Compassion Fatigue

Original Editor - Amanda Ager Top Contributors

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Definition/ Description

We become clinicians because we have compassion an we are interested in positively influencing a person's quality of life. We give of ourselves so that we may help other's obtain optimal health. As righteous as this can be, it can also lead to "clinical burnout" or "compassion fatigue".

There are many terms to describe this phenomenon, including:

• Compassion fatigue;
• Secondary Traumatic Stress Syndrome (STSS);
• Clinical burnout;
• Burnout syndrome;
• Moral distress;
• Occupational burnout.

Regardless of the term, a "burnout" can be best understood as: a syndrome (a collection of symptoms) of emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment. Symptoms of burnout include mental and physical exhaustion, accompanied by psychosomatic disorders and emotional problems. Burnout occurs most often in people employed in occupations requiring working with people (human services and medical services) as a result of coping with stress and experience numerous failures at work. Moreover, a compassion fatigue denotes a state of emotional exhaustion that can occur as a result of intensive empathic involvement with people who are in distress.

A clinical burnout can occur when a physiotherapist / physical therapist is exposed to chronic, job-related stressors.

For clarity sake, the term Compassion Fatigue (CF), will be used hence forth.

Epidemiology

Compassion fatigue may start at any stage during a physiotherapists career, irrespective of the work situation. Although controversial at the moment, women seem to have a higher level of professional burnout than men. It has also been noted that more experienced physiotherapists may be at greater risk for the development of CF.

Clinical Presentation

It is important to distinguish the difference between Compassion Fatigue, workplace exhaustion and general depression. The main distinguishing factor with workplace exhaustion, is that these problems disappear outside work. 

CF denotes a state of emotional exhaustion that can occur as a result of intensive empathic involvement with people who are in distress.

Therapists experiencing CF reported that they:
- struggle to show compassion to their patients while dealing with job related stressors.

Signs and symptoms of burnout:

·      Work addiction

·      Excessive stress

·      Fatigue

·      Insomnia

·      A negative spillover into personal relationships or home life

·      Depression

·      Anxiety

·      Alcohol or substance abuse

·      Heart disease

·      High cholesterol

·      Type 2 diabetes (especially in women)

·      Stroke

·      Obesity

·      Vulnerability to illnesses

·      Feeling like you are involved in workplace bullying

It is possible that older and more experienced therapists hold positions of greater responsibility, in which demands are more difficult to meet. In these situations it can become increasingly difficult to maintain feelings of personal accomplishment.

Burnout among health care providers has also been linked to wider organizational factors, such as increased workload, time pressures, safety issues, role ambiguity, lack of supervision, and reduced resources.

Management / Interventions

There is no "quick fix" for managing compassion fatigue. The most important action is to identify the key personal stressors. Everyone's situation is different and therefore the "triggers" will most certainly be different. The examination of your work-life balance will certainly be at the core of addressing how you are feeling. The first step is recognizing that there is an issue, followed by seeking the appropriate level of support or change in your life.

How to reduce burnout:

• Identify and manage the source of stress to the best of your ability.
• Manage your expectations about what you can realistically accomplish in a day (it will still be there tomorrow!).
• Evaluate your options;
• Adjust your thoughts and your attitudes;
• Seek support as needed (speak to your boss, your colleagues, and your social support);
• Take care of yourself (eat well, sleep well and exercise!);
• Speak to a professional who can help you develop a personalized strategy for dealing with your CF.

Resources

Check out this great YouTube video on Clinical Resilience: Preventing Burnout, Promoting Compassion, and Improving Quality by The Schwartz Center for Compassionate Healthcare (2014).

For an interesting read, take a look at : Physicians are not burning out, they are simply suffering moral injury.