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5 strategies to help cope with compassion fatigue

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“I get so attached to my patients that I just can’t get them out of my head when I go home.”

“Every week I find myself getting distraught over a new favorite patient who isn’t doing well.”

Is this you? As a nurse, you witness the fear, pain and suffering of others every day. But when you get too immersed in the lives and trials of your patients, you can become a victim of “compassion fatigue.” Compassion fatigue is also thought of as “secondary post-traumatic stress.” And once it sets in, you can lose mental energy and get burned out.

How do you know if you’re suffering from compassion fatigue?

• Mistakes go up and job performance goes down.
• You can’t stop thinking about your job or the problems of your patients.
• You have trouble sleeping.
• You have a general feeling of weariness.
• You don’t feel like doing anything—you feel blah.
• You feel less satisfied, less energetic and less efficient.

If you’re unsure whether you suffer from compassion fatigue, it’s time to become more self-aware. Watch how you are reacting to your patients and colleagues…and how they are reacting to you. Are you more sensitive than usual? Are your colleagues getting frustrated with you? Are your patients becoming too clingy? Too familiar? When you recognize how others perceive you and the affect you have on others, you can identify the above symptoms of burnout early.

Use these strategies to cope with job stress and to combat compassion fatigue:

Exercise. You may feel like you just don’t have time to exercise. The physical and mental benefits of exercise will make you more productive and are worth every minute. [Editor's note: Scrubs Magazine has a great series of articles for quick workouts you can do while on the job].

Maintain a personal life, even if you don’t feel like it. When you’re stressed, you may tend to eliminate the very things that will revitalize you—like family dinners, eating lunch out, prayer, meditation, or time with friends. Spend time with supportive people.

Have a sense of humor. People in stressful jobs, such as psychiatric nurses, may often have a wicked sense of humor—but it’s still a sense of humor. When people who work with them recognize they’re joking around less often, it’s a sign that it’s time for a break.

Set limits between work and home activities. Easier said than done, I know. Don’t play nurse or therapist in personal relationships.

Broaden your network. Get involved in professional or social organizations where like-minded people meet and discuss events and mutual problems.

Editor’s note: Some of the symptoms that included in this article could be indicators for depression. Please see a mental health professional if you believe you are clinically depressed. Also, it’s okay to show emotion and share it with families and patients, but try your hardest to not get attached to patients too frequently. Sure, there will always be that special patient that touches your heart, but if you’re suffering from compassion fatigue, it is time to reevaluate your role as a professional in these particular peoples’ lives for your own sanity.

Compassion Fatigue Checklist

Additional resources to download:

Fletcher Compassion Fatigue Scoring Sheet (PDF)

Fletcher Compassion Fatigue Assessment (PDF)

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Susan Fletcher, PhD

Susan Fletcher, PhD, is a psychologist, an author and a speaker who specializes in helping individuals, professionals and organizations apply strategies for fast improvement. Her Smart Zone™ strategies provide ways to be a top performer at work and at home. To learn more about how to be in the Smart Zone, please visit Susan’s Website at fletcherphd.com, or contact her at (972) 612-1188 or by email at drfletcher@fletcherphd.com.
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4 Responses to 5 strategies to help cope with compassion fatigue

