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Compassion fatigue

For the most part, compassion fatigued caregivers have never learned the fine art of saying “no”. Since we thrive on validation from others we can never do enough.

  • Compassion fatigue-state of exhaustion and dysfunction (biologically, socially, psychologically) as a result of prolonged exposure to compassion stress.
  • Compassion fatigue is more about emotional fallout from actually delivering services to patients/clients.
  • Compassion fatigue is accompanied by a rapid onset of symptoms

Standards of Self-Care

Healthy self-care can be achieved in 2 steps:

  • We need to truly understand what compassion fatigue is and how it has manifested in our lives
  • We need to be able to recognize not only what we need to change, but how to start making those changes. Working toward a balanced lifestyle will mean “unlearning” bad habits along the way.

Physical Needs:

  1. Good nutrition 
  2. Restful sleep and relaxation
  3. Regular exercise

Psychological Needs:

  • Lifestyle balance
  • Finding our passions
  • Stress reduction
  • Expand life coping resources

In order to develop our interpersonal needs we must learn to integrate the following in our lives:

  • Build a strong support system
  • Become involved
  • Call for help when necessary

Our spiritual needs:

  • A source of strength other than ourselves
  • A tradition of prayer, worship or meditation
  • A practice of rituals that have the power to restore calmness and serenity

Stress in care giving originates from:

  • Inability to say “no”
  • Chronic need to prove ourselves to others
  • A lack of respect and support from management, colleagues, patients, or clients
  • A lack of clear-cut responsibilities and authority
  • A lack of organizational skills
  • Constantly working against deadlines
  • Involvement in dysfunctional relationships
  • A lack of restful sleep, good nutrition and enjoyable activities

Caring for Yourself in the Face of Difficult Work

10 things to do for each day:

  1. get some rest
  2. get enough sleep
  3. do some light exercise
  4. vary the work that you do
  5. do something pleasurable
  6. focus on what you did well
  7. learn from your mistakes
  8. share a private joke
  9. pray, meditate or relax
  10. support a colleague

Switching On and Off

It is your empathy for others that help you to do this work. It is vital to take good care of your thoughts and feelings by monitoring how you use them. Resilient workers know how to turn their feelings off when they go on duty, but on again when they go off duty. This is not denial; it is a coping strategy. It is a way they get maximum protection while working (switched off) and maximum support while resting (switched on).

How to become better at switching on and off:

  1. Switching is a conscious process. Talk to yourself as you switch.
  2. Use images that make you feel safe and protected (switch off) or connected and care for (switched on) to help you switch.
  3. Find rituals that help you switch as you start and stop work.
  4. Breathe slowly and deeply to calm yourself when starting a tough job.

Do no harm:

  • Adhere to self-care
  • Maximize growth, minimize harm
  • Responsible caring-obligated to sufficient self-care to prevent impaired functioning.

Standard of self-care:

  • Respect for dignity and self-worth…a violation lowers your integrity and trust
  • Responsibility for self-care. Your responsibility to take care of self and nothing can justify neglecting it.
  • Self-care and duty to perform-duty to perform cannot be fulfilled if there is not a duty to self-care.
  • Unethical to neglect self-care

3 Steps to self-care:

  1. Awareness
  2. Assessment
  3. Planning-growth goals and maintenance goals

8 dimension model for self-care:

  1. Physical-body strength, flexibility, balance, aerobic
  2. Psychological/emotional-limit setting, managing emotions
  3. Spiritual-having a sense of purpose, are things in place?
  4. Intellectual-learning, growth, development
  5. Financial-are you saving money?
  6. Social-connectedness to others, network of friends, having fun, outer circle
  7. family-inner circle
  8. occupational-job, how you occupy your time

What’s in it for me? More energy, feel better, joy

Handling stress- be aware, natural response is fight or flight, exercise, meditation, some level of stress, restructuring thoughts (cognitive restructuring), assess own emotional state.

Ethical principles of self care in practice:

  • Respect for dignity and self worth
  • Responsibility for self-care
  • Self-care and duty to perform

Standards of humane practice of self-care:

  • Universal right to wellness
  • Physical rest and nourishment
  • Emotional rest and nourishment
  • Sustenance modulation-self restraint with regard to how much is consumed

Standards for expecting appreciation and compensation

  1. Self-care
    1. Seek, find and remember appreciation from supervisors and clients
    2. Set deadlines and goals
    3. Generate strategies that work and follow them
  2. Strategies for letting go of work
    1. Make a formal, tangible commitment
    2. Set deadlines and goals
    3. Generate strategies that work and follow them
  3. Strategies for gaining a sense of self-care achievement
    1. Strategies for acquiring adequate rest and relaxation
    2. Strategies for practicing daily stress reduction methods

Resilience at the Personal Level

3 steps to self-care:

  1. Awareness
  2. Assessment
  3. Planning

Road to resilience

Resilience is the process of adapting well in the face of adversity, trauma, tragedy, etc. Resilience is ordinary. Resilience is not a trait that people either have or don’t have. It involves behaviors, thoughts and actions that can be learned and developed in anyone.

Emphasis on workplace stress encouraged people to feel like helpless victims. It has people identifying the source of the extreme pressures they experience. This is wrong. It lacks awareness that in pressure filled jobs people can choose to cope well or react like victims.

Research conducted by Mary Steinhardt found that employees who perceived their jobs as full of stress were the least resilient employees. Employees who use problem-focused coping in their constantly changing working environment were the most resilient. Positive numbers indicate the strength of a positive relationship; minus numbers indicate a negative relationship.

Five levels of resiliency are:

  1. Maintaining your emotional stability, health and well being
  2. Focus outward: good problem solving skills
  3. Focus inward: strong inner “self”
  4. Well developed resiliency skills
  5. The talent for serendipity

Some factors in resilience:

  1. Having caring and supportive relationships within and outside the family
  2. Capacity to make realistic plans and take steps to carry them out.
  3. A positive view of yourself and confidence in your strengths and abilities.
  4. Skills in communicating and problem solving
  5. Capacity to manage strong feelings and impulses

Developing resilience is a personal journey.


Ten ways to build resilience:

  1. Make connections
  2. Avoid seeing crises as an insurmountable problem
  3. Accept that change is part of living
  4. Move towards your goals
  5. Take decisive actions
  6. Look for opportunities for self discovery
  7. Nurture positive view of self
  8. Keep things in perspective
  9. Maintain hopeful outlook
  10. Take care of yourself

Resilience involves staying flexible.


Effective relaxation and stress management techniques:

  • Breath work
  • Visualization/guided imagery
  • Meditation
  • Progressive relaxation
  • Emotional freedom technique

Breath work will help relieve anxiety, depression, irritability, muscle tension, headaches, and fatigue.

Visualization will alleviate headaches, muscle spasms, chronic pain and anxiety.

Safe place visualization:

Visualize a place that is peaceful, secure, and joyful. Use as many senses (hear, see, smell) as you can. Focus on comfort, safety and peacefulness.

Breathing meditation:

  • Establish posture
  • Center self
  • Close eyes or fix on spot on the floor
  • Focus attention on each breath
  • Count each exhale breath in cycles of 4
  • If mind wanders, focus back

Progressive muscle relaxation relieves muscle tension, anxiety, insomnia, fatigue and tension. Some examples are: curl both fists; wrinkle forehead; arch back; curl toes; tighten calves, thighs and buttocks.