Compassion fatigue has been recognized as a phenomenon in clinicians for decades. It is essentially a disorder driven by the secondary traumatic stress encountered in the clinical setting. Secondary trauma occurs when experiencing loss, grief, pain, trauma, gore, or being present for the recounting of these factors by our patients. Burnout is a component of compassion fatigue, and burnout can be driven by numerous factors, including overwork, understaffing, difficult interpersonal interactions with patients or coworkers, job insecurity, poor compensation, and disappointment in the workplace.
Symptoms of compassion fatigue include disdain towards or withdrawal from patients/work, feelings of hopelessness, negative self-talk, feelings of inefficacy, an increased perception of threats in the workplace or even at home, and physical symptoms like sweating or activation.
Compassion satisfaction is pleasure and satisfaction derived from working as a helper in caregiving systems and is seen in higher levels in workers who do not have compassion fatigue. Increased compassion satisfaction is what can be achieved through interventions that effectively decrease compassion fatigue.
The search for effective treatments for compassion fatigue has been ongoing since the term compassion fatigue was first used over 30 years ago. In the same way that trauma is a consequence of war, primary or secondary traumatic stress is often a consequence of caring professions. Some precipitants of burnout in the workplace can be addressed through policies that deliberately safeguard workers, like proper staffing matrices, but the gore or loss that is routine in many clinical settings in which nurses work is often intractable.
The trauma that the pandemic has wrought on nurses in the last year means that baseline levels of compassion fatigue are likely to be higher now than have been seen in decades. It’s important to be aware of burnout and compassion fatigue because they are a major driver of non-retirement turnover in a workplace already stretched thin by pandemic-related losses. Non-retirement turnover can also become a proverbial revolving door, as less experienced nurses are left to train newer nurses. The increased stress on all parties precipitates more non-retirement turnover.
Self-help Methods for Addressing Compassion Fatigue
Self-care for the caregiver
- Prioritize your health and wellness and make time for yourself. Nurses can be conditioned to put the needs of others over their own, but when professional roles bleed over into personal life, it’s important to take stock and take time for oneself.
- Engage in activities you enjoy on a regular basis and ask for help from friends or family members if the hectic nature of the workweek makes scheduling time for yourself difficult.
- Humor helps, and it’s okay to seek out sources of humor you enjoy. Humor is an often-overlooked strategy for coping with stress.
Keep work at work
- The work-life balance is tough for caregivers like nurses, especially for those working long shifts. Employ transitional activities to help decompress when you get home: exercise, meditate, watch a show you enjoy, listen to music, or talk to a friend or family member about something other than work for a time.
- Make decompression time a routine part of your day ever workday.
- If your workplace offers a peer support group or wellness resources, make use of them.
- Resist the urge to withdraw from others when feeling burnout or compassion fatigue and find people who are comfortable listening to you and who can empathize. This can be done in a formal setting through counseling, or it can be done informally with friends, family, or coworkers.
Meditation and imagery
- Mindfulness mediation and other forms of meditation are helpful not just because they are calming and helps focus the mind, but because they are an activity that can help shift your thoughts away from work stress.
- Creative visualization is another calming and distracting exercise that can be used for self-care or for the transition from work time.
- Spend some time to take stock of your feelings. Are you feeling burned out? Do you feel overwhelmed by work tasks? Are you having disappointing interactions with patients, coworkers, or people in your life? Are you caring for others and not caring for yourself?
- It’s important to remember that nurses and health care workers have experience and are experiencing a harrowing time with the pandemic. You are not alone.
- Nurses have experienced huge losses, and it is not a reflection of personal failure. Many patients have died during the pandemic. Remind yourself that the pandemic is not your fault—we are all doing the best we can.
Not all interventions are equal—some methods can worsen burnout!
Mandatory didactic training
- Studies of burnout in resident physicians show that mandatory trainings on burnout increased rates of burnout because it made hectic clinical schedules even more hectic.
- The last thing people want when feeling compassion fatigue is an additional time burden added to their plate. This makes addressing compassion fatigue in the workplace tricky.
Voluntary didactic training
- Although voluntary training on compassion fatigue is better than mandatory training, an active pandemic might not be the best time for traditional didactic training. This means it is time to get creative.
Novel workplace ideas for pandemic-weary nurses
Materials nurses can browse at their leisure
- Nurses can’t address compassion fatigue if they don’t know what it is or how to recognize it in themselves. Provide nurses with literature and materials on compassion fatigue they can browse on their own time and give continuing education credit and/or flexible training time to do it.
- Videos and online materials may be helpful.
- Opt-in wellness messages and self-care reminders through text or email are helpful to some.
- Meditation and wellness applications are also increasingly available.
The gift of time off
- The National Health Service in England recently gifted nurses with a day off on their next birthday as a reward for their bravery and service during the pandemic. Time off for self-care might be the most welcome intervention of all for pandemic-weary nurses suffering from burnout or compassion fatigue.
To learn more about mental health and expand your awareness of behavioral health issues, visit Symptom Media, an online film library of video case studies and assessment tools and an ANCC and ACCME accredited CE course collection.
You're a Great Nurse!
Join a community of nurses who will make you feel like the rock start care giver you are!
By joining Symptom Media, you can access over 600 films showcasing stories and symptoms of mental health along with a range of courses taught by experts in the fields of psychology, psychiatric nursing, and more, accessible whenever and wherever you need them.
Symptom Media is proud to support FreshRN’s nurses week with a special discount of 25% on your subscription. Just use the code FreshRN to save.
- S5E46 – Proactively Preventing Nurse Burnout
- For the Overwhelmed New Graduate Nurse
- Nurses and Secondary Trauma
About the Author:
Stephanie Arnold is an Adult Psychiatric/Mental Health Clinical Nurse Specialist working as an advanced practice nurse in psychiatry. She holds an undergraduate degree in Celtic Studies from UC Berkeley, an MSN from Cal State Los Angeles, and is a doctoral candidate in the University of Alabama’s DNP program. Stephanie also teaches mental health nursing to graduate and undergraduate students. She is a member of Sigma Theta Tau and Golden Key International Honour Societies. She was inducted into a chapter of the Philanthropic Educational Organization and is an active member serving on the Ways and Means Committee. Stephanie is an instructor for Symptom Media’s mental health CE courses.
Leave a Reply