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Compassion Fatigue: The Cost of Caring

Compassion fatigue in healthcare is growing problem. It can lead to emotional exhaustion, decreased empathy, and burnout. Mary Wolf, the President of Veritee Partners LLC, has extensive experience in coaching and consulting healthcare professionals and executives, Mary understands the profound impact this phenomenon can have on individuals and organizations. Learn more about Mary and other coaching and consulting resources on our website.

How compassion fatigue manifests in healthcare professionals

Compassion fatigue in healthcare occurs when providers and staff hear stories of fear, pain, and suffering. They then suffer because of how much they care. I see physicians and advanced practice providers losing their sense of self due to the amount of feeling another person’s pain and serving patients with great care and passion. The demands of supporting those who are suffering can lead to what is called secondary or vicarious trauma. Continual exposure to a patient’s trauma can take a toll. This can drain a clinician’s compassion and empathy dry. They can feel exhausted and apathetic even when they want to be empathetic.

Common signs and symptoms of compassion fatigue 

Compassion fatigue can be experienced by:

● Ruminating or worrying about traumatized individuals
● Avoiding or numbing any reminders of an event or person
● High arousal or anxiety
● Lowered frustration tolerance
● Dreading working with certain types of patients
● Ineffective or self-destructive self-soothing behaviors
● Decrease sense of purpose and/or enjoyment
● Diminished capacity for intimacy
● Loss of hope
● Feeling detached, cynical, or apathetic
● Feelings of emotional, physical, and psychological exhaustion
● Blaming yourself or others for not doing enough to help or prevent trauma
● Emotional numbness
● Feeling helplessness and emotional numbness Cited: Compassion Fatigue: The Toll of Caring too much. VeryWellMind. 4-16-23

Other risk factors include recent significant loss, limited work satisfaction, limited stress management practices, and poor self-care.

Patient care and the overall well-being of healthcare professionals

Compassion fatigue has a cumulative effect and can lead to burnout. Often, the clinician does not see their level of burnout, and it takes the encouragement of their leader or spouse before they will seek help. Burnout becomes worse over time.

Christina Maslach has researched burnout for decades and reports three main characteristics:

1 Depersonalization
○ cynical or negative attitudes toward patience
○ lack of empathy
2 Emotional exhaustion
3 Feeling decreased personal achievement

I see clinicians lose confidence in themselves because they can’t help every patient how they want. This is called Moral Distress. I often saw this moral distress struggle during the COVID-19 Pandemic when clinicians were caught between promoting the well-being of their patients and having to follow policies and structures for the delivery of care. The difficulty is that the clinician often blames themselves, feeling like they should be able to handle it all because everyone else does. When the fatigue actually comes from a place of empathy, caring, involvement, and helping. I have seen compassion fatigue negatively affect marriages.

After a particularly difficult incident, a clinician may shut down emotionally, making a spouse feel helpless and frustrated. This takes a toll on the clinician’s stress. It also affects how they are at home and in their relationships. My clients shut down their emotions when seeing patients as a way to cope with overwhelming situations. They become apathetic and even cold. This is their way of coping instead of finding a way to regulate their emotions or seek help for their over-giving and exposure to trauma.

Who is most susceptible to compassion fatigue

Compassion fatigue in healthcare can happen to anyone. Witnessing suffering and having high empathy makes one high risk. Often, we think that emergency medicine and hospice workers are at the highest risk of compassion fatigue. However, any department, clinic, or agency that serves patients who are suffering in some way is at risk. Clinicians serving patients who do not have consistent access to basic needs such as food, clothing, and shelter can also be at higher risk for compassion fatigue. I have seen my client’s worldview change. Often, they become pessimistic. They have a harsh outlook on the state of their community or country. Spiritual beliefs also can shift to more doubt and thinking the worst.

About Veritee Partners, LLC
Veritee Partners LLC is an executive coaching and consulting business designed to promote well-being and success for physicians, clinicians, residents, dentists, executives, and health systems. When people and companies focus on emotional health, it enhances engagement, productivity, and satisfaction. Mary Wolf, president, has extensive experience in physician/provider well-being programs, coaching, leadership, and healthcare dynamics. She coaches professionals to stop the overwhelm and live a more truthful, fulfilling life. Veritee Partners offers executive coaching for physicians, advanced practice providers, executives, and dentists. They also provide assessments and consultation for building well-being cultures. The Veritee process helps clients and companies to become clear in their vision, create an inspiring strategy, and develop agility for thriving with change and uncertainty.

(Coming Soon: Part 2 of Mary Wolf’s series on compassion fatigue which includes strategies for preventing and coping with the condition)