Can you handle a job where your mental resilience is tested every minute? Tens of millions of people do it worldwide, and their contributions help keep humanity on its feet. Nurses, physicians, therapists, healthcare workers, and more make up one of the most vital sections of society. Unfortunately, they also make up the part of the population most vulnerable to compassion fatigue.
Compassion fatigue is the mental and physical exhaustion developed from exposure to the trauma of individuals in their care. Its symptoms align with those of burnout and secondary traumatic stress: exhaustion, anger, irritability, negative coping behaviors (alcohol and drug abuse, etc.), decreased ability to sympathize or empathize with others, decreased job satisfaction, job evasion — and in extreme cases, the development of psychological disorders such as depression, anxiety, and post-traumatic stress disorder.
Unsurprisingly, those that work in healthcare and community services are some of the most susceptible to these symptoms, according to numerous studies. Caregiving heavily relies on interactions with their patients; as such, these workers must be able to feel and convey empathy with those individuals to successfully complete their tasks. Over time, these abilities eventually become strained and exhausted. This is particularly significant for those working with life-threatening cases, such as in the emergency department.
Not only does compassion fatigue impact caregivers; there are also occupational consequences. Patient care standards lower considerably due to stressed caregivers’ decreased decision-making abilities and job turnover rates (because of job dissatisfaction) increase the workload on the remaining workers — which shortens the amount of attention and effort they can partition to each patient. Some also become fearful that they cannot provide satisfactory care, leading to evasion and ultimately impairing patient care. Coworker relationships become strained as well, decreasing organization and the efficiency of the healthcare system to treat patients.
Furthermore, recent years have proven especially stressful to healthcare workers due to the COVID-19 pandemic. Physicians have been forced to make tougher ethical decisions due to limited resources, like having to decide which cases to prioritize. They face an overwhelmed and disorganized healthcare system on one side and patients suffering on the other. The uncertainty of the disease and fear for their safety, along with their unpreparedness to handle a pandemic, led to many caregivers reporting compassion fatigue (including emotional and psychological distress) in separate studies conducted in Spain and China.
There is hope for prevention and recovery from this condition. Although not enough research has been conducted on compassion fatigue, some studies have shown that programs that focus on promoting resilience, such as the Accelerated Program for Compassion Fatigue, help decrease symptoms of burnout and stress in healthcare workers. These trainings include teaching workers how to identify compassion fatigue and take control of their emotions, particularly their stress reactions. As they learn to shift their perceptions more optimistically and develop self-compassion, some have reported feeling more empowered and energetic.
Studies have also found that compassion satisfaction — the positive feeling that healthcare workers develop when they feel competent and socially valued — can protect them from compassion fatigue. A study conducted in Spain found that more nurses than physicians feel compassion satisfaction, which researchers speculate comes from the fulfillment they experience from the closer contact and direct care for their patients along with the recent upsurge in social recognition that nurses have been receiving.
Additionally, support and encouragement from management may not only improve a worker’s feelings of competence and importance but increase job satisfaction. Some engage in self-care activities, which not only bolster compassion satisfaction but also improve self-control over their emotions and allow their minds a mental break to process their feelings.
Compassion satisfaction can also be improved from positive relationships with one’s coworkers. Some institutions implement group discussions after difficult cases to get workers to confide in one another and process their emotions. The connection and support among coworkers have been speculated to protect pediatric palliative care providers from the emotional toll of compassion fatigue in certain studies.
With their mental fortitude, nurses, physicians, and therapists should be considered some of the most resilient people in society. Healthcare workers constantly manage the challenge of handling multiple sets of emotions at once, not to mention their own. Without their strength and compassion, we would not be here today.
Palliative & Supportive Care (2019). DOI: 10.1017/S1478951517001237
Journal of Clinical Nursing (2020). DOI: 10.1111/jocn.15469
International Journal of Environmental Research and Public Health (2016). DOI: 10.3390/ijerph13060618