Burnout and compassion fatigue are a hidden pandemic. A recent Gallop Poll found that 23% of employees reported feeling burnout at work often or always and another 44% reported feeling burnout at times. About 60% to 75% of clinicians have reported exhaustion, depression, sleep disorders, and PTSD since the COVID-19 pandemic began. 18%of healthcare workers, almost 1 out of 5, have quit their jobs since February 2020 and many remaining workers are reporting damaging impacts to patient services because of the resulting staff shortages. Some fear that staffing shortages could lead to a collapse of healthcare industry.
A higher percentage of nurses have succumbed to substance use problems. Physician suicides are estimated to average between 300 to 400 each year. Rates of suicide among healthcare workers reportedly spiked during the pandemic. Doctors are leaving the field at four times the rate of pre-pandemic trends. The collective stress induced by the pandemic and shared between providers and patients has caused many helping professionals to experience a variety of health symptoms including disrupted sleep, gastrointestinal distress, psychosomatic issues, mental health problems, and a general loss of motivation and wellbeing.
Concern has been expressed about systemic inadequacies contributing to burnout and compassion fatigue. Systemic issues are complex and the healthcare industry will need major changes in order for them to be addressed, but policy makers seem to ignore the needs of frontline staff. Meanwhile, helping professionals are left to take care of their own well-being without many external supports. This has led to much attention being paid to the importance of self-care. Most recommendations for self-care include strategies like:
- Setting boundaries,
- Taking breaks,
- Enlisting social support systems,
- Staying attuned to your emotions,
- Seeking mental health care,
- Practicing stress reduction routines like
- Setting boundaries,
Providers running on empty and stretched to their limits by demanding schedules might think that they don’t have time for self-care, but according to the Green Cross Academy of Traumatology, “There must be a recognition that the duty to perform as a helper cannot be fulfilled if there is not, at the same time, a duty to self care.” We can only do our best if we are at our best. Therefore, self-care is essential for care providers.
Some have raised concerns about whether excessive focus on self-care might be linked with narcissism. But this is not necessarily so; caring for self can be used as a foundation for caring for others, especially when integrated with strategies for developing compassion resilience. In fact, some have suggested that caring for others might be the best way to lift ourselves from the malaise of the pandemic. In reality, self-care need not conflict with caring for others, the two can mutually support each other. Research indicates that compassion itself is an aid to self-care. One study of oncology nurses indicated that compassion satisfaction, perspective taking, cognitive empathy, and organizational training/support mitigated burnout and compassion fatigue among staff. Hardiness, which is a combination of resilient commitment to one’s goals, taking charge of stressful situations rather than succumbing to helplessness, and seeing problems as challenges rather than threats, results in better performance and coping under stressful conditions, less worry and anxiety, and higher levels of self-confidence. Research is emerging showing that compassionate activity enhances mental and physical health, aids in quicker recovery from illness, and may lengthen lifespan. It also stimulates the pleasure centers of our brains. Compassion makes us more attractive socially, enhancing connections, benefitting those we encounter, and encouraging others to be more cooperative. Until recently, there were no evidence-based approaches available for building compassion resilience. Fortunately, evidence-based strategies have emerged that have been shown to help with compassion development.
A new book, Compassion’s COMPASS: Strategies for Developing Insight, Kindness, and Empathy, provides a roadmap for developing a resilient form of compassion, starting with self-care and then adding techniques for cultivating compassionate insight. It provides research and easy-to-use techniques for people wanting to integrate self-care with caring for others. The book also contains a handbook for helping professionals with information on the causes and symptoms of burnout, compassion fatigue, and vicarious trauma along with simple ways to prevent and recover from them.
The first step in the process of strengthening compassionate fortitude is to monitor one’s stress levels and to spend time each day draining it off to regain equilibrium through strategies like setting boundaries, relaxation techniques, and mindfulness practices. Prioritizing self awareness, acceptance, compassion, and care provide a foundation for integrating COMPASS (Compassion and Analytical Selective-Focus Skills) to develop resilient compassion. Selective-focus skills are brief contemplations on subjects like equanimity, gratitude, and kindness that are conducive building a feeling of compassion, which then can be strengthened and safe guarded by more advanced skills. These strategies are easy to use once you learn them. Once you integrate them into your daily routine, they can transform caring for others into a form of self-care and defend you against burnout and compassion fatigue.