By Linda Childers
When Yolanda Smith, MSN, RN, CCRN, of Brooklyn, N.Y., started feeling low on energy, isolating herself from family and friends and feeling physically and mentally tired, it never occurred to her that she might be suffering from compassion fatigue.
“If someone had suggested at the time that I was under a lot of stress, I would have denied it,” said Smith, a former cardiothoracic surgery nurse who now operates Self Care Just For Me (selfcarejustforme.com) to help other nurses who are battling compassion fatigue. “Recovering from compassion fatigue doesn’t happen overnight. I had to learn how to set boundaries, change my eating habits and learn how to relax.”
Compassion fatigue often is described as the “cost of caring for others in emotional pain,” said Patricia Potter, PhD, RN, director of research for patient care services at Barnes-Jewish Hospital in St. Louis. Also known as secondary traumatic stress syndrome, compassion fatigue is characterized by deep physical and emotional exhaustion that results from caring for patients who are in severe emotional pain and physical distress. Although compassion fatigue and burnout are similar and can co-exist, Potter said they are distinctly different.
“Compassion fatigue refers to the profound emotional pain that occurs with taking care of seriously ill patients for long periods of time,” Potter said. “On the other hand, burnout is typically associated with increased workload and institutional stress that is not trauma-related and is marked by emotional exhaustion and job disillusionment.”
Compassion fatigue doesn’t mean a nurse stops caring about her patients. Most nurses who suffer from compassion fatigue give too freely of their emotions, Potter said. “Being a caregiver can be difficult and full of challenges,” Potter said. “In order to effectively battle compassion fatigue, nurses and other healthcare providers need to practice self-care.”
In 2009, Potter and her colleague Teresa DeShields, PhD, manager of psycho-oncology services at Barnes-Jewish Hospital, were approached by three nurse managers from oncology units at the hospital who were concerned about compassion fatigue among the nursing staff.
“We conducted a survey and found that burnout and secondary traumatic stress were high enough to warrant intervention,” Potter said. As a result of the survey, The Foundation for Barnes-Jewish Hospital funded a pilot program for oncology nurses to combat compassion fatigue and stress. Specifically designed for Barnes-Jewish Hospital, the program was first offered to oncology nurses. Later, it was rolled out on a hospitalwide basis to all employees.
Over the course of eight hours, the program, which is offered twice a month, teaches strategies to combat compassion fatigue.
[toggle title=”Strategies to combat compassion fatigue” load=”show”]1. Self-regulation: Discovering techniques to control your nervous system so that you can relax your body during stressful situations.
2. Intentionality: Reflecting back on why you became a caregiver. What Powers called “your personal creed.”
3. Professional maturation: Remembering the ways you contribute and the good you do.
4. Connection: Finding other caregivers you can talk to.
5. Self-care: Leaving work concerns at work and taking care of yourself.[/toggle]
For some nurses, the strains of long hours, staffing issues and caring for critically-ill patients can lead to job burnout resulting in physical, emotional and mental exhaustion.
“Over 40% of hospital nurses report burnout,” said LeAnn Thieman, CSP, CPAE-nurse, of Fort Collins, Colo. Realizing that nurses need to nurture their body, mind and spirit in order to avoid burnout, Thieman launched the SelfCare for Healthcare initiative (leannthieman.com) to help hospitals create a holistic, caring and inclusive environment that decreases staff turnover and improves patient outcomes.
“I developed a 12-month initiative that includes videos that challenge nurses to care for themselves, live presentations that teach self-care strategies, working with leaders to set retention goals and more,” Thieman said. “The program has resulted in a 16% decrease in the number of sick days taken by staff.”
As a nurse and executive recruiter, Kim Richards, RN, of Denver, quickly became aware of the demands placed on nurses that often resulted in high turnover. As a result, she founded the Self-Care Academy (self-careacademy.com), a comprehensive program designed to help caregivers take better care of themselves. “Constant stress can lead to burnout, compassion fatigue and nurses leaving the profession,” Richards said. “As nurses we have a tendency to over-give and then there is nothing left for us.”
Richards offers her Self-Care Academy workshops to nursing groups and hospitals and focuses on six self-care pathways — physical, mental, emotional, spiritual, relationships and choice.[pullquote]“A break can often help nurses to identify what aspects of their job are causing stress, and to address them with their nurse manager when they return.”[/pullquote]
“Optimal nutrition, adequate sleep, mindfulness, meditation and routine exercise are some of the better-known methods of self-care that we discuss,” Richards said. “But we also talk about beating burnout by cultivating healthy relationships, practicing positive self-talk and making healthy choices.”
For some nurses, Richards said, taking time off work can help with burnout.
“It can be helpful to get away and to look at how you got to the point of burnout,” Richards said. “A break can often help nurses to identify what aspects of their job are causing stress, and to address them with their nurse manager when they return.”
Linda Childers is a freelance writer.