If you’ve been nursing for any length of time, chances are you’ve experienced a weariness or lack of resolve related to the constant witnessing of suffering and the need to invest emotional energy into your work.
But if that condition has become chronic and overwhelming and you continually feel you’re “running on empty” you may be battling compassion fatigue, a deeper issue associated with the ceaseless demand for support and encouragement while on duty.
It’s a problem that can also be pervasive among military personnel, firefighters, emergency responders and others regularly faced with pain and suffering, but wasn’t recognized in nurses until the late '80s and early '90s.
Despite the frequency of compassion fatigue in healthcare — and the significant threat it poses to employee retention and the quality of patient care — many healthcare employers have been slow to acknowledge or arrange interventions to combat the problem.
“On a daily basis, nurses respond to urgent and life-threatening emergencies that require complex, cognitive work in tandem with the provision of emotional counsel,” confirms Deborah A. Boyle in the Online Journal of Issues in Nursing. “Yet, they frequently have little or no formal supports in place to counter the potentially negative emotional sequelae of their work.”
Knowing the difference: Routine workday stress versus compassion fatigue
So how do you know if you’re just temporarily burned out or suffering from a more severe condition that may require intervention?
According to researcher and author Dr. Michael K. Kearney on ReliasMedia.com, burnout is a more generalized reaction to the daily stress people experience across professions in response to their work environments, their perceived lack of control and/or value differences between themselves and their employers.
In contrast, compassion fatigue — aka secondary traumatic stress disorder — is marked by the following key symptoms, according to the same article:
- Emotional and physical exhaustion
- Depersonalization, or feelings of cynicism and detachment from your job
- A feeling that you’re not meeting expectations or lacking in terms of personal accomplishment
Other indicators may include irritability, worry, forgetfulness, sleeplessness, headaches, backaches, attempts to self-medicate and/or a reluctance to return to work, according to Kate Sheppard in American Nurse Today.
“Nurses talk about feeling bored with their work or feeling detached and distant from patients and colleagues,” she adds. “They may feel they’ve failed to relieve a patient’s pain or to help a patient get well, losing their sense of pride in being a nurse. Frequently, I hear nurses say they feel queasy just driving to work, and those feelings intensify as they walk in the door.”
It’s important to note that in many cases, those suffering from compassion fatigue can still feel compassion — but it tends to add to the sense of being emotionally overwhelmed.
Are you at risk as a traveling nurse?
Compassion fatigue can happen to any nurse, especially those who tend to form close, caring relationships with patients, reports Sheppard.
“We know that nurses who work in oncology or see more patient deaths may be at greater risk,” she advises. “Sometimes a particular patient or a patient’s family member may remind us of someone important in our lives. If that patient or family member has died, we may be triggered emotionally. Nurses who skip breaks, take extra shifts or come in on their days off out of a sense of duty may be more at risk for compassion fatigue. One of the greatest risks for compassion fatigue comes when nurses forgo their own self-care.”
Over time compassion fatigue has the potential to worsen, dictating the sufferer’s life and beliefs while hampering traditional coping mechanisms.
The threat to patients is real
Further, the problem of compassion fatigue goes beyond just clinicians themselves; it can also interfere with the quality of patient care when a nurse can no longer summon the empathy needed to help patients cope with trauma and heal.
"To be a patient on the receiving end of that is maybe to be on the receiving end of the (clinician) who is still doing the right thing technically, but who is not able to be present in an engaged, humane, warm way because they literally don't have it in them anymore,” Kearney explains.
Caring for yourself
What can you do to reduce or even prevent compassion fatigue? Here are some suggestions:
- Acknowledge your feelings and try to identify more specifically what triggers them so you can address the underlying case. “Perhaps you feel overlooked, ignored, invalidated, unfairly treated or criticized,” suggests Sheppard.
- Re-establish healthy emotional boundaries between yourself, other staffers and patients. You can be a great nurse without investing all your inner self into your work.
- Prioritize self-care and self-compassion. Aim for a true work-life balance and mentally separate yourself from your work when not working, scheduling activities you find relaxing and enjoyable. Work on keeping your inner thoughts about yourself kind and non-judgmental.
- Schedule stress relief tools such as workout sessions, massages, yoga classes, meditation sessions, spa days, spiritual retreats, etc.
- Practice self-reflection. The more you understand about yourself, the more you can become aware of the people, situations and events that act as your triggers. “Even if you can’t change your work environment, you can find power within by listening to your emotions with kindness and approaching colleagues and others from a wise and centered perspective,” advises Sheppard.
- Take “mental health days” that serve as mental and emotional mini-vacations from the workplace.
- Find out whether your employer offers a support group or a mental health assistance program for its workers. If not, you may wish to engage an outside mental health provider who can help you work through your feelings.
- Resist the urge to self-medicate, blame others or work harder or longer.
Read our earlier article to learn more general tips for handling stress in the travel nursing profession.