Compassion fatigue in nurses is very real and it’s way more than nurse burnout – it’s the physical, emotional, and psychological impact of helping others. While burnout typically stems from a combination of too much work and too many responsibilities, compassion fatigue is feeling like you just have nothing left to give. If that sounds familiar to you, read on to learn: What is compassion fatigue? How can it be treated? Is it possible to recover, and where can you get help?
Words cannot describe the selfless and compassionate work of nurses. Over the past two years, nurses have been tested and pushed to the limits. Hospitals have been affected by workforce shortages, staff burnout and COVID hospitalisations. This has affected nurses severely, they are working crazy hours, and have higher than usual nurse-to-patient ratios. Undoubtedly, it has taken a toll on their health.
We all know nurse burnout is becoming a serious situation which is why we need to address the problem quickly. In this article, we will discuss compassion fatigue and the simple steps required to resolve it. But first and foremost, we would like to start off with the importance of being compassionate to yourself. Not every day will be the same, but a little self-love every day will add up and make an enormous difference.
What is Compassion Fatigue?
Compassion fatigue is a state of emotional and physical depletion caused by extended contact with trauma or traumatised people. According to the National Center for Biotechnology Information (NCBI), compassion fatigue occurs when one’s ability to cope with one’s daily environment is exhausted, which then leads to an inability to feel empathy toward patients, coworkers, and even loved ones.
Psychology Today defines it as “the more such individuals open themselves up to other’s pain, the more likely they will come to share those victim’s feelings of heartbreak and devastation.” This type of stress develops over time, weeks, months, or even years.
Internal trauma can be created by first responders, doctors, nurses, and others who are constantly exposed to life-threatening, crisis-oriented situations. Caregivers of persons suffering from chronic conditions like dementia may also experience comparable symptoms. This type of fatigue has an emotional and physical impact, and it can be a workplace hazard.
Compassion Fatigue vs Burnout
“I was on a collision course for nurse burnout – I had recenly received a promotion at work and had taken on more resonsibility; was always the one to say ‘yes’ and ‘happy to help’ when we were understaffed, I took on extra patient loads, and it wasn’t uncommon to skip breaks, without thinking about the impact it would have on me. It should have come as no surprose that I’d just burnt out. It was just too much for one person juggling everyting at work and home and trying to be everything to everyone.” 8th Year Medical Ward RN
According to Tend Academy, the distinction between compassion fatigue and burnout is that the latter occurs as a result of “physical and emotional exhaustion that workers can experience when they have low job satisfaction and feel powerless and overwhelmed at work. However, burnout does not necessarily mean that our view of the world has been damaged, or that we have lost the ability to feel compassion for others.”
Burnout is frequently caused by having too much work or too many responsibilities, whereas compassion fatigue develops as a result of helping others—you want to keep helping, but you’re overwhelmed by their trauma.
Similar to burnout, compassion fatigue is a process. Yazhini Srivathsal, MD, a psychiatrist with Banner Behavioral Health Hospital in Scottsdale, Arizona, USA, said, “It takes time to develop. It keeps building slowly, to a point where you start to not care about yourself or others in your life. You end up overusing your compassion skills and reserves, so you no longer have much to provide.” Another overlap is some of their symptoms like exhaustion, helplessness, and stress.
“The easiest way for me to describe how I was felt is that I had no gas left in the engine. I had nothing esle to give. I was numb and didn’t care about my patients the way I used to. I felt emotionally disconnected and like I had no empathy at all, and scarily, it seemed to happen suddenly. I literaaly had no compassion for anyone around me, my patients, my job, my peers, let alone myself. 7th Year ICU RN
Causes of Compassion Fatigue
Because of the occupational obstacles nurses experience, it’s typically easy to quantify the “cost” they face as they work through their shifts trying to offer the best possible care to each and every patient they see.
Individuals who work in critical care are frequently subjected to repeated trauma. These employees interact with people in life-threatening situations on a daily basis. These healthcare professionals work in high-stress situations when their decisions can determine whether someone lives or dies.
Furthermore, there is frequently insufficient time to recharge or absorb each shock. As soon as one person receives assistance, another critical patient may require it. Compassion fatigue, secondary traumatic stress (STS), and turnover are all common among critical care personnel as a result of repeated trauma.
High mortality rates
The enormous volume of mortality that healthcare personnel must witness is another source of compassion fatigue. While it may be a necessary aspect of the job, it can affect employees and make them feel as if their efforts are in vain.
