Compassion Fatigue

Compassion Fatigue in Health Care Workers in the United States

Compassion fatigue is a psychological syndrome that is extremely common in the today’s health care workers. It can range from mild burnout to an all-encompassing need to escape the daily stressors at work by no longer being able to show a compassionate response to the demands presented to the caregiver by the patient in need. Compassion fatigue has a huge impact on the worker’s mental health. Constant exposure to the heart-wrenching situations that many seriously ill patients experience can exert a devastating effect on the health care workers that surround them. As a protective mechanism, the health care worker begins to tune out or emotionally remove themselves from the patient, and lose their ability to have a compassionate response to those same people that might have had them feeling a certain amount of sympathy even hours before. While health care workers have to have a thick skin, this is a much further step away from being emotionally resilient.

It is a well-known fact that many health care workers go above and beyond what their specified duties are on the job, especially those that work in a skilled care or hospice facility. These patients’ needs can range from basic physical care to emotional support due to severely traumatic experiences. There is always a cost to being exposed to such high stress environs, and this can have a pyramid effect. Compassion fatigue can lead to higher turnovers in a place of employment, decreased productivity and lesser job satisfaction overall. We all know that misery loves company, so an action plan must be made to address these factors constructively. Miserable employees compound the issue and spread negativity in the team environment.

The process of managing compassion fatigue in the workplace begs several very important questions. At what point does someone in a management-level position need to step in when they see the signs in their personnel? An increase in the number of sick days, physical symptoms like headaches and increases in the moodiness of the team members who tend to be more well-adjusted individuals could be potential indicators. How should the team manage their collective stress level? Group and even individual sessions to address the needs of the staff should have their time and place outside of a break room or lunch area. Lunch or breaks just aren’t sufficient to get progressive change started. Is there a specific time and place for the team members to express their feelings and concerns for patients? Sometimes the needs of specific patients must be re-evaluated sooner. Every work place holds its own unique dynamics and the channels of communication need to remain open above all else. Employees need to feel secure in talking to their superiors and addressing their concerns for the welfare of the patients as well as themselves.

For example, if everyone in Nursing Unit 820 in a long term skilled care facility dreads going to work when they know they must spend time caring for John Doe because he’s constantly in tears and mourning his own terminally ill condition, then it needs to be addressed as a team. The work load may need to be split up differently as to not bog down a single worker, or additional counseling services can potentially be ordered for the patient. A multimodal approach should be considered as this a multifocal problem. When it’s only a single patient problem, compassion fatigue stands out quite clearly in multiple staff members as a specific trend with their avoidance behaviors in relation to that patient. Things get a little bit foggier when multiple patients are involved. Maybe the caregiver doesn’t get to take their usual number of breaks throughout the day and the burnout starts there. The bottom line is recognition when and where it starts; the caregiver’s personal triggers and how to manage personal limits.

Compassion fatigue is a complex process sometimes involving one’s mental, physical and/or emotional well-being. The biggest sign is avoidance or dread when working with certain patients in particular. It’s normal to want to avoid a negative situation, but it’s another thing entirely when it begins to cause physical maladies such as headaches, fatigue and insomnia. Working stressors are common, but compassion fatigue shows itself when the caregiver’s personal limits have been exceeded.

The Online Journal of Issues in Nursing is an excellent resource for checking on your own personal symptoms of compassion fatigue. Scholarly journals are an excellent route for gaining insight into relevant issues in the field.

Nursing World: Compassion Fatigue

Everybody needs a mental health day once in awhile. Be sure to de-stress and respect yourself. Take that respect with you to work and play nicely with your team mates. Everyone is fighting their own personal battles both at home and in the work place. Don’t be afraid to keep a journal about your experiences and determine what your personal triggers are. Many people find that there is a certain time frame within which they will reach a state of burnout without having some time to themselves away from the work place. Plan ahead for when you’re going to take time off and have a break from thinking about the patients that you’re caring for and give yourself that same attention.

While it may seem like a separate topic entirely, it bears mention that most Americans take very little vacation time compared to many other countries. With a generalized lack of vacation time, burnout and compassion fatigue seem even more likely to occur at faster rate than in other countries. In fact, Forbes online published an article in August of 2013 stating that the US is the only advanced economy that does not require employers to provide paid vacation time. Read their article here:

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