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Handling Stress
Countering Compassion Fatigue
How to replenish your energy for work.


Extreme tiredness, negative feelings, weight gain, and marital problems.

One moment, Kayla thought she was depressed and that medication would help. Another moment, she thought her husband was the problem and that she should quit her marriage.

But Kayla wasn’t depressed. She suffered from something that affects many professional caregivers.

In recent years, Mary Jo Barrett, author and social worker from the Center for Contextual Change, in Elmhurst, IL, has helped many nurses deal with compassion fatigue. Read on as Mary Jo describes what it is, how it affects a nurse at work and home, and some simple solutions to fight it:

What is at the root of compassion fatigue?
Compassion fatigue is the physical, emotional, spiritual, and intellectual exhaustion a caregiver experiences.

And the symptoms?
They vary from person to person. When you’re intellectually depleted, you feel stupid, incompetent, and judgmental. You start comparing yourself to other professionals; you might decide you’re better or worse than them. There’s a lot of self-judgment. You start believing your work isn’t meaningful or won’t really help.

Physically, it’s easy to have a breakdown. Nurses eat mindlessly and gain weight. They might struggle with addiction to caffeine, alcohol, or drugs. They’re trying to medicate; they’re trying to soothe.

For those of faith, some might even have a spiritual crisis. They stop believing, lose sight of the role of faith in healing, and become bitter.

How does compassion fatigue spill over into other aspects of a nurse’s life?
“Shutting down” carries over into the home life.

The energy you use as a nurse is the exact same energy you use to be a mother, partner, or child. At the end of the day, you might not have the emotional energy to listen to your partner or kids. You might bring the numbing feeling home, or you might act hypervigilant and overprotect your kids from every little thing.

Nurses also see the world through the eyes of the illness or disease they specialize in. For example, neonatal nursesmostly younger womenare neurotically anxious about having babies. When a nurse is pregnant, they talk to the doctor about everything that could go wrong, even though they’re nurses. Some are even afraid of getting pregnant.

How do you counter and heal compassion fatigue?
Nurses need to understand the consumption, conservation, and replacement of energy.  They need to be mindful. When you’re mindless, you’re consuming energy instead of replenishing it.

What are some things nurses can mindfully do?
They should mindfully eat. Nurses wonder why they have no energy; the problem is that they load up on white sugar, white flour, and caffeine. Instead of eating doughnuts or downing Diet Coke, nurses should include lots of protein in their diets.

They can also mindfully relax. Attend to your breathing by practicing meditation. Listen to music, which is neurologically proven to change your mood. Keep flowers at your station and use aromatherapy. Also exercise 30 minutes every day. It may mean 10 minutes, 3 times a day. Another simple thing is to sit in a chair that supports your neck and back.

Take breaks. You don’t have to take an hourtake a few minutes. If a patient dies, instead of moving mindlessly on to the next patient, take two minutes and let it affect you. If you have a terrible disagreement with a doctor or administrator, take three minutes and think about something you really love about your job.

What about nurses who say there’s not enough time to do all this?
I understand their viewpoint, but that’s the compassion fatigue talking. Everybody has time; you have to prioritize.

You’re not as efficient when you’re exhausted. The more compassion fatigue you have now, the more you’ll have laterit feeds on itself.  By the same token, energy creates more energy. Replenishment re-feeds itself.

Mary Jo Barrett, MSW, is the Executive Director of the Center for Contextual Change, Ltd. She teaches and presents workshops annually at Chicago Center for Family Health. She is also on the faculties of the University of Chicago, School of Social Service Administration, and the Family Institute of Northwestern University. Ms. Barrett holds a masters degree in social work from the University of Illinois Jane Addams School of Social Work.


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11 Responses to “Countering Compassion Fatigue”

  1. Kathy Quan RN BSN Says:

    This is an excellent article!! As I wrote in my book, The Everything New Nurse Book, “nursing is one of the most physically and emotionally demanding careers.”

    Nurses must learn to replenish themselves. This is essential, and should be taught in nursing school. We give and give and give, until we have nothing left to give. Too many times, nurses walk away from their careers because they can’t do it anymore.

    Sometimes people become nurses after having been caregivers for a relative or close friend, and if they haven’t allowed themselves time to heal and replenish, they will quickly burnout.

    One suggestion I wrote in the book and have written about many times is to keep a journal or have a box that you fill with notes when you have made a difference in someone’s life. Then when you find yourself physically and emotionally spent, read through your comments and remind yourself why you became a nurse, and that you have made a difference many times over.

    Sometimes this may be just what you need, and other times it will only touch the tip of the iceberg, but you must take time for yourself everyday, even if it’s just a couple of minutes alone in the bathroom! Do something just for YOU, so that you can continue to do for others!

