How do I deal with compassion fatigue?

> Feeling overwhelmed with challenging patients?
> Struggling to manage the emotions that arise from patient deaths?
> Constantly asked to do more, get patients discharged more quickly and respond to the demands of doctors, family members and supervisors?

If you answered yes to any of these questions, you’re not alone.

Many nurses find themselves feeling exhausted and physically ill, and wonder why they can’t seem to get enough rest or time off. These nurses may be experiencing “compassion fatigue.”

Compassion Fatigue
Compassion fatigue, often referred to as “secondary traumatic stress,” is a natural consequence of working with people who have experienced extremely stressful events. It develops as a result of the provider’s exposure to their patients’ experiences combined with their empathy for their patients. Compassion fatigue can be described as a severe malaise as a result of caring for patients who are in pain or suffering.

The good news is that there are ways to manage compassion fatigue. The first step is to recognize that avoiding difficult emotions such as sadness and grief from patients’ traumas or deaths can affect your physical and emotional health, as well as your job satisfaction. When nurses write reflectively about their patient challenges and deaths instead of keeping their emotions bottled up inside, they usually experience a sense of release, relief and integration.

“Those truly dedicated to the profession are at the highest risk of burnout. We need to recharge ourselves, find balance in our lives and rekindle the passion periodically so we can continue to do our best for our patients. My Healing Companion: A Journal for the Healthcare Provider helps you achieve that personal goal,” says Lillie Shockney, RN, BS, MAS. Lillie is a Distinguished Service Assistant Professor of Breast Cancer and Administrative Director of the Johns Hopkins Avon Foundation Breast Center, and also a 16-year breast cancer survivor.

The Science of Writing
Whether writing alone or in a group, scientific research suggests that writing about emotional distress has beneficial influences at both physiological and psychological levels. Anecdotal evidence from those who write also suggests that writing about upsetting experiences produces long-term improvements in mood and indicators of well-being, along with a significant reduction in distress.

A Nurse’s Journaling Exercise
Try completing the following exercise, titled “A Special Patient,” in a notebook, journal or computer file the next time you’re feeling overwhelmed:

Can you recall a time when you experienced the loss of a patient who had touched your life? Reflect on this experience.
> What emotions did you experience?
> What lessons did you learn?
> What would you do differently?
> How can you apply this to future situations?

After completing this exercise, write a reflection in which you comment on what it was like to write about a special patient. Or read it out loud to a trusted friend, family member or colleague. Then continue writing on your own about ways you can express these difficult emotions in order to promote self-care.

As you get started with a self-care journal, keep your writing simple and remember that this is for your eyes only. Grammar, penmanship and spelling don’t count. If you’d rather type on a keyboard than write by hand, go right ahead. Start writing, and keep writing until you feel you’ve released all of your feelings on paper. Then reread what you wrote and note anything about your writing that may have surprised you. Starting a facilitated journaling group for the nursing staff and using a guided, structured text such as My Healing Companion: A Journal for the Healthcare Provider can help nurses utilize journaling and support from other nurses to combat compassion fatigue.

If you’re trying to combat compassion fatigue or just want to promote personal growth and reduce stress, try writing and see for yourself what it can do for you!