This post originally appeared on the website of The Rabbinical Assembly.

Reframing Our Concept of “Burnout”

by Len Muroff, Hospice Chaplain, Los Angeles

Compassion fatigue

During my early days as a Hospice Chaplain, I perpetually wondered what toll the job was having on my inner life. I knew that the persistent worry about others, the perpetually intense situations, and the powerfully touching moments at the bedsides of dying people, could not be going unnoticed by my inner self.

To be honest, it was abundantly clear that it was taking a toll. Thankfully, my closest friends and daughters were patient, but not everyone in my life could understand or appreciate the hidden toll this was taking on me. They did not respond well to my lack of patience and sometimes lack of control of my emotions. I did not understand so how could I expect them to?! I was slowly being drained. I felt burnt out. I felt less than I ought to be feeling while doing such vital and valuable work.

It was not clear how to move forward. Was I responsible? Was this really burnout? Was it my personal failings which precipitated my challenges in my personal and professional life? I felt I was responsible. It was clearly not a good feeling and though clearly things would improve, it was always a temporal change.

A way forward

I knew that I needed a better way to understand my feelings. I knew I was overwhelmed but I knew that knowing the source of the feelings would help me move towards some resolution. I knew the former would drive the latter.

Burnout implies the health care worker is lacking in some way. Looking at things through this prism is not enriching to the person who has that feeling and it does not facilitate personal and professional recovery and growth.

After thirteen years, I finally developed a metaphor that helped me reframe the issue. I felt like an oversaturated kitchen sponge. If I was like the sponge, then it was not my fault. The cause of the over saturation of travail was not due to something wrong internally or to my inability to cope well enough. It was due to a feeling or a situation that I felt powerless to prevent.

Enter moral injury

Recently, I learned the term Moral Injury. It is said to occur when we perpetuate, bear witness to, or fail to prevent an act that transgresses our deeply held moral beliefs. It describes a time when we are placed in an untenable situation by a broken system.

This helps me. This shifts the focus from there being something wrong with me to an external reality which I am committed to changing. By viewing my intense feeling as a sign that my heart is working overtime and is just dealing with too much, I feel better able to move forward. By viewing it this way, I take the pressure off myself because, as we often say, “it is not about me”. It is about something out there, like with the COVID-19 virus, an intensely sad new reality in the world. The change in focus, emboldens me and helps me chart a course forward, even while my being overwhelmed. It helps me feel radically hopeful, rather than being radically inferior, and less than.

The phenomenon of moral injury describes how I feel when I sit with a family in a hospital whose loved one’s pain is not being controlled or one who cannot be admitted quickly enough to hospice to facilitate the start of comfort measures. It is when a co-worker’s mother and uncle died of the COVID-19 virus back home in NYC. When this occurs repeatedly, one’s body is filled with psychic pain due to experiencing so much unfairness. It is not because one is incapable or poorly prepared. In this situation, one is just walking with patients and their families, through some deep, almost paralyzing, muck.

So rather than pushing me down, this framework validates the merit of my work. Surely, some curative steps are needed to allow me to move forward but knowing where I am starting makes that movement possible.

Rabbi Len Muroff was ordained at the Jewish Theological Seminary in NYC 28 years ago, where he also received a Master’s Degree in Jewish Studies and a Bachelor’s Degree in Bible. He also holds degrees in Education from AJU/University of Judaism and in Political Science from Columbia University. He was born in NJ and was raised in Canada. He attended high school in Toronto. He has served congregations in Georgia, Massachusetts and Los Angeles. He has been a Hospice and Hospital Chaplain for thirteen years.

Len is a devoted social justice advocate. He has focused on aiding the hungry, those suffering from AIDS, climate issues and helping oppressed people around the world. He has also made interfaith and inter-racial outreach a priority in his rabbinate. He is the proud father of two daughters, Shira (26) and Elana (23). He enjoys walking the Stairs in Santa Monica and hosting people for Shabbat dinner. He is a devoted LA Dodgers Fan and a weekend bicyclist and softball player and a grateful member of Ikar.