Compassion Fatigue: The Disease of a Caregiver

October 30, 2017


Work Safety


Dr. Ben Janaway

'Live to work, not work to live.' A saying oft-quoted but little heeded. Caring is a noble profession filled with challenges, but sometimes comes at great personal cost. And Compassion Fatigue (CF), a condition driven by traumatic experience, is more common than you think. And Healthcare workers and those working with people are especially susceptible.  What is CF, what causes it, how do you know you have it and what can you do about it?

Disease of the Caregiver

'I found myself no longer caring about work. About my patients. I was more angry than interested, and it took little to set me off.' - Jane

CF is a psychological and physical disorder caused by exposure to dealing with suffering. And it mainly affects those working in care. Disturbingly, CF is estimated to affect up to 10% of trauma counsellors, 26% of hospic nurses and one study found that 49% of child protection staff were at 'high risk'. It is also highly associated with Burnout, a complex but distinct disorder driven by overwork.

CF is theorised to occur when exposure to suffering and compensatory mechanisms such as worker satisfaction, concern, baseline empathy fall out of balance.Within healthcare workers, this can be exposure to sick or dying patients, and within education to children with enhanced needs.  It can also result from external factors such as working beyond expectation, bureaucratic changes and a hostile work environment.

I dreaded going into work, and found that I could'nt stop thinking about it.  I found sleep difficult, and this just made things worse. I began to underperform at work. - Jane

<blockquote class="twitter-tweet" data-lang="en"><p lang="en" dir="ltr">Compassion fatigue is real. I understand. Personally I find that focusing on what I can actually control helps me to combat this.</p>&mdash; #Prisonculture (@prisonculture) <a href="">September 27, 2017</a></blockquote>

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Symptoms may include;

  • Sleep disturbance, weight loss and headaches
  • Chronic exhaustion, cognitive difficulties
  • Intrusive thoughts, emotional avoidance or numbness,
  • Emotional insensitivity or hypersensitivity
  • Feelings of anger, anxiety or irritation
  • Feeling that your job is 'unfair'
  • Personal relationship breakdown
  • Impaired decision-making
  • Reduced job satisfaction
  • Fear or dread of work
  • Depersonalisation - a feeling of disconnection with yourself.

<blockquote class="twitter-tweet" data-lang="en"><p lang="en" dir="ltr">Y&#39;all... I&#39;m going to be real for a minute. I haven&#39;t been tweeting a lot lately because I&#39;m feeling &quot;the burnout&quot;</p>&mdash; ScrubsandPearls (@ScrubsandPearls) <a href="">September 23, 2017</a></blockquote>

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How to fight back; Compassion satisfaction

Part of being a caregiver is learning to take care of yourself. If you are unwell, you cannot be expected to help others. Plus, you deserve a happy life too'- Jane

You could argue that CF is a curse of the Caregiver. And the more suffering that you are exposed to, the higher the likelihood of becoming a sufferer yourself. But models of the disease provide both a way to prevent it, and also fight back.

Compassion Satisfaction (CS) denotes satisfaction derived from helping people. It is argued that if your CS is high, you are less likely to develop CF.

This can be achieved in a number of ways;

  1. Realise that you have a problem. Only by noticing the symptoms can you begin to fight back.
  2. Put yourself first. Take up exercise, prioritise sleep, eat well and put your own emotional needs first.
  3. Set emotional/work boundaries and stick to them. You cannot save the world alone. Try not to over-invest in your clients and you won't break yourself if they fall.
  4. Strengthen your resilience. Find meaning in your work, accepting change, and developing a support network of friends. By redesigning your approach to problems you can remove the threat.
  5. Keep a journal. By channeling your concerns into prose you can spot patterns and reduce their emotional impact.
  6. Build an outside life. By taking up satisfying hobbies, prioritising yourself and creating time for just you. When your entire life is work, work problems become impossible to escape.
  7. Develop a strategy. If you suffer, create a way to access help. Many employers will offer to counsel, and doctors will help you access other support. And taking the odd 'mental health' day is just as important as any other sick day.
  8. Seek professional help. If you are really suffering, seeking the help of an outside professional could be useful. Especially if you are beginning to develop severe symptoms.

You are doing a great job

By seeking help I realised that I was not alone. And by taking a well earned break, meeting new and interesting people and seeing more of the world, I realised just how lucky I am. I get to make a difference, but now I will do it without suffering. - Jane

Caregivers are wonderful people. They help the sick, and go above and beyond to make others lives better. But such philanthropy need not become martyrdom. By adopting the strategies above you can tip the balance of fatigue to joy, excitement, and purpose. You can make the world better, and be happy doing it. And let's be honest, your life is pretty damn worthwhile.

<blockquote class="twitter-tweet" data-cards="hidden" data-lang="en"><p lang="en" dir="ltr">&quot;Perhaps the most important way to prevent or reduce <a href=";ref_src=twsrc%5Etfw">#compassion</a> <a href=";ref_src=twsrc%5Etfw">#fatigue</a> is to take care of yourself.&quot; <a href=""></a> <a href=";ref_src=twsrc%5Etfw">#nurse</a> <a href=""></a></p>&mdash; American Nurse Today (@AmerNurse2Day) <a href="">October 7, 2017</a></blockquote>

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Disclaimer. The information presented here is not substitute for seeing your own doctor. Opinions presented here may not necessarily represent those of Smith's Lawyers or its affiliates. Names have been changed to protect anonymity. 

Dr. Ben Janaway

Dr Ben Janaway is a strong advocate for humanism and has interest in public health education, science communication and political activism. He graduated from the University of Sheffield in 2014 with degrees in Medicine and Neuropathology. He writes about legal rights for healthcare workers and for medical journals. His work has been published internationally in The Independent and The Guardian and he has been interviewed on national news including the BBC on issues affecting the NHS.