’t know, I think sometimes we are so afraid of making a mistake or choosing the wrong thing that we, instead of acting, we try to get everyone else’s opinions and perspectives first to try to cushion the blow of potentially, quote, unquote, making a mistake,

Stephanie: And it all comes down to socialization and thinking like, that’s the way, and especially can we talk about this. How we are socialized as women and how we show up in our work leading to burnout.

Jess: Yes. So when it comes to burnout and how gender norms intersect with that, there are a lot of different layers to consider. There are things like, we are taught from a very young age to be the caregivers and to put our needs On the backseat compared to making sure that everyone else is okay. And we often kind of self sacrifice to make that happen.

Jess: That’s that’s conditioned to in us very, very early on. that gets compounded. Then if you are also a helping professional, because. You are also taught through your schooling then that your job is to help other people. You have to not necessarily sometimes they’ll say like, yes, take care of yourself, but, what they say and then what they actually do or what they teach you is sometimes different.

Jess: but you kind of get this mindset of almost like you’re here to be a martyr. You’re here to. Give and give and give, and you just have to be resilient and do better. And that leads to a form, a form of burnout, a spinoff of burnout called compassion fatigue, which can be distinct from burnout and it can also lead to burnout, if we don’t address it.

Stephanie: So, let’s talk about what is compassion fatigue versus burnout. Is there different types of burnouts? Is that what I’m hearing?

Jess: Generally speaking,it depends on who you ask. I think we’re still really early in our studying of burnout as a phenomenon. The way that I look at it is that burnout is distinct from compassion fatigue, but that compassion fatigue can contribute to burnout compassion fatigue, or sometimes viewed as like caregiver fatigue or caregiver.

Jess: Stress happens when we are in that helping role and we are giving and giving and we’re holding space for other people. We’re taking on other people’s emotions. If you happen to feel like you’re an empath or a particularly, Emotionally aware human. You can sometimes take on that even more. I don’t know a lot of helping professionals are.

Jess: So, we wind up with that issue and it just starts to feel heavier and heavier. as your needs aren’t being met.

Stephanie: And that leads to the burnout, which is on a scale and it’s a different representation by individual.

Jess: there’s one study is specific to dietitians. but I, I would expect that it was pretty similar across all healthcare professionals.

Stephanie: I bet you the same thing with

Jess: Oh, yeah. Oh, yeah.it found that over 2 3rds, or almost 2 3rds of dietitians reported double or triple duty caregiving duties, which means that in addition to being a caregiver professionally, they were also maybe a parent.

Jess: They were taking care of Their own parents, they were maybe in that sandwich generation where they’re doing both. and dietetics is a predominantly female field. I believe therapy is as well. yeah. so. We’re more likely to find that because again, how we’re socialized, we kind of default under patriarchy to be the caregivers, whether we choose to or not.

Jess: And moreover, the study found that the more those roles conflicted with each other, the higher the rate of burnout. So the more remember, you’re a human, right? So you don’t just stop being a parent. You don’t just stop being a caregiver when you show up at your job. Those stressors carry into it and it impacts your capacity for caring for other people and caring for yourself. So the more those conflict with each other and pile on top of each other, the more likely you are to burn out.

Stephanie: You talked about earlier, you repeated a few times, disconnection to self, disconnection to self. could we say that’s the underlying root cause of burnout to some degree?

Jess: I like to say that exploitative systems are the root cause, but I would say that probably a, a undercurrent in terms of symptoms and maybe precursors. Yes. it is hinged on you being disconnected from yourself and your authenticity. And it’s supposed to kind of make you feel like you don’t really have authenticity autonomy, right? Like you just have to do the things the way that they are. so yes, it very much is often one of those initial Stages that we wind up in that leads and domino effects to these worsening symptoms.

Stephanie: I’ll make the parallel to diet culture because that’s my zone of genius. And then you can, like, carry on the story and hustle culture, but that’s what diet culture does, which diet culture is an oppressive system, it disconnect people from their body, self, in order to satisfy the standard of diet culture.

Jess: Well, diet culture is hustle culture, because when we’re talking about diet culture, when we’re talking about hustle culture, these are just like more comfortable ways of calling out systems like patriarchy, capitalism and supremacy culture. if they’re just cutesy names that sound a little bit more palatable to us,

Stephanie: call them the

Jess: Yeah, yeah. So we’re talking about the same thing. It just, it just matters. Are we talking about food and body? Are we talking about our work. Exactly. They’re really the same thing.