    Kathy Quan RN BSN
    http://theNursingSite.com

  2. Mr Ian Says:

    Didn’t we used to call this ‘burn out’?
    More and more places are recognising the importance of not wasting their staff over the immediate issues and helping them to pace themselves out. My current workplace happily accepts “mental health” days off – Or “Doona Days” (Doona being a bed-blanket which indicates spending the whole day in bed and literally doing nothing).
    In the UK some years back I recall reading about 10 minute massage breaks that were given to staff. The hospital paid for a masseuse/reflexologist to pop around various wards and just give a 10 minute foot or shoulder rub. Never saw the research outcome but common sense tells me – I should have worked there!

  3. nicunurse Says:

    that is very true about us nicu nurses… i will be terribly neurotic when i get pregnant.

  4. andrea Says:

    There was a time, just recently, when smoking was still acceptable. One could and would take a break, go outside with colleagues and have that cigarette and regroup. Often, it was just getting off the floor for a few minutes, that made all the difference in the world. And, being able to air whatever the issue was with another work-friend. Now, one can go off the floor, get a juice or a power bar and have often, the same break from floor environment. Too often, nurses will say, “I can’t even go to the bathroom”. Well, you make that choice to do what you need to do to maintain oneself. Taking mental and physical breaks from the floor during a shift usually makes for a less agitatied careprovider. That has been my observation over the years.

  5. Andrea Says:

    A few years into my career my husband caught the flu and apparently expected to be waited on after I got home from working a 12 hr shift on a med-surge unit. When I told him what to do to get well (instead of coddling him), he jokingly diagnosed me with “sympathy fatigue”. I guess he was on to something! Although I still feel like my fellow nurses and management don’t approve of me leaving the unit for my break, over the years I have learned that this is the only way for me to replenish. Even if it is for 20 minutes over a 12 hr shift. I am always a better wife, mother and nurse when I take time to take care of my needs too.

  6. Leigh Ann Laughon Says:

    I did my thesis on Compassiom Fatigue. I have a great paper and slides in interested. I have evidenced base reseach in my article.

  7. Rachel Says:

    This is all so true. I am a social worker, and having a ‘scheduled’ lunch is out of the question. I usually eat at my desk and keep on going. I am becoming irritable, I feel ‘taken advantage of,’ I’m feeling resentful that others can go where they want WHEN they want, and I go home totally wiped out. I can’t plan an evening during the week because I never know how long I will be working. We work around the families and their time schedules instead of ours. That’s where a lot of my resentment comes from, too.

  8. Anne Says:

    I work in critical care and I recently lost a patient in a code. I was precepting a soon-to-be-graduating nursing student at the time. It was my last day before my time off for my sister’s wedding out of town. Boy did I forget to take care of myself. I am in bad shape. I didn’t let myself have that 2 minutes I usually do after a pt dies because I had a student with me – I was trying to teach him how to cope. Then, I switched gears to quickly and was everything to everybody for my sister’s wedding. I ended up having a panic attack the day I got home from the wedding. I’m still trying to recover from everything. I think I’m on the right track finally because I’m looking for help, I’m researching and talking about it etc etc.

  9. Sara Says:

    There were a few nursing instructors who emphasized “self-care” but the majority said, “Well, no, you don’t have time for that, so you just need to deal with it. If you think nursing is rainbows and sunshine you picked the wrong career.” Things like that.

    I think those nursing instructors had certain burn-out or “compassion fatigue” or whatever many names you could call “it.”

    Either way, as a new grad-RN I know very little about self-care even though I have also been a CNA for many years. Yes, there is a “choice” to an extent about when to go to the bathroom or quickly sip a little water…but even things like that are “learned” esp. when you are super worried about a patient or two.

    But it is also true that you start resenting your patients/family/friends if you don’t eat for 12 or more hours and are dehydrated and pushed to fatigue…I guess finding a balance in all of that is just a struggle for many nurses…it will just take some time.

  10. rondodondo Says:

    The real problem IMO is too many patients, too little staff, and management that could care less about the individual nurse or the problems we face every day. If you don’t believe it, our hospital, which is in very bad financial shape, just put out new guidelines for breaks and lunches: the 2 10 min breaks we got( which we never took anyway) for a 12 hour shift have now been eliminated and our lunch 1/2 hour now is “guaranteed 20 min uninterrupetd” but the additional 10 minutes is not guaranteed to be uninterrupted. What other profession gives you 20 min out of 1/2 hour uninterrupted and the restof the time……well thats too bad. Nurses need to Unionize now. I for one am sick of being the health care door mat and whipping boy for EVERYTHING that doesn’t go the patients or Dr’s way………

  11. Rose Says:

    I think it is so important to take care of ourselves.I get addicted to the adrenaline of being a nurse. I like the back to back shifts and long hours at times.Very few things rivet my attention like nursing. This is not so good for my health.

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