― Tahereh Mafi, Shatter Me
The health care industry is made up of nurses, doctors, and other medical professionals who are dedicated to the care and healing of others. The modern medical field is a very fast-paced, stressful, and demanding environment. Often, the constant stress and demands of the job can adversely affect the healthcare provider. Not surprisingly, those who go into the healthcare industry, do so because they have a sincere desire to make a difference in people’s lives and provide care for a patient’s spiritual, mental, and physical needs.
However, this type of career requires energy and dedication way beyond that of other comparable careers. “Compassion fatigue” is a common side-effect. “Compassion fatigue” can be defined as, “the gradual decline of compassion over time as a result of caregivers being exposed to events that have traumatized their patients (Cherry 497).” In fact, the damage that results from this condition has been linked to more sick days, high turnover rates, and decreased productivity. If left untreated, this condition can adversely affect patient safety, so it is vital that hospitals and healthcare providers are able to accurately recognize compassion fatigue and treat it early. (Landro, L. 2012)
Compassion is an important and critical gift necessary for the care of others. Compassion can be defined as, “sympathetic consciousness of others’ distress together with a desire to alleviate it” (Merriam-Webster 2013). No one is immune to compassion fatigue. In fact, anyone caring for another person can suffer from it. However, compassion fatigue is more prevalent in the health care industry due to the extenuating nature of the work. The reality is that healthcare providers have an exhausting array of job duties that entail lengthy shifts, selfless service, endless dedication, love, and compassion. Due to the extreme demands, medical professionals often neglect their own personal needs for the sake of others. Every single day, healthcare professionals come face to face with disease, illness, decline in health, and death. Over time, it can be incredibly traumatizing.
“Compassion is a verb.” ― Thich Nhat Hanh
If not prevented or left untreated, “compassion fatigue” can negatively affect a caregiver emotionally, spiritually, cognitively, physically and behaviorally. Warning signs can manifest themselves in a variety of ways.
The emotional effects of compassion fatigue can include mood disturbances, increased apathy, lassitude, irritability, discontentment, hopelessness, aggressiveness, hostility, numbness, and helplessness. (Eagan, T. 2012) Other signs may include oversensitivity, restlessness, depression, anxiety, and even substance abuse. (Lombardo, B., Eyre, C., 2011)
The spiritual effects of compassion fatigue may often be harder to pinpoint. Warning signs may include subtle things such as starting to question one’s purpose in life, an increasing sense of disbelief or an increasing sense of aimlessness. (Ginter, C. 2010). The caregiver may start to question their personal religious beliefs, become increasingly skeptical and even question life’s meaning. (Portnoy, D. 2011)
The cognitive effects of compassion fatigue can be easier to identify. It’s easy to observe when someone is having difficulty concentrating or is unable to focus on tasks and duties that are critical to the job. The work ethic and performance of the healthcare provider may also be affected, resulting in increased absences, low morale, decreased motivation, and overall negativity in the workplace. This not only affects the healthcare provider, but also their co-workers and patients.
The physical effects of compassion fatigue can include, but are not limited to headaches, chronic pain, sleep disturbances, fatigue, and self neglect (poor diet, lack of exercise, poor hygiene). (Eagan, T. 2012) Other physical effects can include gastrointestinal complaints, hypertension, (Pfifferling, J., Gilley, K. 2000) muscle tension and cardiac symptoms (chest pain, tachycardia, and palpitations. (Lombardo, B., Eyre, C., 2011) Behavioral changes can include “isolating”, withdrawing, extreme hyper-vigilance, (Portnoy, D. 2011) apathy or extreme attention to work, avoiding, faking interest, blaming, restlessness, and even inappropriate humor (Ginter, C. 2010).
“I would rather make mistakes in kindness and compassion than work miracles in unkindness and hardness.”
