How to Recognize Compassion Fatigue


Nurses are particularly vulnerable to compassion fatigue in the specialty areas of intensive care, mental health, pediatrics, and oncology because they enter lives of others during times of critical illness becoming partners as opposed to observers in their patient's health. It is essential that nurses are aware of work stressors and warning signs of compassion fatigue so that work-life balance can be maintained.

Compassion fatigue is not the same as burnout, although they are related. Compassion fatigue is the profound emotional and physical exhaustion that develops over a course of time. It is the gradual erosion of all the things that keep us connected to each other as caregivers. When compassion fatigue begins to set in, we see changes in our personal and professional lives. We can become bitter at work; we may add to the toxic work environment; we are more prone to medical errors; and we may violate client boundaries. At home, we may become short-tempered with out loved ones and feel a sense of guilt or resentment at the ongoing demands on our personal time. This is the "cost of caring".

Burnout is the physical and emotional exhaustion that you experience when you have low job satisfaction and feel powerless and overwhelmed at work. Burnout does not mean that our view of the world has been damaged or that we have lost the ability to feel compassion for others. Individuals who are non-helping professionals experience work-related burnout. Burnout can be easily resolved by changing jobs that provides immediate relief. This is not the case for compassion fatigue.

To develop your warning scale, you must increase your awareness of your own symptoms of compassion fatigue. Do you have any of the following symptoms?

Physical Signs of Compassion Fatigue

  • Physical exhaustion - feeling depleted not just tired
  • Insomnia or hypersomnia
  • Headaches and migraines
  • Increased susceptibility to illness
  • Somatization and hypochondria

Behavioral Signs and Symptoms
  • Increased use of alcohol and drugs
  • Other addictions (shopping, workaholic, compulsive eating)
  • Absenteeism from work
  • Anger and irritability (two key symptoms of compassion fatigue)
  • Exaggerated sense of responsibility
  • Avoidance of clients (not responding timely)
  • Impaired ability to make decisions
  • Forgetfulness
  • Problems in personal relationships
  • Attrition (quitting or taking extended time off)
  • Compromised care for clients

Psychological Signs and Symptoms
  • Emotional exhaustion (the hallmark of compassion fatigue)
  • Distancing; avoiding friends and family
  • Negative self-image
  • Depression
  • Reduced ability to feel sympathy and empathy
  • Cynicism and embitterment (not supporting new ideas; eye-rolling at a new nurse)
  • Resentment
  • Dread of working with certain clients
  • Feeling professional helplessness
  • Diminished sense of enjoyment/career
  • Depersonalization
  • Heightened anxiety or irrational fears
  • Increased sense of personal vulnerability
  • Inability to tolerate strong feelings
  • Problems with intimacy
  • Hypervigilance
  • Hypersensitivity (crying over simple things)
  • Insensitive to emotional content
  • Loss of hope
  • Difficulty separating personal and professional lives
  • Failure to nurture and develop non-work-related aspects of life

Make it Personal - What are YOUR warning signs? Take some time to answer the following questions.
  1. What S/S stand out most for me?
  2. What S/S do I bring home with me most often?
  3. What S/S do I experience at work?
  4. What do I have to lose if I don't deal with the effects of this "occupational hazard"?
  5. What do I stand to gain if I move toward improved self-care?
  6. Who will be the biggest supporters of my self-care?



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