CareTalk: Read the signs of burnout and compassion fatigue

Q  I have worked as a senior nurse for the past 15 years and have mostly enjoyed it. However, over the past 12 months, I have become increasingly frustrated as there are petty workplace issues that are unresolved. Also, I feel I care too much, and sometimes I carry my sadness and frustration home with me. One of my colleagues suggested I might be “burning out”. I don’t think I am depressed but I find it increasingly difficult to go to work each day. Could ‘burnout’ explain what is going on with me?

A Two terms come to mind when I read or hear about situations similar to yours: burnout and compassion fatigue. Nurses are particularly vulnerable, due to their intense working environments and the fact they are required to provide compassionate care, on a daily basis, to people who are ill, in pain, vulnerable or dying.

Burnout and compassion fatigue share similar features but develop slightly differently.

Burnout arises over time and is related to stress and conflict in the work environment. Factors could include high workload, lack of resources, team conflict, dissatisfaction with salary, long hours. People may go through different stages before reaching burnout: enthusiasm, stagnation, frustration and finally, apathy. Burnout can give rise to decreased empathy and withdrawal, and many people end up resigning.

Compassion fatigue can build up over time or be caused by one incident. Compassion fatigue is directly related to the emotional aspect of a caregiver role. Nurses witness patient tragedy, trauma, injury, sickness, life and death. This necessary compassion also extends to families, further engaging nurses in the emotional world of others. Compassion fatigue can result in continued “giving” despite increased suffering for the caregiver/nurse, blurred boundaries and finding it difficult to balance empathy and objectivity (ie making ‘emotional’ decisions rather than fully professional and ‘objective’ decisions). Many people also leave their job, even if they love what they do.

Burnout and compassion fatigue can involve a variety of symptoms, features and behaviours across all personal and professional domains. Symptoms include anger, irritability, apathy, low mood, preoccupation with work issues and patients’ issues, concentration difficulties, weakened attention to detail, lack of energy, physical exhaustion regardless of sleep pattern, social withdrawal, loss of interest in previously pleasurable activities, loss of spirituality or questioning your purpose in life, absenteeism, desire to quit and making errors at work.

The impact of burnout and compassion fatigue can extend to the wider team, organisation, the caregiver’s family and even patients. It is important to know your triggers and to be aware of the signs of burnout and compassion fatigue. You do not have to manage this alone – there are personal steps you can take to look after yourself, but your organisation should also provide some support as well. Find small ways to replenish yourself – be a little bit selfish. Reflect on the healthy things you are no longer doing that made you feel calm and relaxed and start doing something small for yourself daily. Also, talk to your manager who can provide you with advice on workplace support. Your workplace may have an Employee Assistance Program (free counselling for staff and/or family members) and your manager may be able to come up with some practical ways of improving your working conditions as well. Do not ignore your feelings – you know that something needs to change and now is the time. 

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Tanya Russell

Tanya Russell is CatholicCare's Assistant Director and a registered psychologist.

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