Countering compassion fatigue
13 July 2022
Compassion fatigue is a specific form of burnout due to a professional’s deep investment in helping others, particularly caretaking or providing emotional support to others. Vicarious trauma, sometimes called secondary traumatic stress, happens when professionals are repeatedly exposed to the stress of others due to traumatic events and adverse circumstances. Compassion fatigue happens when a professional becomes depleted from repeated exposure to the trauma or adverse circumstances of others. Healthcare workers are at high risk of developing compassion fatigue, especially those on the frontline.
The most common signs and symptoms of compassion fatigue also known as secondary or vicarious trauma are:
- Insomnia and other sleeping problems
- Feeling exhausted
- Intrusive and/or negative thoughts
- Avoidance of reminders of upsetting experiences with patients
- Increased startle response and feelings of being “on edge”
- Isolation and disconnection
- Substance abuse with increased use of alcohol or other drugs
- Changes in appetite
- Difficulty making decisions
- Anger, irritability and depression
- Reduced enjoyment or satisfaction with work
- Increased cynicism, negativity, and apathy
- Sense of lack of control or agency in your job
- Feelings of disconnection from colleagues and work teams
- Feelings of being overwhelmed by the amount of work to be done
- Impaired ability to care for patients
- Reduced ability to feel sympathy or empathy
Work environment factors which predispose to compassion fatigue include:
- Long hours and a poor work-life balance
- Excessive workloads and unrealistic deadlines
- Poor workplace culture which lacks teamwork, kindness and compassion
- A dysfunctional work environment leading to a high turnover of staff
Self-care and stress management are key to preventing and addressing compassion fatigue. Regular exercise and healthy eating, a commitment to adequate rest and regular time off including holidays are all important lifestyle choices which will counter compassion fatigue. Likewise paying attention to mental health through support networks including family, friends and colleagues as well as seeking professional counselling and debriefing when needed. Stress management and relaxation techniques can include breathing exercises, progressive muscle relaxation, visualisation, mindful movement such as yoga or tai chi, mindfulness meditation and religious and spiritual practices.
It can also help to set emotional boundaries without barricading yourself from the world by consciously leaving work behind. Rituals such as showering and changing into your “civvies” can help as well as listening to music or a podcast during the commute home. Breaks from media including news broadcasts and social media can be valuable during times of high demand or crisis.
While countering trauma is not a conscious process engaging in playful or creative activities including music and the arts, enjoying humour and laughter and feeling gratitude are all helpful.
Those in leadership roles need to support colleagues with adequate resources and supervision, as well as helping with workload when demand is high. Good teamwork is essential and a leader who is willing to chip in and help when needed is leading by example. Leaders also need to model self-care and healthy boundaries and ensure that everyone can take their rest breaks and has access to healthy food and refreshments as well as being able to leave work on time. In healthcare settings, leaders need to make sure that ward rounds and handovers run efficiently and everyone has time for documentation activities within their rostered shift. A supportive workplace environment is important to minimise the impact of trauma.
Those working in management roles need to ensure that the basic rights of healthcare workers are met including fair rosters, adequate resource and staffing, access to training and education, appropriate and correct remuneration including overtime and access to leave at a time chosen by the employee. The impact of trauma is reduced when managers show that they respect, value and appreciate healthcare workers. Providing compassionate support to employees is the best way to improve their health and wellbeing. Healthcare workers who are well supported are better able to deal with stress and trauma and provide compassionate care to patients.
AMA Victoria Coordinator of Doctor Wellbeing
- Compassion Fatigue | Psychology Today Australia
- Compassion Fatigue | Psychology Today
- Compassion Fatigue vs. Burnout: How To Tell The Difference & Spot The Signs | Pathways.com
- Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review | MDPI