Compassion fatigue in nursing is a common problem rarely recognized by nurses. Most nurses often mistakenly identify compassion fatigue as simple work burnout. The two, after all, are usually found in nurses who are starting to nurse on empty. They even have similar symptoms. However, compassion fatigue is completely different as it has more emotional involvement than the plain work frustration problems involved in burnout.
A Nurse’s Perspective
To give you a glimpse of what it’s like to have compassion fatigue, here are some real-life statements from nurses that reflect the problem:
“I’ve been working hard to take care of my critically ill patient. Sometimes, I don’t even mind skipping my meals and ignoring my urge to drink or pee just to keep up with his nursing care demands. He thankfully recovered but one day he got off from his bed and fell. When I saw him sick again, I was crushed.” – Nurse M.A., from Maryland
“We had this trainwreck patient we took care for so long. I thought he would never recover, but he did after a month of hospitalization. We felt proud as nurses when the patient was discharged from our ward. But a week later, we were informed that he died in our emergency room. It appeared that he was shot in the chest by a passerby who was under the influence of drugs. The news of his death brought a lot of frustration to us. We worked so hard to save his life and with just a click of a gun he was already gone. I suddenly felt my profession was worthless at that time.” – Nurse J.M., from Chicago
“I work in pediatric oncology. I thought I knew what I was getting into and I thought I could handle it. For every sick child that came in, I did my utmost best. One time though, I had a sweet young patient who had an equally kind mother I immediately got along with. They had no other family and they were precious to each other. Though they spent a long time in the hospital with us, our patient was getting better. And then she suddenly took a turn for the worse. I was there when my young patient took her last breath and her mother was crying and holding on to her hand like she would hold on forever. I was utterly heartbroken seeing my patient go and her mother bereft and alone like that. I don’t know how I’m going to keep it up if I feel like this everytime.” – Nurse L.K., from New York
Compassion Fatigue – What Is It?
Empathy and compassion are the two traits nurse take into their profession. Empathy is putting yourself into the shoes of other people so you know how it feels to be in their situation. Compassion, on the other hand, is the drive that will urge you to do something to fix the problem.
The nursing profession, in nature, practices compassion in providing nursing care. Compassion fatigue comes when there is confusion in the emotional boundaries between the patient’s need and the nurse’s personal needs. It literally translates to “tired of providing care”. It is the emotional stress a nurse may feel in providing care to patients.
Compassion Fatigue versus Work Burnout
Compassion fatigue and work burnout are often seen in combination but they are different problems.
Compassion fatigue has a more emotional component than work burnout. It involves the frustration of being unable to help a patient despite the enormous amount of effort and care expended by a nurse even at the cost of their own health or well-being.
Work burnout, on the other hand, is associated with work overload and other environmental factors at work. These may include workspace design, assignment levels and scheduling. Such negative variables place a real strain on nurses making it hard for them to come back to work each time.
Compassion fatigue and work burnout are often mistaken for one other as they are always seen together among those who are ready to give up their nursing career. Work burnout is easier to fix with a nice vacation, a new schedule, or a department reassignment to take the edge off a growing sense of burnout.
But with compassion fatigue, a nurse needs to come to terms with the losses that come with the job.
What Are the Signs and Symptoms of Compassion Fatigue?
Consider you are having compassion fatigue if you have the following signs and symptoms:
– Relation disturbances
– Psychological stress
– Somatic and physical complaints
– Decreased intimacy to friends and family
To help in identifying presence of compassion fatigue, therapists often use the tool ProQOL measure. This tool aims to measure the negative and positive impact of helping others who are suffering. It has sub-scales not only for compassion fatigue but also for compassion satisfaction and burnout.
How to Beat Compassion Fatigue?
If you feel that you are already suffering from compassion fatigue, here are some recommended ways on how you can beat it:
1. Set boundaries at work
Accept the fact that you are not a superhuman. Set boundaries and make it clear with yourself that you can’t fix everything. Determine until when or where you shall intervene. Set your personal and professional limits.
2. Talk about your emotions
Do not keep those negative emotions all to yourself. Talk it out so you can vent your feelings. Talk to the right people who can understand you like your colleagues, your friends and your family. Also, try to seek for professional help. Hospitals usually provide this kind of assistance for their medical staff.
3. Don’t go beyond the limits you set
Learn to say no if you can’t. Sometimes it feels great to see that you can go beyond the things you thought you can never accomplish but over time, it could lead to burnout and compassion fatigue.
4. Practice positive self-talk
Self-talk makes you aware of your own feelings and issues. You need to know yourself more so you can properly address personal flaws that may affect how you handle patient care. This way, you will be able to identify the times that you need to take care of yourself first before anyone else.
This is the easiest way to brighten up your day a little more. Even if your day is going downhill, take a deep breath and smile. Smiling often helps lift up mood and improve positivity at work. By having a positive outlook, you can have more strength in facing the emotional challenges of being a nurse.
6. Forgive and move on
Don’t keep the hate all to yourself. Whenever you feel oppressed at work, forgive and move on. Forgiveness is not something you do for others as it is actually something you do for yourself.
One of the signs of compassion fatigue in nursing is detachment and isolation. Overcome these problems so you will not sink deeper into clinical depression. Make an effort to socialize with your friends and participate in social events. Through this way, your attention will be diverted into meaningful activities.
8. Be creative
Creative activities like knitting, journal writing, dancing and quilting help in releasing stress and negative emotions. These activities will help you become more self-aware as you focus on your inner self. These activities will also help you in expressing your well-kept emotions if you have difficulty in venting out your frustrations.
9. Go on a retreat
A retreat is a vacation away from home. It may be a simple mountain hiking spree, a beach getaway or any nature-related trip. By changing your surroundings and going on a trip, you can have a refreshing break from your life as a nurse.
Take this time to reflect on your profession and reaffirm why you became a nurse in the first place.
10. Develop a career plan
A career plan is a good reminder of your dreams and aspirations as a nurse whenever you feel trapped in your job. It can serve as your driving motivation in getting yourself together. Develop a 3-year, 5-year and 10-year career plan. Afterwards, lay out your career plan like a portfolio and go through it whenever you feel like giving up on your job.
11. Relate with other nurses
Those who have dealt with compassion fatigue before are the ones who will best understand you. Ask your senior nurses about it and take note of their advice. Older nurses have time-tested strategies in overcoming compassion fatigue and they may help you in understanding your frustrations at work.
12. Keep in mind that you have a purpose
Remind yourself that nursing is a noble career and everything happens for a reason. Take a sad experience as an opportunity to learn and grow. Remember that the healthcare system is not complete without a nurse. Ask a patient about who he remembers the most during his hospital stay and the answer would be “the nurse”.
13. Whenever you feel yourself going down the slide, reach out for your victories
A nurse’s job isn’t just all about loss. A nurse also has moments of triumph.
One oncology nurse, for example, gets the occasional letters from recovered patients. She gets news (or photos) of them going to college or having their own families, all after receiving care from her during their battle with sickness. Unlike other professions, a nurse doesn’t have to ask at the end of the day if he or she made a difference. The answer would always be a yes.
Compassion fatigue in nursing is one of the obstacles you will encounter early in your nursing career. Those who can’t handle it end up switching careers while others who are able to overcome it feel better about their profession. Don’t think twice about seeking professional help if you are not feeling better with the self-employed interventions we’ve listed.
Nurses, do you have advice for your fellow nurses? Do you have questions about compassion fatigue? Drop by our FB page anytime.