Last updated on March 16, 2019
The term “compassion fatigue” might imply that physical fatigue leads to the loss of ability to feel compassion for others.
After all, what physician hasn’t experienced running on too little reserve? Feeling some degree of emotional numbness?
Many physicians may not realize, however, that compassion fatigue can go much deeper.
Physicians and other health caregivers suffering from compassion fatigue may actually develop a secondary traumatic stress disorder. According to the Compassion Fatigue Awareness Project website:
When caregivers focus on others without practicing self-care, destructive behaviors can surface. Apathy, isolation, bottled up emotions and substance abuse head a long list of symptoms associated with the secondary traumatic stress disorder now labeled: Compassion Fatigue.
In this post I have compiled 5 facts about compassion fatigue that physicians need to know now.
1. Compassion Fatigue vs burnout.
In the article Overcoming Compassion Fatigue, authors John-Henry Pfifferling, PhD, and Kay Gilley, MS summarize:
Whereas physicians with burnout adapt to their exhaustion by becoming less empathetic and more withdrawn, compassion-fatigued physicians continue to give themselves fully to their patients, finding it difficult to maintain a healthy balance of empathy and objectivity.
Physicians suffering from compassion fatigue may not only suffer from burnout, but continue to draw from an empty well. Harming themselves in the process.
2. The symptoms of compassion fatigue may be physical.
Chronic physical symptoms can include gastrointestinal symptoms and headaches. When chronic stress is suppressed internally, it finds its way out externally. Often manifesting as a physical symptom.
3. Admitting you might be suffering from compassion fatigue does not mean you are no longer a caring doctor.
In fact, it can mean the opposite. As summarized on the Compassion Fatigue Awareness website:
Accepting the presence of compassion fatigue in your life only serves to validate the fact that you are a deeply caring individual. Somewhere along your healing path, the truth will present itself: You don’t have to make a choice. It is possible to practice healthy, ongoing self-care while successfully continuing to care for others.
4. Inability to release the stress of work after hours is a sign of compassion fatigue.
As Patricia Potter, RN, PhD, and Mimi Alvarez, RN, MSN explain in the article “Caring is Hard Work” in ACP Hospitalist,
Separating life inside and outside of the hospital is an important component, and clinicians who engage in spiritual and mindfulness practices may be better able to avoid compassion fatigue … “Something simple is having a ritual when they walk into the hospital of finding a way to ground themselves, either saying some kind of mantra or some kind of prayer or setting the intention for the day, and the reverse when they leave work to release it.”
Another exercise to try is this: visualize putting your stresses and worries about patients into a drawer. Then visualize shutting the drawer tight for the night . In the morning you can open the drawer and face them again (hopefully after a good night’s rest!)
5. The personality characteristics that drive many physicians to a career in medicine are also risk factors for developing compassion fatigue.
From the Compassion Fatigue Awareness website:
Leading traumatologist Eric Gentry suggests that people who are attracted to care giving often enter the field already compassion fatigued. A strong identification with helpless, suffering, or traumatized people or animals is possibly the motive. It is common for such people to hail from a tradition of what Gentry labels: other-directed care giving. Simply put, these are people who were taught at an early age to care for the needs of others before caring for their own needs. Authentic, ongoing self-care practices are absent from their lives.
If you think you may be suffering from compassion fatigue, a good place for help is this list of resources.
Don’t wait. Awareness is the first step. Pick one small thing to make the first step to better self-care. Go to bed 30 minutes earlier. Leave the office 30 minutes earlier one day a week. Start with little steps and build from there. As a retiring physician said to me my first week in practice, “It’s a marathon, not a sprint.”
It’s imperative to find ways to pace yourself. You cannot go at a full-on sprint day-in and day-out for your entire career. Not if you want to make it to the finish line intact.
It is possible to attain compassion satisfaction, as Mary Vachon, RN, PhD says in the article “Caring is Hard Work” in ACP Hospitalist:
The flip side of compassion fatigue is compassion satisfaction. Whereas we may get drained helping people, we also get sustained in helping people and we can derive a great deal of satisfaction.
Wow, Jennifer. I’m disappointed and a little stunned that you failed to acknowledge nurses even *once* in this post. Nurses suffer from compassion fatigue at least as much, if not more, than doctors. Critical care nurses in particular have high rates of work-related PTSD. I’m floored (and not in a good way) that many doctors consider nurses so insignificant (and not professionals) that RNs do not even get a nod in blog posts such as yours. I was so fortunate to spend my career in an ICU where MDs and RNs worked as a team and enjoyed mutual respect.
Dear Catharine, Thank you so much for your invaluable comment. As the daughter of a CCU nurse, I am mortified to think that my post may have come across as intentionally slighting nurses. Please believe that was never the intent. I agree with your comments 100%.
Hi again Catharine. I dedicated my most recent post in thanks and recognition of nurses. https://jenniferlycette.com/20-things-thankful-to-nurses/ . – Jennifer
Jennifer: no need to apologize. It is impossible to address everyone in every post, and as you mentioned you did a separate post recognizing nurses. Sometimes it is necessary and desirable to dedicate a post to solely one profession. Nothing wrong with that!