  1. BlueRoses RN

    I took the Compassion Fatigue assessment and I scored off the the charts for both burnout and compassion fatigue. I’m a young new nurse about a year out of nursing school and I haven been on the ob for about 10 months. During the past 4 months or so I have had increasing anxiety to the point of being physically sick and having to call off work, and now I only have one more absence left until they fire me.
    My boss is very strict and unsypmathetic. If you try to talk to her she says things like “well sometimes life just isnt fair.” instead of trying to help you. She holds grudges and has favorites and least favorites, and if you are the latter you know it and feel it in the way she treats you.
    About 2 months ago I had two patients pass away on me in a two week period, and since then I have been a complete and total mess. I have been getting dizzy and passing out both at work and at home, I constantly feel like something terrible is about to happen, and I have a constant underlying current of fear and anxiety in my mind and heart. It doesn’t help that we have been consistantly understaffed and overworked the past several months (I work on a med surg floor in a huge city hospital). Every night I go in I’m terrified of what I might face when I get there. I cry all the time. I can’t sleep, I don’t eat because I feel nauseated most of the time. I’m also facing stress outside of work, confict within my family and trying to plan and pay for my wedding coming up in May mosty by myself.
    I know I have bitten off more than I can chew. It came to a head last night when my fiance woke up to me sobbing my eyes out because I stay awake all night to make sure he’s still breathing. I have been in denial, I know I have a history of depression and self-mutilation as a teenager, although I was never diagnosed with anything. But now I feel like a train speeding at 100 mph towards a solid concrete wall.
    I have appointments this week to see both my PCP and a free counseler service provided through my work. I don’t really know what they will be able to do for me, as I am very reluctant to go on any mood altering drugs for fear of side effects and addiction. I am going to try and talk to my boss, but I don’t see her doing much to help me. I have tried yoga, excercise, meditating, hobbies, etc etc and I still feel this way. It’s like I’m trapped inside myself and inside this job that I am so afraid of. I have also applied for several other nursing jobs in the community, but that was just recently and I haven’t heard back from any of them yet.
    I don’t really even know if anyone will read this. I just feel like I need to express myself to others who might understand or who might be able to relate and tell me what they did to help themselves. I can’t talk to anyone at work because it will come accross as complaining and if my boss gets wind of it we get written up or fired. I am pretty desperate at this point. I barely have the motivation to get out of bed anymore. Normally I’m a generally happy person. I want to feel happy again.

    • nursejacki

      Sweetie Nurse, Don’t you dare miss those appts with your PCP and the counselor!! Take a copy of this letter with you. Let them read it.

      Is there an older nurse on your floor who you trust that you can talk with? If not, go over your boss’s head and talk with HR. Have it all written out. Word for word. Cite episodes of discussions you have had with your boss where you have gotten no support.

      You are understandably overwhelmed, anxious, and depressed. Got a lot on your plate right now. One day at a time. One problem at a time.

      Meds for anxiety and depression are NOT addictive, especially if needed! You cannot live your life like this can you?? Temporarily take something the doc prescribes to get over this hump, it doesn’t mean you are on them for the rest of your life.

      My last bit of advice????? Pray. Prayer and faith that God will lead you thru this mess, because he will. I am proof of that. Many times over!! I will be pulling for you and praying for you! You are strong! You are woman! You made it through nursing school! You made it past your teenage psyche problems! You can do this with Prayer and Faith!!

  2. queenie RN

    BlueRoses,

    I love your login name.

    I have been a nurse over 25 years and it has mostly been stressful. Most nurse managers still do think we should just “Suck it up.” Yes, I have been told that. Most of us are overworked, underpaid, and mentally abused. Also expected to leap tall buildings in a single bound. If we complain we are told to leave, yet if we don’t report problems we are told, “Why didn’t you report that?” It takes just one patient or family to report you that they didn’t like you to get in trouble. Yet, most patients don’t take the time to thank us or report us that we were outstanding. I could go on, but won’t. I just want you to know that you are not alone and the nursing profession is hard and it is only getting worse. I have made thousands of decisions, yet if I make one decision that my DON doesn’t agree with, I will get written up, or put on probation.

    First of all; take care of yourself!!

  3. TeeTee

    BlueRoses,

    You should feel so proud of yourself!! Just by stepping out and expressing how you really are feeling on here right now is a sign that you no longer willing to go on like this any more.

    I have read the feedback – it is totally true and really amazing what the others have said.

    The fact that you have come so far to where you are and with this baggage only means that you are truly a very strong woman. Don’t give up – never… Just keep fighting your way through. It will become easier. Its not about what you go through, its all about how you deal with it and how do you get yourself out. Like little mini tests of life. Tests and trials is always going to be there but each time you get a knock it just makes you that much more stronger.

    You most definitely need to look after you first because if you don’t you will not be able to care for anyone else.

    Stay blessed and continue to believe in yourself!!! xxx