Forty years ago, as a new nursing grad I watched Karen, an experienced nurse on the oncology floor, sobbing in the nursing station, ” I’m just done – I can’t do this anymore.” Her 23-year-old patient had died – the second death that week. Karen had comforted the family, cared for her patient’s body, and then collapsed in tears at the desk.
Burnout and compassion fatigue were taking its toll on the entire 2 West nursing staff. As a relief nurse, I had been spending significant time on the floor: the nurses were often absent; many seemed exhausted and overwhelmed as they worked their 8 hour shifts. The high turnover rate in staff kept the Head Nurse busy with orientation and in-service training.
Today, the personal and professional cost of compassion fatigue and burnout continues to challenge nurses and management. “Compassion fatigue affects not only the nurse in terms of job satisfaction and emotional and physical health, but also the workplace environment by decreasing productivity and increasing turnover.” (Medscape.com, 2011)
Unfortunately, it isn’t just the nursing profession that finds itself confronted with these occupational health hazards. Teachers, social workers, law enforcement officers, EMS, the military, the clergy, in fact anyone in a caring role, is vulnerable to burnout or compassion fatigue.
Although many people can describe and recognize burnout, identifying strategies for coping may be a stretch. On the other hand, “compassion fatigue” is a term and condition which may be completely foreign.
Compassion fatigue has been described as “the physical, emotional, and spiritual depletion associated with caring for patients in significant emotional pain and physical distress” (Figley, 1995). Essentially, it’s the extreme emotional and physical exhaustion that takes place when we’re unable to refill and regenerate.
Wondering how it feels to have compassion fatigue?
Well, imagine that today, just like yesterday and the day before, you’re dragging yourself to work. You’ll spend time with your patients, students, or clients as they struggle with the issues taking them to a place of hopelessness and pain. You’ll share your skills, compassion, and ever-diminishing energy while trying to cope with your own response to their challenges. At times, you may be shocked to find yourself thinking, “I really just don’t care.” By the end of your day, you’ll feel as if you’ve given more than you actually had to give – the well is dry.
In fact, you also may be experiencing difficulty remembering that you had a lunch meeting with your supervisor. Your hobbies and social life have become non-existent; all you can do once you get home is sleep until tomorrow morning when it all starts over again. Perhaps you’re losing your patience with your co-workers and even your family’s aging pet; you seem to have a standing appointment with your physician. Sound familiar?
Don’t fret – here’s good news. Compassion fatigue can be managed and even avoided.
So, did I myself escape the ravages of burnout and compassion fatigue? Sure – until the day that my own twenty-something-year-old patient, Sally, died of a brain tumour, her 4 year- old triplets asleep next to her on the bed. If I had known how to manage my reaction to Sally’s death, and the other trauma I experienced in the hospital, I may have lasted more than one entire year in nursing. Instead, I became a high school guidance counselor…let’s talk about burnout!
Written by Wendy Kurchak, B.Ed, BMusA, DipN, CT