Preventing compassion fatigue through community

Irina has a rewarding career as a nurse. But lately she hasn't been feeling quite herself. She's not sure when or how it started...

Her work seems to go with her everywhere and she finds herself rehearsing it over and over in her mind. Other times, she finds herself in tears, angry or irritable with others. And, when she has much-needed time off from work, she finds she can't relax, can't sleep, and can't think clearly...she begins to wonder if she's depressed.

Irina may be experiencing a syndrome that affects many different types of caregivers- compassion fatigue. And I'm convinced that compassion fatigue is something every nurse needs to understand.

Why? Because regardless of whether you're a student nurse or an established professional, you are likely to encounter compassion fatigue at some point in your career. In fact, young nurses are particularly susceptible.

Untreated compassion fatigue can lead to job dissatisfaction, burnout, and ultimately leaving the nursing field.  It's also associated with overeating, depression and even substance abuse.

That's why it's critical for all of us to develop tools and strategies for combating compassion fatigue. (And, if you've read my previous blogs, you may not be surprised to hear that participating in a community of nurses is an ideal place to start!)

Too much of a good thing?

Compassion fatigue comes from a good thing-the compassion we bring our patients as nurses. Many of us decide to become nurses because of a strong desire to help alleviate suffering.

Compassion fatigue occurs when we become preoccupied with the suffering of others to the extent that we begin to suffer. In fact, the symptoms of compassion fatigue can mimic those of post-traumatic stress syndrome. And this suffering is only heightened if we don't practice good self-care.

Think of it as having a bank account of caring. When we care for others, we are drawing from this account. If we aren't regularly depositing good self-care and the support of others, we are more at risk of overdrawing, or being in a constant state of deficit. 

Certain types of nursing may present more risk of compassion fatigue-end-of-life care for instance.  (Personally, I can't imagine being non-emotional when working with hospice clients!)

But it can also be compounded by rushing from one job caring for others to another-raising children, taking care of elderly parents, a sick partner, etc.

So how can we combat compassion fatigue? 

Here are five things I've found to help...

1. Make sure to replenish your physical and emotional stores - For me, this means having dinner with close friends with whom I can be myself. It means long bike rides or a water aerobics class.  When I had small children at home, they knew I needed "mommy time" when I got home (twenty minutes to take a hot shower and de-stress!)
2. Develop a checklist for self-care - In a Medscape interview, Dr. Charles R. Figley noted that, "those who are selfless and compassionate have an Achilles heel-they don't pay enough attention to themselves." He suggests setting goals for self-care, including how much sleep you need and finding an advocate who promotes your well-being.
3. Infuse humor into your work - Why are there so many doctor jokes? Maybe, it's the same reason that 911 operators are known for their joking.  Humor helps us de-stress.  (Dr. Figley suggests that someone who is joking around less then usual may be in need of a break.) Help your co-workers lighten up and ask them to do the same for you.
4. Seek encouragement within your workplace - I used to tell my students that they should focus on at least one positive thing that happened or that someone said to them every day (I know, there are some days when this might seem impossible...) Keeping a journal of positive feedback you receive from doctors, other nurses, or patients can also be therapeutic; re-reading your journal will remind you of the good you are accomplishing.
5. Rely on a community of nurses - Learn from the experience of others. A CE class can be a great way to gain new perspective and new energy for difficult tasks. As you join in discussions where you can share more deeply with others like you, you'll draw from the power of community.

Now it's your turn...

What suggestions do you have for preventing compassion fatigue?  What helps you?

How can nursing students begin establishing habits of good self-care?

Resources:

(2005, October 17). Compassion fatigue: An expert interview with Charles Figley, PhD. Retrieved November 17, 2009 from www.medscape.com

Nurstoons. (2009). Why nursing. Retrieved November 17, 2009, from http://www.nurstoon.com/comic77.html