Linda's empathy and understanding of struggle both professional and personal has fuelled her passion for learning from others and in turn empowering others. There are many bullies, negative wizards and hob nail boots to trample on our aspirations, but learning that we have to power to shrug off their influence and have the life we choose, is personal freedom. Confident effective communication is a cornerstone to improving self-
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What is Compassion Fatigue?
So you work in health/social care, or education. Perhaps as an OT or physio? Doctor, nurse, social worker, speech and language therapist, teacher, Teaching Assistant, lecturer, or administrator…(we could go on…)
Perhaps you work in a hospital environment? Or in the community? Maybe in palliative care? In a school, college or university. You may work for a Government entity, a charity, a private organisation… (you get the idea).
But whatever your role you probably work with people who are ill, suffering, in distress, undergoing some kind of trauma or dealing with multi cultural issues.
Your role requires, emotional, psychological and physical input. There are long hours, deadlines and a wide variety of demands on your time.
All of which means you are at risk of compassion fatigue.
Compassion Fatigue is the gradual wearing down of compassion and empathy, or the ability to care over a period of time.
It is what happens when the stories and experiences of the people we are caring for or teaching and working with overwhelm us. Add to this the stresses of our own personal life, and the expectations of the organisation we work for and the results can be:
Exhaustion, emotionally, mentally and physically
Physical symptoms such as headaches, stomach pains, inability to sleep
Emotional symptoms such as low moods (or mood swings), anger, frustration, anxiety, a feeling of ‘why bother’, anger, frustration, bottling up of emotions, crying more often than usual, small annoyances become huge issues.
A change in the way we see the world and the people we work with, less tolerance of clients/patients/students, leading to a negative attitude, over generalisation (John is ALWAYS so difficult to work with, Eve NEVER appreciates what I do…) and a tendency to avoid situations or patients/clients/students we perceive as difficult.
Compassion Fatigue is a normal consequence of doing the work you do, over a period of time. It is an errosion, it is not a medical diagnosis, it is a set of signs and symptoms that you can choose to do something about.
Anyone can suffer with work based stress or burnout, you don’t have to be working in a caring profession. It is often caused by things outside of our control or organisational pressures. So everyone from bankers, butchers, bakers (and probably candlestick makers) can and do suffer from work related stress. Tight deadlines, organisational pressures and inflexible working patterns all combine to raise our stress levels – eventually leading to burnout where people decide that they can no longer cope and often leave their profession. So this type of stress does not lead to compassion fatigue on its own, but it is a component as we will see in a moment…
Post traumatic stress disorder (PTSD) is a specific, medical diagnosis. People suffering with PTSD have often witnessed a serious, traumatic incident (or series of incidents) which they cannot forgot. Symptoms include ‘flashbacks’ to the incident and intrusive thoughts, often leading to an ability to sleep due to nightmares and the re-
living of the experience. Those experiencing PTSD symptoms are encouraged to speak to their GP to get specialist help.
Compassion fatigue is often not about one incident or story. It is more often about all the experiences and stories you hear over the years, many of which you can’t even remember, but they impact on you over time as you carry them with you.
This is possibly the easiest part to write. The simple answer is EVERYONE.
Everyone who works in health or social care is at risk of compassion fatigue as they are exposed to organisational and personal stress and are exposed to the traumatic or distressing stories of the people they work with. We are not just talking about the so called ‘front line’ workers. We really do mean everyone.
I was working with a neurologist specialising in working with people with motor neurone disease. I popped into the neurologist’s office and asked Julie, the secretary, how she was.
“Not great” said Julie. “They’ve changed the way we work and reorganised the department and the computer system, I’m struggling to keep up. I’m exhausted.” I was just about to make some kind of sympathetic murmur about how stressful that must be when Julie continued.
“The thing is, I spend my days typing up the clinic letters and team meeting notes of the patients. All day I read about their awful illness and the impact it is having on them and their families. I never meet these people; occasionally they might ring and complain about the time they have to wait for a clinic appointment or test results. I feel like I know them but I have no control over what happens to them or the care they get. It’s really hard. I love my job, but sometimes it’s really, really hard”.
If we were to draw a set of scales for Julie what would it look like? Julie might not be on the ‘front line’ of care for patients but she is certainly exposed to their stories and trauma.
The bottom line is that Julie, like all of us, is at risk of compassion fatigue. It is a normal reaction to the work we do and it affects those of who are good at our jobs, care about the people we work with and have empathy and compassion. Once you accept this you can start to work out what you can do about it., because you need to accept that we are all at risk, but we don’t all experience compassion fatigue. You can take action to protect yourself.
The next step is to work out what you can do about it. Unfortunately we can’t give you a ‘one size fits all’ solution, this is about you looking at your work and personal life and working out what action you CAN take and then deciding what action you WILL take..
We can, however, give you some ideas of things that might work for you.
