Compassion Fatigue and Burnout
Burnout is a product of workplace stress that results in anger and feelings of being ineffective and can lead to apathy and depression. Compassion fatigue is a term first used to describe the inability to nurture in nurses (Joinson, 1992). Compassion fatigue affects professionals and others who work in caring professions, such as nurses, ministers, and counselors. Joinson writes that those in caring professions must be aware of and respond to compassion fatigue for four reasons:
- Compassion fatigue is emotionally devastating.
- Caregivers’ personalities lead them toward it.
- The outside sources that cause it are unavoidable.
- Compassion fatigue is almost impossible to recognize without a heightened awareness of it” (1992).
Figley amended the Joinson definition to include a broader variety of professions, describing compassion fatigue as “a state of exhaustion and dysfunction biologically, psychologically, and socially as a result of prolonged exposure to compassion stress and all it invokes” (Figley, 1995, p. 253). Some of the factors that contribute to burnout and compassion fatigue and make those in caring professions particularly vulnerable to it can be the very qualities that make people in caring professions good at what they do, according to Joinson. Being a compassionate, giving person is not necessarily an advantage if that person has no self-compassion or lacks awareness of what working with those in chronic mental or physical pain, who have experienced trauma, or working in a stressful environment can do to themselves, their co-workers, and even their family, friends, and clients. They must also learn what they can do to mediate the effects of those factors (Joinson, 1992). For mental health providers who may promote self-care to clients this concept does not always translate to themselves, nor does the idea that burnout and compassion fatigue make them less effective.
In her original article for nurses Joinson offers strategies that include checking priorities against reality. If a person claims not to be a workaholic and is working workaholic hours or spends most of their time away from their family while claiming they are their first priority then the disparity needs to be brought to light. She also suggests setting limits and boundaries, taking private time for recreation, setting priorities, and developing a spiritual practice. As compassion fatigue can be an ongoing issue, she also suggests making these actions part of a regular practice (Joinson, 1992).
More recent research points to building resiliency as a key strategy as the Catalyst blog post about CASAT Conversations Season 2: Exploring the Importance of Resilience in Primary and Behavioral Healthcare explains. The actual podcasts are also available for listening on the CASAT Conversations Website. Other strategies in the workplace that are supported by research include reducing workload intensity, providing adequate rest time periods between shifts, and reducing task repetitiveness (Baranowsky, 1999). A systematic review of the literature on compassion fatigue among healthcare, emergency, and community service workers found 13 studies that met the researchers criteria and of those the majority studied stress reduction using yoga and/or mindfulness, structured meditation, music therapy, or a combination thereof. The rest of the studies evaluated interventions focused on building individual resilience or building professional self-efficacy. Of the 13 studies included in the review, all demonstrated mixed or no effects(Cocker & Joss, 2016). The researchers pointed to the lack of studies specific to many professions and the need for additional study of the impact of compassion fatigue in future research.
Additional Suggestions for Self-Care
Especially with the anticipated surge in COVID-19 cases and the impending holidays, self-care has become an extremely important focus for health and behavioral health providers and for the rest of us as well. Some really great suggestions are contained in our blog post What’s in Your Self-care Toolbox? Strategies for self-care during the holidays are featured in National Stress-Free Holidays Month: How to Put Self-Care at the Top of Your To-Do List. Anticipating the impact of those in recovery (including care providers potentially in recovery) is the focus of How COVID-19 Can Impact People in Recovery and What Providers Can Do About It. Even more suggestions and resources are featured in our holiday posts Ho-Ho-Ho or No-No-No: Stress, Recovery, and Coping During the Holidays and the one from one year ago Hope for the Holidays and Beyond. If you would like to take a deep dive into the topic of self-care, many resources and links are contained in our Learning Lab Laughter Therapy And Happiness where you can learn about the science behind the healing power of laughter. Don’t forget to Listen to a Podcast: It’s good for your brain!