Stephanie: So. So, when we’re talking about liberation from those systems in order to heal, the first step is to reconnect with ourselves.

Jess: I absolutely believe so. If we back it up a little bit, it’s probably flagging the thoughts that we’ve internalized that are not actually authentic to us. So starting to question whose values we’re living by, Thank you. Where we learned them, and if they continue to serve us, and once we start to recognize what we’re holding onto that is no longer ours, or that isn’t ours, or was never ours, then we can start the process of getting back in touch of with who we actually are.

Stephanie: Can you give us a few of those thoughts a dietician slash caregiver perspective to give us a flavor of what we’re looking

Jess: Yeah, absolutely. So, you’re going to notice some themes around things like perfectionism. and imposter thoughts are going to come into these 2 of like, I have to get X certification before I’m. Worthy to do this work, or, I have to prove myself by having X number of clients before I’ve really made it.

Jess: or I’m not good enough compared to this other coach or other dietitian because look at them putting out 6, 000 reels a week or tick tocks a week or selling out and making 6 figure months or whatever it is. Right. so it’s, it’s always this rat race of I have to do better. I’m not good enough. Everyone else is farther along than me and I’m behind.

Stephanie: And it’s funny, I was laughing as you were saying that if you’re watching the videos, because I put out, I had this brain, my brain crack one day when I started to look at business culture. And I put the parallel between business culture, six months, a six figure, and like, versus that culture. I’m like, it’s the same fricking

Jess: It’s the same thing. It’s just these crazy promises, external validation, and the benchmark, the target always moves. So you’re, you never actually. Hit it. If there’s six figure months, or, you know, you hit six figures, then you have to figure out seven figures. if you do master, fill up your one on one slots, then it’s time to figure out group coaching.

Jess: so we never actually, the same thing with diet culture, you know, that’s why the beauty standards change. You have to be curvy, you have to be twiggy thin, you have to be whatever. It’s always going to move so that you are never.

Stephanie: So what’s the solution? Or what’s like, where do we even begin?

Jess: Yeah,

Stephanie: From your perspective.

Jess: think that that phrasing where do we even begin is the appropriate one because it’s so much more comforting to think that the problem is us because we can do something about that.

Stephanie: we control

Jess: when I start saying the problem is capitalism and patriarchy and supremacy culture, it’s like, well, what am I, what am I supposed to do about this? Right? It’s overwhelming. So the way that I explain it, I like to talk about a three tiered approach because I don’t think that there is 1 solution to this. They’re certainly not. 1st of all, part of it is rejecting that there’s 1 anything that’s part of supremacy culture is part of hustle culture is part of diet culture to convince us there’s 1 right way to do X. there is not, but we have to take it. Yes, from an individual standpoint, and sometimes that’s the easiest place to start because. We are more within our own control. So I think very first step, just starting to recognize it the same way that we would do with diet culture. Recognize it when what someone else says is really a reflection of that hustle and that never good enough scarcity space. Recognize when that thought is coming up for you. And we can use some of those same coaching techniques, therapeutic techniques, whether it’s cognitive behavioral techniques, whether it’s mindfulness based techniques, whatever it is that that works for you to start not judging them and reframing them. so, so starting with yourself can be a comforting, more like realistic doable place. It’s, it’s not going to end there because it can be just as easy to burn out when, you know, you start working, realizing that the system is completely antithetical to what you believe in and yet you still have to exist in it. So we do have to go extra layers and extra steps. But starting with yourself can be helpful.

Stephanie: Well, I think it’s, you gotta, to some degree say, strengthen yourself in order to like re imagine the system plays on you.

Jess: I think strengthen and soften ourselves. yes, we need resilience because this is not something that’s going to be fixed by 1 person. And it’s not going to be fixed anytime soon or changed anytime soon as maybe a better way of phrasing that. and so we do need some resilience and coping skills and the ability to withstand the stressors and the injustices and the frustrations.

