Compassion fatigue in 5 questions

Healthcare workers such as nurses, doctors and psychologists show an enormous amount of empathy and compassion every day. They give so much of themselves and do so with their heart and soul. But when the exposure to human suffering grows and grows, even healthcare professionals can reach their emotional limits.

“Compassion is not a bottomless reservoir”, says Anneleen Vanlook, prevention advisor for psychosocial aspects at Mensura. “You could compare it to a water jug, filling several glasses. If this jug is not refilled on time, it will be empty at some point. This can also happen to healthcare professionals. We give so much as care workers, that we become emotionally exhausted all of a sudden. The worst scenario is that we are unable to even muster empathy for patients or clients. This emotional burden is called compassion fatigue.

A lack of empathy is an extreme for of compassion fatigue in itself, says Anneleen. “Compassion fatigue usually manifests more innocuously, such as: losing your patience, becoming irritated with patients more easily, becoming distracted when talking with clients, or avoiding contact with certain patients.  As healthcare professionals, it is important we recognise and acknowledge these signs and make time for our own needs to prevent it from getting worse.

There are several possible underlying causes, but the fundamental issue is usually the same: high exposure to human suffering. “Various factors can provoke this” explains Anneleen. “Issues such as high caseload, difficult and complex causes, a feeling of powerlessness or a hopeless situation like a palliative patient. Don’t forget that many healthcare employees take on a caring role both at work and in their homes.”

“Healthcare professionals usually manage to recharge their batteries in time. If they can’t, however, the worst case scenario could be an inability to empathise: which is exactly what gives healthcare professionals fulfilment.”

“Empathy and compassion create a bond between healthcare professional and client. This empathic connection is essential for quality care, but also for the healthcare professional’s motivation and fulfilment. In this respect, empathy seems to be a double-edged sword. On the one hand, it is what drives healthcare professionals, but if we go beyond our limits we lose our empathic ability. Compassion fatigue strikes at the heart of a healthcare professional. If not addressed in time, compassion fatigue could eventually lead to serious health issues, such as depression or burnout.”

It is essential to be aware of the risks and acknowledge the problem. But there’s the rub: “Compassion fatigue has always existed but it’s a relatively unknown phenomenon. It’s a taboo subject, directly opposed to the essence of care. Healthcare professionals who show signs of compassion fatigue are often reluctant to talk about it for fear of being ‘a bad caregiver’. However, compassion fatigue is not abnormal and does not necessarily pose a problem, provided we recognise the signs in time, and make time for self-care. Raising awareness among employers in sectors susceptible to these issues is key concern.”

Compassion fatigue is becoming more prevalent. Every aspect of healthcare has been under pressure for years. The coronavirus crisis has added another dimension. “Indeed, hospitals and doctors are noticing an influx of patients. Demand for psychological assistance is also seeing a peak, organisations are reporting a rise in partner and child abuse and social welfare bodies are receiving more requests for a living wage. Almost all healthcare professionals are confronted with increased workload.”

“At the same time, coronavirus has meant organisations are much more committed to caring for their caregivers. There is attention for the pressure of work and they are working to raise awareness; by discussing the impact of the coronavirus as a team, with the help of a psychologist, for example. Or by sharing posters with tips on self-care. They create more connection within the team, making it easier to discuss the emotional burden of work.”

Although there is a risk this support might disappear when the coronavirus crisis is behind us, warns Anneleen. “Even after the epidemic, healthcare professionals will still be confronted with mental and emotional stress. It is important for employers not to lose sight of this burden of work, but rather include it in the well-being policy, by focusing on resilience.”

Employees can take action themselves to prevent compassion fatigue, or to manage it responsibly. There are four specific factors that can protect healthcare professionals from compassion fatigue:

1. Self-care
   Caring for others starts with caring for yourself. Share relevant tips with your employees on how to recharge their batteries. Some examples: timely breaks, realistic work schedules, and making time for relaxation and hobbies.
    
2. Disconnection
   Creating mental and physical distance when needed - especially from the most stressful situations - is crucial. Disconnection means a healthy work-life balance and letting go of the patients’ problems when you get home. A ritual to end your working day may be useful. A short stroll, noting down remaining to-do’s for the next day, or a chat with a colleague might help.
    
3. A sense of accomplishment
   Healthcare professionals usually achieve a sense of fulfilment from their job. This feeling of satisfaction may end up on the back burner due to high workload, complex cases and little progress. Encourage employees to reflect on interventions that are successful and to enjoy every achievement, however small. Try to allay a lack of perspective by shifting the focus from the outcome - recovery or healing - to the care itself: be proud of the support you provided today.
    
4. Social support
   It is essential for healthcare professionals to feel they are not in it alone, especially if they are confronted with suffering regularly. This support should be present both at home and at work. The encouragement from colleagues in particular is important to build a barrier against compassion fatigue. After all, colleagues know exactly what the job is all about. As such, encourage employees to gravitate towards each other for an informal chat or a talk about work. Invest in a pleasant team atmosphere, too. Teams that are built on trust have a lower threshold when it comes to asking for help.