Compassion Fatigue

Compassion Fatigue and Empathic Stress

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Do you ever wake up and feel like you have never been to bed?  Do you feel like calling off work  a lot?  Do you feel sad about some of your cases, and helpless to help them? Do you feel like you can’t face one more difficult patient or family? Do you take events that happen at work home with you?  Do you wonder if you chose the right career?  If you said yes to some of these questions you may be experiencing Compassion Fatigue/Empathic Stress. Compassion Fatigue is an occupational hazard of the helping professions.  It’s not a question of if you get it, it’s a question of how often and how severe it is for you. It can be caused by prolonged or continuous exposure to stressful events or a very intense event. Dr. Charles Figley describes Compassion Fatigue as the “cost of caring” for others in emotional or physical pain (Figley 1982). “The very act of being compassionate and empathic extracts a cost under most circumstances. In our effort to view the world from the perspective of the suffering, we suffer”-C.Figley “It is characterized by deep physical and emotional exhaustion and a pronounced change in the helpers ability to feel empathy for their patients, their loved ones and their co-workers. It is marked by increased cynicism at work, a loss enjoyment of our careers, and eventually can transform into depression, secondary traumatic stress and stress-related illnesses.  The most insidious aspect of compassion fatigue is that it attacks the very core of what brought us into this work: our empathy and compassion for others” (Mathieu 2007). 

Many individuals get Compassion Fatigue and don't realize what’s happening to them. While Compassion Fatigue was first identified in the 1990’s until recently not much was available on the subject. There was a culture of silence around the subject and the symptoms. It was thought you were either tough enough to take the stress or not good enough to do the job.  People in the helping professions made doing a hard job even harder on themselves and others by not recognizing it and talking about it.  One of the good things that has happened as a result of the Pandemic is the awareness of what repeated trauma does to healthcare professionals. One of the bad things that happened is many more healthcare professionals are suffering. Now we know that one of the ways to mitigate the effects of Compassion Fatigue/Empathic Stress is to recognize the symptoms when they start. When you openly talk about Compassion Fatigue you will be surprised how many people will want to talk about their experiences too. 

Just looking at the symptoms list may bring clarity to why you have been feeling the way you have. Take a few minutes and check off the symptoms you have recently experienced using Compassion Fatigue Symptoms Checklist shown below. Please note that this is not a finite list of symptoms and you may experience other feelings as well.

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Now that you have some idea whether Compassion Fatigue/Empathic Stress is a problem for you, we recommend that you take a few minutes one or twice a year to evaluate the extent of which you are being impacted. You can do this by taking a short free self-scoring test called the Professional Quality Of Life Scale. This scale measures your Compassion Satisfaction, Burnout, and Secondary Traumatic Stress/Compassion Fatigue. It can help you determine your steps going forward.  Do you need to make minor changes and take better care of yourself, or do you need to get additional help and possibility make career or position changes? This Scale was designed by Barbara Hudnall Stamm. More information on the scale is available at www.proqual.org. 

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http://www.proqol.org/uploads/ProQOL_5_English_Self-Score_3-2012.pdf

“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.” 

                                                                                                       —Rachel Naomi Remen, MD

                                                                                                       Kitchen Table Wisdom , p. 52

86% of ER Nurses suffer from Compassion Fatigue

40% of ICU Nurses suffer from Compassion Fatigue

24% of General Practice Nurses suffer from Compassion Fatigue

50%-60% of Physicians suffer from Compassion Fatigue  

Now that you have an idea of the extent of your Compassion Fatigue lets look at ways to mitigate the damage that it can cause.  The first lines of defense against Compassion Fatigue are:

Step 1:  Awareness—Its always easier to deal with feelings if you understand them. The tools given above makes it all make sense.

Step 2:  Debriefing—Debriefing within 48 to 72 hours often helps the brain to keep from making a traumatic event a lasting injury.  See Critical Incident Stress Management page to learn the steps of debriefing.  If symptoms persist, taking to a mental health professional may be helpful. 

Step 3:  Time Away—This is not a time to pick up overtime.  It is the time for self care and to decrease your exposure to traumatic or chronically demanding events. This is a good time to learn some new survival skills and give yourself a break.

Step 4: Organizational involvement—Organizations can play a major role in identifying problems and keeping their staff healthy. By identifying traumatic everts or staff under stress and providing education and team support the organization can add stability and resilience to any situation. See Organizational tips. 

Step 5:  Mindfulness Skills—Learning easy Mindfulness skills and using them daily can repair the brain and your DNA (The Body Keeps The Score, by Bessel van der Kolk). These short exercises can help you make it through your day and the emotional trauma you are facing.

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The second line of defense against Compassion Fatigue is to become as strong and resilient as  possible. Developing your core strengths will shield you in times of stress and misfortune. Some of the ways you can do this is to:

1. Analyze and expand your support network.

2. Work on physical, mental, and spiritual wellness.

3. Learning new skills and habits like Mindfulness and Reframing.

4. Learn how to recognize and deal with Lateral Violence.

5. Stay in touch with your personal purpose for doing this work. 

6. Debrief distressing situations frequently and before too much time has passed. 

7. Take The Professional Quality of Life Scale (ProQuol) at least twice a year.

8. Get addition help if you need it. We all need a leg up sometimes. Free counseling help is available. 

9. Visit the other pages of this website for more information, ideas and techniques.  Participate in the Facebook Stat Lavender Compassion Fatigue and Resiliency Forum and Blogs.

10. Start the conversation about Compassion Fatigue with your co-workers.  You may help them recognize and deal with their own Compassion Fatigue.  

Start now by writing down your plan of action!

Diane McKeyhan RN CFS

Resilient Professionals