Jess: And. We also need the compassion and the softening and the not again, I think we get in this hustle mentality of there’s something wrong. I have to do something about it. There’s something wrong. I have to work. I have a goal. I have to move into it. We’re always in this future oriented. Action oriented, goal oriented space. So part of the healing is understanding when we need to pace ourselves. Understand when we’re not going to do it well, or, when we are going to fall back into hustle mentality. Right? when we need to take breaks and be kind and gentle. Right? so I think it’s, it’s both of those things.

Stephanie: Well, as you’re saying that, what I’m seeing is the ultimate goal, I guess, of nervous system kneeling, which is the capacity to be flexible, right? To take the highs and the lows and to come back to

Jess: yeah. And we also have to recognize that it’s same thing with like social justice warriors and all of these things. You are one person and you are trying to address centuries of the world operating under certain assumptions and with certain people in power who are not going to want to give up their power. And so we have to know. When fight quote unquote, and when to just exist as a human, right? Like we can’t fight every battle. And I think, especially if you are someone who lives with privilege, sometimes there’s a lot of like layered guilt and shame. And like, I have to always correct someone. I have to always say the right thing. I have to always be acting towards this because for so long, people like me didn’t say anything and that’s going to burn you out. In and of itself, right? Again, it’s that always on. So being very aware of how sneaky that hustle mentality is and how it slips into our own self care work, our own self development work, right? That we have to constantly be doing better. No, sometimes you can coast. Sometimes you can drop the ball, right? Sometimes you can just like chill and be an imperfect, messy person.

Stephanie: So one of the ways you help people is supervision. So I want you to explain, because in the coaching world and even to some degree other counseling world, supervision is not, is not present or not that understood, but I know it’s very well inbred into dietician. So what is supervision generally?

Jess: I will say it’s not very well ingrained in dietitian. Oh, I wish that’s my dream reality. it’s not there yet. I see it more prevalent in therapy spaces, but it is all about holding space. So it’s not about telling or teaching or guiding. It’s about being a constant in someone else’s life where they’re not here to be your therapist, right? Like I’m not qualified to do that, but I understand being a dietitian. I understand the specifics that my colleagues are going through in particular, and I am here to validate. And hold space and let you show up and be vulnerable because. There’s a lot of pressure to show up and have the answers and be the expert and have it all figured out because, you know, you, you want to make sure that you’re well cared for and that your clients aren’t worried that they have to attend to your needs while, you know, you’re trying to help them so supervision is the space where that happens. Can be case consultations of like, Hey, this is happening with one of my clients and I don’t know if I handled it well, or it’s bringing up these uncomfortable feelings in me. What do I do with that? So it can be that it can be I’m feeling really burnt out. I’m feeling like I’m losing my mind. I’m feeling like things are spiraling out. Can we talk about it? Right? so it’s not. It’s not very goal oriented all the time, or like, fix it oriented, it’s more learning how to sit, and be, and regulate, and just have someone who sees you and hears you for who you are.

Stephanie: So I’m seeing a midpoint between therapy and

Jess: yes. Yes.

Stephanie: It’s like it’s the midpoint between goal oriented and full on counseling world.

Jess: I’m not going to go into past trauma that you have, right? Like, that is beyond my scope. I might suggest, if that’s going on, that you pair this work with therapy. so I’m not going to unpack all of that with you, but I can help you develop compassion for yourself. I can help you get in touch with your values. I can help you see the toxic systems that you’re working in and remove some of that self blame and, and doubt. so that’s more of the, the supervisor’s role.

Stephanie: And do you supervise beyond dietician

Jess: I personally haven’t. I have had therapists and, other kind of allied health professionals in group supervision calls before. But I haven’t one on one, primarily because, you know, I, I, again, I think that it can be very beneficial to have someone specifically in your field.

Stephanie: in your

Jess: exactly. Because again, Everyone’s a little different. Like, if I taught, I have a therapist, and I can talk to my therapist about the stressors in my work, and I do, but she’s not aware of the exact culture of dietetics. Whereas, I don’t have to, like, no one has to explain that to me. I get it. I live in it. And while there are so many parallels across, helping professionals, where there’s a lot of cultural similarities, There are going to be distinctions in each one, so I would love to see it where we have supervisors in all health professions. That being said, I wouldn’t be 100 percent opposed to it. but I, I think that the end goal is to have people who really, really get it intimately with where you’re coming from.

