What to Do When Caring Hurts

Health care providers spend much of their lives in the trenches of sorrow, pain and trauma. So, it’s no wonder that many nurses, social workers and physicians develop their own scars while trying to heal others.

Compassion fatigue, also thought of as secondary post-traumatic stress disorder, is the inability to react sympathetically to a crisis because of overexposure to previous crises. The condition is common among professions that require helping or showing empathy.

On Auto Pilot

“I think a person cannot protect themselves from getting so emotionally embedded,” said Lisa Dillard, R.N., MSN, Nurse-Family Partnership supervisor with the School of Nursing. “They get so drained in taking care of others that they go through the motions of caring, when they really have lost the desire to care deeply for themselves and others.

“They go on auto pilot as they slowly lose sight of balance in their own life, they allow themselves to get drained in their efforts and spend energy worrying about things they cannot control, until the pilot light goes out, and they no longer find themselves being therapeutic in caring for others.”

Dillard said she experienced compassion fatigue about 10 years ago when she was caring for home-bound chronically ill, disabled children and their families. Her anxiety, apathy and agitation were so severe she began to question why she chose to become a nurse.

“It was emotionally more draining than prior cases of job burnout, and took a greater toll on my physical well-being,” Dillard said. “I look at compassion fatigue as the darkest hole you can be in, while trying to be the best you can as a caregiver.”

Feeling Helpless

Monica Garcia, a community health worker, or promotora, with the Patient Navigator Program at the Combest Center, said she regularly finds herself in helpless situations as she provides services to clients through home visitations.

“I have high expectations for myself and sometimes unrealistic outcome expectations within certain populations,” Garcia said. “Home visitation is the most stressful. Navigators are on the front line of barriers and needs the client is facing.”

As a result, Garcia found herself feeling more and more distracted, and had trouble sleeping and overall negative health changes.

Licensed psychologist Susan Fletcher, Ph.D., agrees. She said those with empathy skills as their primary job are more vulnerable to experience the feelings of stress, anxiety and apathy that characterize compassion fatigue. The condition not only affects caregivers, but also the people around them.

“When there is compassion fatigue, productivity goes down, mistakes are more likely to be made, job turnover increases and overall job satisfaction suffers,” Fletcher said. “People are hired for their talent and when there are no safeguards in place to prevent compassion fatigue, the workplace suffers and so does the person’s home environment.”

An Action Plan

Fletcher said anyone who thinks they may be suffering from compassion fatigue should quickly identify a personal plan of action as well as suggestions to change his or her work environment.

“Addressing [compassion fatigue] up front is an investment in the productivity of the workplace,” Fletcher said. “It also acknowledges that the person has value and that that value and his or her contributions need to be protected so the person is effective and satisfied long-term.”

Dillard and Garcia said they were able to overcome their bouts with compassion fatigue by acknowledging the problem and sharing their feelings with co-workers and counselors. Dillard said volunteering, eating well, exercising, taking vacations when needed and occasionally saying “No,” also helped.

“I had to realize I was not a good caretaker until I put myself and my family first,” Dillard said. “A job has a beginning and an end, but your family and your own well-being are a part of life’s continuation. We must preserve ourselves and loved-ones, in order to extend our caregiving.”

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