Compassion fatigue: the cost some workers pay for caring

People who experience compassion fatigue are taking on the issues they witness without an appropriate outlet. Mr.Nikon/Shutterstock

Health and social workers often choose their profession because they want to help people. But seeing trauma and suffering on a regular basis can have a deep impact on these workers. “Compassion fatigue” is a response to the stress of caring for people at times of crisis and is often referred to as the cost of caring.

Researchers first identified compassion fatigue in the 1970s when they recognised certain psychological symptoms among health care and social service workers. The term “compassion fatigue” was coined in the early 1990s to describe nurses who worked in emergency care and were experiencing symptoms similar to burnout.

Compassion fatigue is now defined as a “combination of physical, emotional, and spiritual depletion associated with caring for people in significant emotional pain and physical distress”. If left untreated, compassion fatigue can cause burnout and ultimately depression.

Who gets compassion fatigue?

The prevalence of compassion fatigue ranges from 7.3% to 40% of workers in intensive care settings and 25% to 70% among inexperienced mental health professionals. The higher prevalence is often seen in health professionals who repeatedly witness and care for people after trauma.

Compassion fatigue can affect anyone in a caring profession: nurses, police officers, mental health workers, counsellors, family therapists, hospice workers, doctors and emergency care workers. It is more common in women because they’re more likely to work in caring roles.

Although prevalence statistics for other professions are not currently available, there is some evidence that lawyers, especially those in criminal, family and juvenile law, also experience compassion fatigue.

Compassion fatigue can affect anyone in a caring profession. AAP Image/Joe Castro

Compassion fatigue is more likely to affect inexperienced professionals and people who help others in short-term spurts. These people may not have the same coping mechanisms and debriefing opportunities as those who repeatedly work in trauma and care-giving.

Due to the extensive media coverage of human suffering and worldwide disasters, more people are beginning to report symptoms that mirror those of compassion fatigue.

Essentially, this is indirect exposure to trauma, which can result in emotional, cognitive and behavioural changes in people who are exposed to too much “bad news”. But it is still considered compassion fatigue.

Burnout or compassion fatigue?

Untreated or unmanaged compassion fatigue can lead to burnout, but the two conditions are not the same.

Burnout is related to the job environments in which we work and the stresses attached to those jobs and requirements, such as paperwork or poor supervision, management or support. It is equally common among men and women.

There is a significant overlap between compassion fatigue and burnout symptoms. These include:

  • decreased concentration
  • minimisation of one type of loss over another
  • preoccupation with trauma
  • withdrawing
  • isolating
  • loss of purpose
  • impaired immune system
  • bottled-up emotions
  • substance abuse to mask feelings
  • mental and physical tiredness
  • being in denial about problems.

People who experience compassion fatigue or burnout are taking on the issues they witness without an appropriate outlet. They then “store” these issues – like storing toxins inside your body – which then compromises their immune system.

Compassion fatigue often has a quick onset, whereas burnout is a prolonged response to chronic job-related emotional and inter-personal stressors. If untreated, prolonged burnout (three to six months) can lead to depression.

Getting help

If some of the symptoms sound familiar, you can complete a compassion fatigue self-test. Although this won’t replace a medical diagnosis, it may be a useful starting point, especially if further assistance is required. An awareness of the symptoms and their negative effect on your life can also lead to positive change, personal transformation and a new resiliency.

If you think you are showing signs of compassion fatigue, ask for professional supervision or help. If you take time off of work to “reset”, talk to someone about your feelings and experiences to learn how to process the symptoms and feelings.

Employers should be aware compassion fatigue exists and have professional development, training and supervision in place to help employees during and after compassionate-driven work.

If you think you’re showing signs of compassion fatigue, ask for help.

There are some things you can do to reduce your risk of developing compassion fatigue:

  • Have a strong and supportive team around you that you can debrief with both personally and professionally.

  • Get regular supervision – or at least have someone to talk to. It is vitally important to be able to talk to someone more experienced in the field to explore your feelings and what has occurred. Think of supervision as an information-sharing and event-processing session conducted as a conversation between peers.

  • Continue to do professional development activities and “grow” personally and professionally. Try to expand your knowledge in various areas rather than being singularly focused. This will help build resilience, broaden your perspective and give you greater experience with different aspects of your work.

  • When you know things are getting difficult, take a break. If you continue to “work through” it, the fatigue will get worse and burnout will set it.

  • Start thinking to yourself, when is enough enough? Take positive steps to action change in your life.

If you think you may be experiencing compassion fatigue through social media, watching news and so on, then be sure to switch off, turn off the TV, put down the technology and do something that you enjoy with people you enjoy being around. Refocus on yourself and your life.