Furthermore, when you are regularly exposed to something, you grow desensitised to it. Even for something as dreadful as patients dying, this is true. Compassion fatigue syndrome can develop over time, and death begins to feel less awful.
Long periods of overwork increase the risk of compassion fatigue. When health care workers have too much on their plate, the often reaction is to get everything done.
They don’t have time for compassion or emotional processing when they’re going through the routines of the day. For example, your favourite patient passes away, but you’re also dealing with three other situations. You just cannot pause to mourn your loss since you have more work to complete.
Stress at home
You need to go home to unwind and recharge when you work in a high-stress environment like health care. If your home, on the other hand, is a source of stress, it becomes impossible to “refill your cup.”
Compassion fatigue in health care, as previously said, is a sort of stress trauma. When you’re stressed in various aspects of your life, it’s easy to lose compassion for others at work or at home. You’re using all of your emotions and energy to keep afloat, and you’re unable to empathise with others.
Other causes of compassion fatigue that nurses face on a daily basis are the following:
- Heavy workload
- Stressful work environments
- Risk of being assaulted or abused by patients
- Decreasing resources
What are the Symptoms of Compassion Fatigue?
Compassion fatigue can have major physical, emotional, and mental consequences for a person. This can have ramifications in both the individual’s personal life and professional performance.
When determining whether you or someone else has compassion fatigue, check for the following signs:
- Extreme physical, psychological, and emotional exhaustion on a regular basis
- Increased anger and irritability
- A diminished sense of self-worth
- Lower levels of job satisfaction
- A decreased sense of personal and professional accomplishment
- Reduced empathy
- Disruption of world view
- Irrational fears and extreme anxiety
- Detachment and isolation
- Impaired ability to make well-informed decisions
- Difficulty separating work and personal lives
- Dread of or losing interest in going to work
- Sleep deprivation, loss of appetite, nausea and dizziness
- Feeling helpless, hopeless or powerless
- Misplaced anger
- Mood swings
- Loss of morale or self-worth
One of the problems of compassion fatigue is that those who experience it deny it. Psy.D. Sherrie Bourg Carter illustrates why denial is dangerous – “because it prevents those who are experiencing compassion fatigue from accurately assessing how fatigued and stressed they actually are, which prevents them from seeking help.”
The sooner you recognise indicators of compassion fatigue, the easier it will be to take care of yourself and restore your empathy reserves.
Nurses are at High Risk of Compassion Fatigue
The population most at risk for compassion fatigue is the healthcare professionals and long-term carers. They commit themselves to caring for, healing, and protecting the individuals they come into contact with due to the nature of their jobs.
Compassion fatigue is more common in women due to their preference for caring occupations. Hospital, emergency, and community service employees are particularly vulnerable to compassion fatigue.
Critical care nurses, possibly more than anyone, are exposed to trauma on a daily basis, and this prolonged exposure can lead to compassion fatigue.
The profession can be extremely rewarding, but only if critical care nurses track their mental health. If you work in adult, paediatric, or neonatal critical care, keep in mind that you’re making a significant impact and that you’re doing an important job, but you’re also in danger of compassion fatigue. You must be emotionally vigilant to avoid losing compassion for patients and fill your cup by taking care of yourself while caring for others.
Oncology healthcare workers, especially critical care nurses, are also likely to experience significant levels of compassion exhaustion. Nurses and medical assistants who care for cancer patients on a daily basis witness a great deal of death. Regardless of how important the profession is, that constant loss can deplete even the most sympathetic healthcare worker in a couple of years. They may feel that they’re always losing and that their efforts may appear worthless.
Healthcare workers who lack peer support are more likely to suffer from compassion fatigue than those who work in a cohesive team. Non-healthcare friends and family members can provide a distraction from the everyday trauma you witness at work, but you need your peers to process your grief and uncertainty because they understand. They’ve probably been through something similar, and their support might help you maintain and even replenish your compassion when you’re feeling low.
On the other hand, compassion fatigue affects the patients as well. Patients who are treated by nurses who are suffering from compassion fatigue frequently receive lower-quality care, which can be life or death in some cases. As a result, compassion fatigue in nursing is a workplace concern that should be addressed as soon as it is suspected or identified. Unfortunately, because it’s an occupational danger, nearly every nurse will experience it to some degree.
How To Prevent and Treat Compassion Fatigue
If you or a nurse you know is dealing with compassion fatigue, know that you are not alone and that it is a treatable and controllable condition. Recognising and admitting that it exists is the first step toward treating it. From there, you can try to figure out why it’s happening.