The first step is to work out what you are in control of. These are the things that you can change. They include your:
awareness of how you respond to stress
- Health, diet, exercise
- Attitude to those around you
- Training, education and skills
- Boundaries between work and home
- Support and supervision
- How close you get to patients (not in a physical sense, but in a taking-
their- story- home- with- you sense)
There are also things that are less likely to be in your control. These include:
- Your patients/or clients/or students experiences/distress/attitudes. Your colleagues and managers
- Organisational priorities and systems
- The life issues that gets in the way (traffic, weather, dog being sick on the carpet, family problems, (everyday problems) etc
- There are also major life issues and personal traumas, divorce, death, or close relationship ending, moving house, and diagnosis of a major illness.
…but you are in control of how you choose to deal with these
What action could I take against Compassion Fatigue?
Once you have looked at the things going on in your life and identified the things you have control over, then it is time to make a commitment to take action and makes some changes that will reduce your risk of compassion fatigue. You may have your own ideas of what will work for you.
But here are some of ours:
- Be aware of how you feel in different circumstances. You can identify how your body is responding to stresses. If you can recognise the ‘early warning signs’ of compassion fatigue then you can take steps to take care of yourself.
- Put boundaries in place between work and home. These could be simple techniques such as taking off your work uniform before you get home (and preferably putting on some other clothes, but we’ll leave that one up to you!), leaving your work ‘thoughts’ somewhere on the commute home and picking them back up again when you commute back to work the next day
- Put in boundaries at work. Start and finish on time. Take your lunch hour. Work smarter, not longer.
- Get GOOD supervision. Supervision is key in protecting yourself from compassion fatigue. Having the opportunity to de-
brief and talk through your experiences is key. Peer supervision, where colleagues spend protected time talking through difficult or challenging cases in a non- judgmental way is a brilliant way of fostering a supportive work environment.
- Decide on how you will deal with the things you can’t control. For an easy to understand and very British take on mindfulness try the online resource from Headspace or read ‘The Art of Being Brilliant’ to bring a new perspective on the way you think about the things we can’t control.
- Deal with the guilt. If your work or work/life balance is making you feel guilty, find ways to regain your balance.
- Use tools to identify the things that cause you stress and identify practical interventions that might help. Exercise is worth a try.
- Learn to say ‘No’ (practice in the mirror). Are you the person at home or work who is the ‘go-
to’ person every time something needs doing. How does that make you feel (it may tap into one of your ‘shadow needs’ – the need to be needed, so be honest here). How can you learn to say no better?
- Make some time for you. What makes you happy? When was the last time you had some fun? Spend time with family and friends who make you smile and give you energy. Try to stay away from the people who suck all the life and energy out of you.
- Look at your diet and exercise – are there changes there that you can make? Research shows that gentle exercise can help with a feeling of well-
being (and lets not pretend we don’t know that we should be eating a balanced diet, not over indulging on the alcohol front etc etc etc).
- Breathe (well, we are hoping you are doing this anyway), but think about your breathing. There are lots of resources online which demonstrate breathing techniques and exercises which have been proven to lower stress levels.
- Talk to your team; maybe do a presentation at a team meeting. The more you talk about compassion fatigue, the more we normalise it and can get the support we need.
- As a team, share the changes you are going to make and ask your colleagues to help you on track. When you share your goals with other people it makes them much more real, and helps you be more accountable for your actions.
- Learn more – there are lots of resources online, or book Linda to come and talk to your team or run a workshop to learn more practical ways of combating compassion fatigue.
- Learn to say ‘Yes’! Compassion fatigue can leave you exhausted, demoralised and
- lacking in energy, so you stop doing the things that make you happy and rejuvenated. Start saying ‘yes’ to nights out, walks in the park, training sessions at work, lunch with a colleague etc.
- Be more mindful. Mindfulness is the awareness of ourselves and the world around us. There is lots of research which shows that the brain changes the way it connects when we practise mindfulness, there arephysical changes in the brain after just 11 hours of mindfulness practice. Check out a free online resource to find out if it works for you. We love Headspace as a great start.
- By taking action to change the things that are in your control and deal differently with the things that are outside of your control can up your resilience, increase your job satisfaction, give you better boundaries when working with your patients or clients or students and ultimately protect you from compassion fatigue.
- Choosing to start with one or 2 simple changes will give you the impetus to keep going. You may be looking at the list above and be thinking ‘Yeah, right – start and finish on time, that’s NEVER going to happen’.Well, it’s your choice. But as we’ve said before:
- “If you always do what you’ll always did, you’ll always get what you always got.” Or in the words of Jim Rohn, “For things to get better, I have to get better, for things to change; I have to change.”
- Feel that you need to redress the balance between your work and personal life?
- Wish you had more time/motivation/confidence?
- Support people who are experiencing suffering or distress?
- Sometimes feel overwhelmed by the stories and experiences of the people you support?
- Want some space and time to concentrate on you?