Caring for Those Who Care for Us
There’s a great deal of public discussion around “care” as we navigate the COVID-19 crisis. We hear about the vital care provided by doctors and nurses, the care neighbors have shown to each other, and the care with which teachers have continued to educate and support their students. Arguably, none of these people were providing any less care before the pandemic hit. Now, however, the importance of their work, and how they care for others, is in the limelight.
While we are deeply appreciative of this care, it comes at a cost. There is increasing awareness and discussion of burnout in social workers, nurses, doctors, and others in caring professions. In the midst of the pandemic, there has been even more attention paid to the emotional and physical toll of caring for others. As rates of burnout increase among care providers, there needs to be more conversations about how we can better support our care workers. They are providing essential care for us in so many ways; how might we, in turn, care for them?
Care & Burnout
Burnout can be broadly defined as the physical, emotional, and behavioural symptoms related to work stress, which include such things as emotional exhaustion, withdrawing from relationships, and poor physical health. The stress and emotional intensity inherent in working with people who are suffering is now exacerbated by lack of necessary resources and fear of catching the virus. Burnout not only impacts one’s ability to do one’s job, but also negatively impacts one’s health and personal life.
Unburdened and Burdened Virtues
To the extent that burnout changes the way one engages with the world, we might see burnout as an ethical problem. Lisa Tessman introduces the concept of burdened virtues in her book, Burdened Virtues: Virtue Ethics for Liberatory Struggles. Unburdened virtues are virtues that benefit the person who possesses them, such as honesty and courage. They are the sorts of virtues that Aristotle describes in The Nichomachean Ethics as being an ideal medium between the extremes of excess and deficiency. Burdened virtues, in contrast, are virtues that are simultaneously admirable qualities yet also cause harm to the person in possession of such qualities. Tessman suggests attentiveness to others’ suffering and rage (in the face of oppression) as two examples of such virtutes. Like normal, unburdened virtues, burdened virtues also exist on a continuum, but in this case, there is no ideal place between the two extremes; regardless of where one finds oneself on the continuum, one will feel – or be criticised as being – too far towards one extreme or the other.
Care, I think, fits into this paradigm of burdened virtues. A healthcare worker wants to help people who are ill, or a teacher is passionate about educating students; they each approach their work from a place of care. If they are seen to be too emotionally invested in their patients or students they are more likely to be overwhelmed and burn out, as well as face criticism from friends and co-workers for “caring too much.” However, if they try to care less by being emotionally detached and distant, they might still be criticised for being apathetic and uncaring, in addition to potentially experiencing their own feelings of guilt for not caring enough. There is, then, no appropriate middle ground in which one can care enough without overburdening oneself emotionally. At any point on the continuum of caring, one can be criticized for caring too little or caring too much. There might not be a way to entirely eliminate the burdened nature of care, but it might be possible to create work environments that are more supportive and less burdensome. Perhaps this can help to alleviate some of the stressors that contribute to burnout.
Care Ethics and Essential Workers
I believe Care Ethics offers a useful way to make sense of the factors contributing to burnout and also provide ways of remedying them. There are three major theorists in Care Ethics: Joan Tronto, Virginia Held, and Nel Noddings. Noddings (2013) conceives of caring as something that occurs between two individuals and is dependent upon interpersonal relationships. Joan Tronto (1993, 2006) and Virginia Held (2006), however, both believe that care can and should be integrated into social institutions. In each of their understandings of care, subjectivity – the importance of considering an individual’s unique situation – is an essential element.. That is, when one person cares for another, they must consider the unique situation of the person for whom they’re caring and their relationship with them.
Noddings writes about engrossment as an essential aspect of care, which broadly means that the carer must be fully attentive to and aware of the cared-for’s needs and situation and see them as a full person rather than defined solely by their need for care. In a healthcare setting, this might look like a doctor seeing a patient as more than the illness she’s being treated for, or even taking into account other factors in her life that might be contributing to her symptoms. The attentiveness to individual’s needs also strikes me as something many teachers were doing for their students before the pandemic and are doing now on a larger scale. With students now learning at home and in a wide range of environments, teachers have had to adapt not only their lesson plans but also navigate supporting students who might have family members who are ill or don’t have reliable internet access or are otherwise struggling.
In Care Ethics, care is not entirely one-sided with the carer only providing care for the cared-for, but rather fosters the creation of mutually caring relationships between the carer and cared-for. In a mutually caring relationship, caring is not exactly reciprocal, but the cared-for does feel some interest in the well-being of the carer and recognises their individuality beyond the service or care that they provide. Both the carer and cared-for understand their well-being as tied up with the other’s well-being insofar as they are both working within the same system and each benefit from the other’s well-being and equitable treatment. As so many of us now are being cared for by healthcare workers, teachers, grocery store workers, and a host of other essential workers, we ought to consider how our own actions can contribute to this mutually caring relationship. Doing our part by staying home as much as possible and following guidelines around social distancing when we do have to go out is an important way that individuals can show care for workers – we are helping to keep them and their work environments uncrowded and safer. We can show our care for care-givers directly by thanking them when we do see them and advocating on their behalf for safer working conditions and other needs.
Creating Organizational Structures that Prioritize Care
Care goes beyond just how individuals treat each other and, especially given the problem of burnout in care workers, I think it needs to be built into broader community and organizational practices. While teachers, healthcare providers, and other essential workers are caring for us, they, too, should be properly cared for. For an organization to care for its workers, it must be invested in its workers’ well-being insofar as it provides resources for them to be able to do their job properly and more importantly to attend to their personal needs both in and out of work. Like the interpersonal caring relationships, the organization needs to listen to the expressed needs of its workers, addressing issues that are most pressing to them and adjusting its practices and policies as needed. Whether it’s more flexible time off, hazard pay, safer working conditions, or more support, organizations can and should do their best to ensure that their employees have the resources available to safely do their jobs and take care of their own lives outside of work.
Another way that organizations can care for their workers and help to alleviate burnout is by adopting policies and fostering an environment that encourages mutually caring relationships. This can look differently depending on the organization and needs of the workers, but broadly could entail fostering camaraderie among staff and a supportive, affirming work environment. It should be an environment in which workers feel comfortable asking for help and being open about feelings of burnout that they might be experiencing. For teachers and healthcare professionals, for example, there could be mental health resources and support readily available to those who want it, as well as, ideally, a shift to a workplace culture that takes a positive view of utilizing those resources. Organizations could incorporate other simple changes like having a check-in with staff at the beginning of meetings. It is a small action, but, when done with genuine attention to and concern for people’s answers, demonstrates care about workers’ well-being and helps to create space for people to be open about their feelings and stress levels. It would also hopefully give care workers a forum to express any concerns they have, which can in turn inform changes within workplaces.
In this time of pandemic and quarantine, there may be an increased sense of being isolated from each other. A framework of Care Ethics can help to show us how we are still connected in positive ways and how we can shift our perspective to one of care and community.