For nurses, compassion fatigue can mean disruptions to their emotional and physical health. It can manifest itself as headaches, anxiousness, changes in appetite, or mood swings. Understanding the effects of this condition and finding ways to combat them can improve your overall well-being and help you provide compassionate care. Compassion fatigue occurs when there is repeated exposure to stressful, traumatic, or saddening experiences or environments, which creates a decline in empathetic ability. As a nurse, you provide care with empathy and sensitivity, and compassion fatigue may cause you to feel disconnected from the compassion you usually have. Signs of nurse compassion fatigue -- increased anger or agitation, low self-esteem, loss of interest in activities, or sleeping difficulties -- not only affect patient care and your professional life, but your personal life as well. A 2019 study on compassion fatigue in nursing found that it affects nurses regardless of specialty, years of experience, or age. On the bright side, the results also showed that supportive leadership, awareness of symptoms, and coping strategies were successful in preventing or reducing this condition. Your role is instrumental in providing quality patient care, so by recognizing compassion fatigue and implementing strategies, you can mitigate its effects.
Self-regulation
Because nurses are on the front lines of health care, they're bound to have stressful encounters with patients, families, or even colleagues. Their roles require them to maintain composure in difficult situations even if their own well-being is at risk. Self-regulation refers to regulating and relaxing the body to maintain control when responding to a stressful situation. Mindfulness techniques, such as breathing exercises, can help. A study on mindfulness found that nurses who practiced these techniques showed an improvement in their emotional well-being. These methods can aid in fostering self-compassion and reducing negative responses or thoughts that could lead to compassion fatigue. Trish Richardson, MSN, BSBA, RN, NE-BC, CMSRN, former director of post-acute care solutions at Relias, discussed how self-regulation has helped her throughout her career. "I made it a practice to stop at a patient's door and cleanse my mind before entering, reminding myself that they need my full attention," she said. "Our unit put into practice post-code debriefs, allowing staff to receive care and attention and an opportunity to 'refill their cups'." Post-code debrief is a practice that gives healthcare staff time to process emotions and reflect with colleagues after a traumatic situation. Richardson added that because this technique focused on the well-being of herself and her colleagues, they were better prepared to care for others during the remainder of their shifts.
Self-care
Nurses spend much of their time tirelessly caring for patients, and oftentimes, this can lead them to overlook their own physical and emotional health. Self-care is the act of preserving your physical and mental health, in part, through activities such as taking a walk with a friend, getting a massage, taking a yoga class, or eating a nutritious meal. [caption id="attachment_78222" align="alignleft" width="270"]
Trish Richardson, RN[/caption] However, self-care doesn't have to be limited to relaxing activities. An act of self-care can also be setting boundaries for yourself -- saying no to coming in on your day off or taking on a larger workload, for instance. By adopting these practices, you're taking steps to improve your own physical and mental health. "Compassion fatigue can set in quickly after continued exposure to endless suffering and death without the ability to debrief and decompress," Richardson said. "Self-care is an essential element to finding and embracing emotional balance and sustaining one's health amid chaos." Richardson also added that this act of self-focus promotes stability and presents an opportunity to rebalance your own health -- physically and emotionally. Self-care "nurtures your inner caregiver spirit and allows you to be at your best when providing patient care," she said Nurses who implement self-care practices may also find they have more autonomy, increased self-esteem, and feel more empowered, according to one study. Results like this show how effective self-care is, and that it can be a tool to reduce the effects of compassion fatigue.
Connection
The high emotional demands that nurses experience on a regular basis can come at a cost. That is why connection with friends, family, and colleagues is vital in combatting conditions like burnout, moral injury, or compassion fatigue. Solid support systems provide safe spaces to find emotional relief. The strength and closeness of these relationships can have a positive impact on your overall well-being, improving both mental and physical health. A study on nurses' social support found that nurses who had strong and effective relationships with colleagues had better mental health. This study also suggested that if more nurses were given opportunities to strengthen their relationship with colleagues, including nurse managers, there could be a shift in the number of nurses experiencing burnout or compassion fatigue.
"Something as simple as a loved one or close friend offering a safe space to share feelings, emotions, and tears [can] have a significant impact in the life of a nurse," she said.
Self-compassion
Compassion fatigue can influence a person's self-worth, especially in nursing. Nurses carry a large amount of responsibility, and the weight of this can create different emotional responses, including self-criticism, frustration, or stress. "Whether your primary role is a bedside caregiver or volunteer, when you're in the service of others, there's always a possibility you could become overwhelmed," Richardson said, adding that the COVID-19 pandemic has exacerbated these feelings. If you're feeling overwhelmed, inadequate, or hurt, you can practice self-compassion to minimize these feelings. With self-compassion, you're removing instances of anxiety, shame, or frustration and making space for comfort, respect, and validation. This way, you're offering yourself understanding and gentleness when you feel as if you're failing.
By replacing self-judgment with self-kindness, you may see a positive shift in your focus.
Being self-compassionate is a challenge for some nurses. A study found that some nurses felt they needed "permission" to be self-caring and self-compassionate. This issue affected the nurses' well-being and their ability to provide empathetic care. However, results revealed that by helping nurses be more proactive about self-compassion they can reduce or prevent negative effects on their well-being. "It makes a tremendous difference when we recognize and celebrate that we are not alone in our struggles," Richardson said. "Through self-compassion, we can lessen the pain associated with compassion fatigue and allow ourselves to empathize more fully with our patients once again."
Reflection
Nursing remains the largest profession in healthcare, and throughout the course of their careers, nurses continue to learn, advance, and adapt. They will face both positive and negative aspects in their roles, and that includes obstacles that impact their well-being. Reflection or reflective practice has been shown to improve nurses' well-being by reducing work-related stress and conditions like compassion fatigue. Using this method -- individually or as a group -- allows you to break down aspects of your personal and professional life and ruminate on these experiences to enhance your overall well-being. While reflection allows you to consider what went wrong, it also invites you to focus on what went right. This technique can make you feel more motivated, provide more learning experiences, and produce higher quality care. Reflective practice breaks down elements in stages that define the overall situation, how the situation made you feel, why it happened, and what you could have done differently. This practice also isn't limited to individual experiences. Reflecting on how far you've come in your nursing career and seeing areas of your practice you've strengthened and continue to develop are helpful in combatting compassion fatigue. Compassion fatigue can have lasting effects on the physical and mental well-being of nurses, impacting both nurses and patients. By recognizing and addressing the signs of this condition, you can protect your mental and physical health. If you're looking for career support, education resources, or connection, explore the Nurse.com app. 
