What is Compassion Fatigue?

Medical doctor and young couple patients.
Caring for others has long been recognised as having a detrimental effect on a person’s health and wellbeing. Mother Teresa mandated that her nuns take an entire year off from their duties every four to five years so that they could heal from the effects of their care-giving work. The phrase compassion fatigue was first used in the early 1990s by a nurse describing the experiences of her fellow nurse. But what is compassion fatigue and how is it recognised?

Compassion fatigue may also be called vicarious trauma or secondary trauma. It is something that develops over time as a result of the accumulation of dealing with patient trauma and can often impact healthcare workers who are regularly dealing with traumatised patients such as doctors and nurses working in hospital emergency departments, as well as psychotherapists.

Symptoms of compassion fatigue can include sleep disturbance, physical fatigue, loss of appetite and weight loss, nausea, headaches, and irritability and anger. It can also result in symptoms associated with depression and post-traumatic stress-disorder. People who are drawn to care giving roles tend to be naturally compassionate and empathic people. Some care providers empathise with their patients to the extent that they experience the same physical symptoms.

Compassion fatigue differs from burnout which tends to develop as a result of a health care workers interactions with their work environment, whereas compassion fatigue is attributed to interactions with patients. People experiencing burnout typically go through several stages. Compassion fatigue typically develops more rapidly than burnout but can also be recovered from quicker.

Compassion fatigue can co-exist with burnout and can be exacerbated by heavy workloads and insufficient time to process each case. People suffering from compassion fatigue tend to get sick more frequently and miss work more often so it has an impact on service delivery. They may also become more accident-prone or deliver reduced work performance which impacts on co-workers.

How to avoid and treat compassion fatigue

Setting emotional boundaries can be helpful in reducing the risk of developing compassion fatigue. Healthcare workers such as nurses and doctors are often asked for advice and support by family and friends who respect their knowledge and experience. Not getting involved in cases outside of work and keeping home life separate is important.

Knowing and understanding the symptoms of compassion fatigue is an important first step in managing the condition. Keeping a journal of emotional responses can be helpful in recognising changes and can also be a therapeutic tool.

It is important that care givers take time for their own self-care. This can include eating nutritious healthy meals, exercising, and getting sufficient sleep. Taking time out for oneself amongst a busy workload is not always easy to do but can be as simple as doing some basic stretches, listening to relaxing music, or deep breathing. Other strategies are to engage in hobbies and healthy social activities.

There are compassion fatigue self-assessments available online as well as advice on recommended strategies to help healthcare workers manage compassion fatigue. Many healthcare facilities also have an Employee Assistance Program which is a confidential service that assists workers with managing emotional well-being.