Stephanie: Yeah, I think the word get it, this is the thing about supervision.

Jess: exactly. because it’s not this top down. I have the answers and I’m giving them to you. It really is that, like, we’re sitting on a level playing field. I’m just here to bring things out in you to ask you the right questions to get you thinking about things. So, while I can do that with any. Profession. I’ve got the experience in dietetics personally.

Stephanie: Okay. That’s been a very powerful conversation. when we talk about burnout, is there any angle of it that I missed that I didn’t ask you a question about that you would like to bring forward?

Jess: The only thing that I will say that I haven’t, we haven’t really discussed is, and it’s a big one. So it might just be like a, Hey, you might want to look into too on your own. In addition to compassion, fatigue and burnout, there is a concept called moral injury or moral distress. And it is by far the thing that I think we mistake for burnout the most, or we call burnout, and it’s originally coined with, war veterans with PTSD and witnessing or participating in immoral acts that conflict with your values. More and more, they’re studying it with healthcare providers. Particularly if you provide health care within, for example, like the U. S., very capitalist based system, where everything is based on the bottom line and ROI, and it almost feels like we become disconnected from being able to truly help people the way that we can. Thank you. Want to help them. It happens a lot with weight inclusive providers as well who are working in weight centric environments.

Stephanie: Yes.

Jess: So I want people to understand that these influences happen. And if you’re feeling that way, you’re not crazy. You’re there’s not something wrong with you. This is us existing in a system. That isn’t really well suited for the work that we are so passionate about doing.

Stephanie: Or that is misaligned with your personal value. Because as you’re like, you’re saying that it’s like the flash are going up in my of all the people, particularly in the non diet space. Like I was just coaching a fitness professional, it’s like work for like a big label gym. And she was asked to do things that she’s like no longer aligned with. She was at some point, she’s no longer.

Jess: it’s it’s even the same as people making assumptions about what you do when they hear that you’re a dietitian or a nutritionist or You work with body image or relationship with food They make assumptions about the work that you do and constantly having to explain it or introduce people to the concept. and feeling like again, nobody else is like. Getting it, or it’s so foreign to them. So that creates its own source of stress that isn’t discussed enough. And I would highly encourage anyone listening who is feeling that disconnect or feeling that frustration to look more into that concept as well because it, it adds an extra piece to the puzzle.

Stephanie: it names what it’s happening within you that you haven’t put a name on it. You just feel it, but you haven’t intellectualized it yet. But that’s exactly what it, that’s a lot of my

Jess: Exactly. And again, I think that when we talk about moral injury, moral distress, we start to more easily recognize that this is not a personal failing, this is a systemic failing, or at the very least, a systemic misalignment.

Stephanie: Yeah, thank you for bringing that up. How can people get more of you or experience you more?

Jess: You can check out any of my offerings at my website. Empowering dietitians dot com. I do have self paced courses and classes. They offer continuing ed for dietitians specifically, but they’re of course open. I have, physical therapists, all, all different types of individuals who, to participate in those. So they’re available. and then I have my own weekly podcast. So if you are listening to podcasts and like that, I come out with episodes for the most part on a weekly basis and they’re most of them are very reflective. I do speak to dietetics. Issues, but again, I have a lot of listeners who are not dietitians who. Very easily see the connection to what they’re doing as well. So I ask a lot of open ended questions offer a lot of thinking points for you to spend more time and kind of chew on throughout the week.

Stephanie: Think of it uh, self paced supervision session.

Jess: I try to give that similar vibe with a lot of those episodes where I’m not sitting here. Sometimes I sit here and tell you my opinion on things, but a lot of the episodes are more, let me help you think about this in a different way.

Stephanie: that’s brilliant. And because there’s not a lot of you in different

Jess: Yes.

Stephanie: there’s not a lot of us thinking that way in each of the profession.

Jess: Yeah. So, in the meantime, I’m happy to serve that gap. and I encourage you within your own professions, start these conversations, start looking into what supervision is in other professions and how we can incorporate this and, and really make it more accessible for all of us.

Stephanie: and have that systemic conversation, that misalignment of value conversation in all the profession because it’s happening

Jess: Absolutely. Absolutely. I couldn’t agree more.

Stephanie: Thank you very much Jess for being with us

Jess: Of course. It was my pleasure.