It’s critical to take measures to alleviate compassion fatigue. Compassion fatigue symptoms, if left untreated, can lead to a range of mental health issues, as well as sadness, anxiety, obsessive-compulsive and substance abuse disorders.
From an organisational standpoint, it’s critical to make compassion fatigue in nursing evident and well-known across all departments. It becomes easier to create a supportive work atmosphere that fosters reasonable workloads for each nurse, adequate debriefing procedures, a suitable number of mental health days, collaborative peer support, and more if compassion fatigue is widely recognised as a real mental health condition.
Providing yourself with increased self-care is the cornerstone of dealing with compassion fatigue on a personal level (exercise, healthy diet, free time to enjoy hobbies like making art, etc.). Self-care is tough for nurses since they are accustomed to putting others’ needs ahead of their own. However, taking additional time for yourself is critical to avoiding compassion fatigue.
“It might sound cliché, but you need to put your own oxygen mask on before you help others with theirs,” said Yazhini Srivathsal, MD, a psychiatrist with Banner Behavioral Health Hospital in Scottsdale, AZ. “We need to make sure we are tending to our own emotional and physical well-being and needs while we are involved in providing care for others.”
Dr Srivathsal recommends:
- Finding a balance between your work and personal lives and, if possible, taking time off
- Getting enough sleep, eating healthy foods, exercising regularly, and maintaining social contacts as part of your self-care regimen
- Monitoring how stressful or upsetting information affects you and avoiding information overload
- Identifying your priorities and engaging in replenishing and rejuvenating activities
- Gratitude exercises and being present in the moment
- Recognising that hardship and pain are part of the human experience and that you don’t always have control over them
- Rather than having unreasonable expectations about changing things that are beyond your control, focus on areas where you have influence, such as your thoughts and feelings
- Seeking expert assistance, if you feel the need to do so
You can lessen the unpleasant emotions it causes and find positive solutions to repair relationships that have been harmed by compassion fatigue. The primary purpose is to teach you how to take care of yourself and to assist you in striking a healthy balance between your career and your personal life.
Here are additional steps to explore to help minimise the severity of symptoms:
- Recognise empathy as a feeling as much as a talent. When empathising with others, use this skill to control your emotions.
- Consider individual, group, or family therapy
- Participate in things that will rejuvenate you and make you happy.
- Eat healthy and good quality food
- Get enough sleep and exercise
- Step back from work to relax and recuperate
- Recognise that you have limited power over the sorrow and suffering of others, which you cannot change.
- Set attainable goals for yourself in terms of job and caregiving. Setting small, realistic objectives might provide a sense of accomplishment, but keep in mind that you are only one person and cannot always meet everyone’s requirements.
- Make an effort to do things that will improve your mood and spirit. Play your favourite songs, get yourself flowers, and display your favourite images in conspicuous areas to make the world around you more cheerful.
- Express your thanks for the good things in your life. Many people keep a gratitude diary. Every day, find something that is satisfying or makes you feel wonderful. It might be as simple as receiving praise, accomplishing a chore, or achieving a personal goal, but shifting your focus onto what you are grateful for and shifting your focus on the positives in your day can help uplift you.
How to support someone who is experiencing compassion fatigue
Recognise that a loved one who belongs to a high-risk category may suffer from compassion fatigue. Keep an eye out for warning indicators and personality changes. If you are not paying attention, it is simple to overlook symptoms. Allowing quiet and denial to persist for too long is dangerous. These interactions can make the individual suffering from compassion fatigue, as well as family members, feel alone, frustrated, and furious. One of the difficulties with this diagnosis is that those who have it may be in denial.
If you have concerns about a loved one and notice behavioural changes that are affecting them and their relationships, gently question. If a loved one is continually complaining about work or seems to dread coming to work, encourage them to talk to you about it. You may need to take this first step to assist them in more honestly and productively exploring their problems. If your loved one is taking on a caretaker role in their personal life, think about how you might help them cope with the stress of caregiving outside of work.
Helpful Resources For When You Need Support For Compassion Fatigue
Nurse & Midwife Support: A free, confidential 24/7 national support service for nurses & midwives: 1800 667 877
Nursing & Midwifery Health Program Victoria: 03 9415 7551
The Happy Nurse – Run by a friend of uPaged and Registered Nurse, Elaina Mullery, visit The Happy Nurse for webinars, podcasts, online courses and private coaching and support.
Lifeline: 24/7 crisis support for all Australians: 13 11 44 or chat online here
Black Dog Institute: free courses and support for healthcare professionals and emergency help here.
Check out the uPaged post on Nursing the Nurses and RUOK for more on nurse mental health, self-care and support.