What is Compassion Fatigue?

By Matthew Kramer, MD, medical staff president, Miami Valley Hospital

Everyone has heard the term burnout, especially if you work in health care, and much has been written about the effects of work overload and unrelenting fatigue during this seemingly endless cycle of COVID-19 surges. But have you considered the effect of compassion fatigue?

Compassion fatigue, sometimes referred to as Secondary Traumatic Stress (STS), is a condition that almost preferentially strikes at health care workers, first responders, law enforcement officers, at-home caregivers, and others whose work requires constant empathy. It is similar to burnout in its symptoms but is the result of being placed in the position of having to constantly help others, without respite. You want to keep helping, but you’re overwhelmed by constant exposure to the trauma of others. This leads to a diminished capacity to empathize with and feel compassion toward others, which can have psychological, emotional, and even physical consequences. The signs of compassion fatigue include:

• Feelings of physical and psychological exhaustion
• Feeling helpless, hopeless, or powerless to change the situation
• Mood swings and other changes such as irritability, anger, sadness, or emotional emptiness
• Detachment and anhedonism, decreased sense of self-worth and accomplishment
• Intrusive thoughts about the suffering of others and anger toward the events or people causing the suffering
• Self-blame, self-doubt, or guilt over inability to help
• A change in your worldview or spirituality
• Physical symptoms that might include sleep and appetite disturbances, nausea and dizziness, palpitations, nonspecific aches and pains, headaches, or disrupted sleep

How prevalent is compassion fatigue? Recent studies using the Pro-QOL (Professional Quality of Life Scale) have shown that up to one-quarter of ambulance crew members, one-third of hospice nurses, and more than three-quarters of Emergency Room staff are at serious risk of compassion fatigue. These could be your friends and colleagues. They could be you!

Addressing Compassion Fatigue

There is often little that the emotionally exhausted person can do to decrease the suffering of others. But there are things you can do to address compassion fatigue. Options include:

• Step back and work toward finding a better work-life balance
• Set up a self-care routine – get enough sleep, choose healthful food, exercise, and build on social relationships
• Build self-awareness of how stressful or traumatic information affects you
• Engage in activities that replenish and rejuvenate you, and become involved in a supportive community
• Practice gratitude and being present in the moment
• Understand that suffering and pain are parts of the collective human experience that you do not always have control over
• Focus on what you do have control over, such as your thoughts, feelings, and response to stress
• Seek professional help if you need it

Helping others without replenishing yourself can be overwhelming. Anyone who has flown on an airplane has heard the announcement to “Put on your own oxygen mask before helping others!” We should be willing to give ourselves “permission’” for self-care, as well as honor that commitment in others. We are a community, and now, especially in the time of battling COVID-19, we must remember that none of us is alone.

Back to the February 2022 issue of Premier Pulse