― Mother Teresa, A Gift for God: Prayers and Meditations
Although compassion fatigue can be an easy problem to identify, the specific causes of this condition are often varied and harder to pinpoint. The stressful nature of a healthcare career can certainly create “the perfect storm”. Overall, health care professionals can feel stressed about things like control over workload, lack of recognition or appreciation of doing a good job. Lifestyle changes can also cause compassion fatigue. If the person is working too much without taking time off to relax, taking on too much responsibility with no help from others, not getting enough sleep, or not having a supportive relationship in their personal life, it becomes easier for compassion fatigue to develop.
People with certain personality traits (pessimistic, perfectionist, those who do not delegate, and type A, and overachievers) are particularly predisposed to experiencing compassion fatigue or burnout. The constant exposure to negative situations, stress, loss, and giving more than receiving, in addition to having a more intense personality, can increase the risk of developing compassion fatigue. (Frandsen, B. 2010) “Compassion fatigue is caused by empathy. It is the natural consequence of stress resulting from caring for and helping traumatized or suffering people” (Portnoy, D. 2011). In the medical field, nurses, doctors, and other health care providers often witness pain, suffering and death first-hand. They play numerous roles with less time, resources and support. The increased demands and stress along with the constant exposure to negative and traumatic events can build up over time and put anyone at risk for compassion fatigue.
“Love and compassion are necessities, not luxuries. Without them, humanity cannot survive.”
― Dalai Lama XIV, The Art of Happiness
A caregiver is not so different from a patient. Both caregiver and patient have physical, spiritual, and emotional needs that must be met. When their own needs are neglected, caregivers are unable to properly care for their patients. In short, they’re hurting themselves as well as the patients. Maintaining regular exercise, staying hydrated, staying productive, eating healthy and taking time to rest and relax are critical ways to reduce the chances of developing compassion fatigue.
Although spiritual beliefs may be different from person to person, it is vital to nourish and grow in one’s faith. Those needs may be different depending on beliefs and may include going to church on a regular basis, taking the time to pray or meditate, speaking with a church leader, reading scriptures, or having time alone to reflect and think. There are many different ways a caregiver can begin to focus on their spiritual health. (StopPain.org 2013)
Emotional needs are another important area that should be nurtured. Emotional needs are just as important as physical and spiritual needs. A caregiver may need time to mentally unwind, have peace and quiet, laugh and cry, and “tune in” to their personal experiences and emotions. Taking short breaks to renew emotional energy and doing things that bring you joy and happiness are ways to increase and improve emotional health. (StopPain.org 2013) By making sure the needs of the caregiver are met, the caregiver, patients, and even the company will benefit from it.
There are many ways to cope with compassion fatigue. Perhaps the most important way of addressing the needs of the caregiver is to acknowledge compassion fatigue when necessary and take aggressive steps to assist caregivers in finding supportive coping strategies. Some coping strategies according to Varner, J. (2004) include: asking for assistance and support from peers or other support groups, staying positive, smiling and talking to peers, using humor to decrease anxiety and tension, giving comfort through physical contact, taking breaks with peers and not alone, using problem solving tools, generating solutions, and focusing specifically on tasks at hand.
Learning how to balance work and life essentially means learning how to invest the time and energy into taking care of oneself in order to effectively take care of others. Putting together a plan of self-care (journaling, yoga, meditation, exercise, proper diet, doing things that you find pleasure in, and doing non work related activities) as well as educating yourself and others on communication skills is vital in preventing compassion fatigue. Employers can aid in combating compassion fatigue by offering on-site counseling, support groups, de-briefing sessions, and bereavement interventions (Boyle, D., 2011) that all work together to give employees the tools and skills needed for prevention.
Early recognition of compassion fatigue is vital to anyone in a caring profession. Maintaining and constantly improving self-care and creating optimal wellness are crucial in order to properly care for others. .”Caregivers need to be able to deliver excellence without compromising their well-being”(Portnoy, D. 2011). Caregivers often neglect their own personal needs for the sake of others and need to realize the importance of focusing on their own needs first. By taking care of their own needs and ensuring they have a life that entails supportive relationships, health care providers will be able to successfully care for their patients long-term.