The Occupational Hazard for Caregivers
by Phyllis Quinlan, RN-Bc, PhD • Flushing, NY

The newest concept in the field of understanding post-traumatic stress is the syndrome, Compassion Fatigue.

Compassion fatigue can develop as a cost of prolonged caring for others. The concept made its way into the healthcare literature in the early 1990s.

What is Compassion Fatigue?

Compassion Fatigue is the erosion of a caring nature. It can be the consequence of overexposure to patients, clients, or family members who require chronic care. The person experiencing compassion fatigue typically feels and demonstrates a great deal of concern and caring toward another person(s) but as time goes by, experiences a physical, emotional, and spiritual exhaustion that affects his or her ability to maintain an interest in or derive satisfaction from caring. They perceive themselves in a continuous state of giving with little in return or no end in sight.

There are Human Costs

Unresolved Compassion Fatigue can cause the healthcare practitioner or family caregiver significant distress that can result in impaired occupational and social functioning. It is important to understand that the development of compassion fatigue is not sudden. It takes time. It is usually slow and insidious and often unrecognized by the person experiencing it until things become unmanageable. The signs and symptoms include but are not limited to:

• A heightened state of irritability associated with rendering care
• Increased conflict at work or home
• A general lack of interest or numbing, apathetic behavior
• Resistance to help when offered
• Gradual detachment or insensitivity toward patients, family members or co-workers
• An increased sense of separation from friends, family & other support groups
• Excessive absenteeism from work

Who is at Risk?

Physicians, nurses and other health professionals are not the only individuals at high risk for developing role overload. It is not uncommon in special education teachers, social workers, or first responders. Compassion fatigue is not exclusive to the healthcare and rescue professionals. Those caring for a frail, elderly parent, chronically ill or challenged family member are just as susceptible to compassion fatigue as those in the high-risk professions.

Regaining Perspective

The first step is to recognize that you are indeed experiencing something that is changing the way you feel and how you act. Listen to those trying to help. Denial is the real enemy here – not a concerned colleague or family member. Living a balanced life is the key to prevention but here are some specifics:

• Start putting yourself first. This is not a selfish act. It is actually very generous to maintain your own availability by ensuring that you are renewed, flexible and ready to continue to give. The airline industry has given us the correct vital instructions for years, “Put your oxygen mask on first.” Do not push yourself to the point of exhaustion. You cannot be of service if you can no longer function.
• Delegate responsibilities appropriately. Whether you are at work or at home, seek and accept help from others. If you are caring for a family member seek out the available family, friend or community resources for a respite. Check out the not-for-profit website, www.sharethecare. org. Give yourself the ability to catch your breath.
• Accept help. Relinquish the illusion of control and embrace a lifeline when offered.
• Keep healthy boundaries at work. Do not allow your work ethic to be used against you. Finding yourself as the “go to person” on a constant basis is not a complement. It can deplete you of your energy and sow the seeds of frustration that can lead to resentment and anger.
• Debrief. Healthcare and rescue professionals can benefit greatly from formal debriefing sessions after extraordinary events. Healthcare facilities have capable mental health specialists that can lead such sessions in a therapeutic manner.
• Seek out a sounding board. Some private time in a safe, confidential environment with a professional who can help you regain perspective can be priceless.
• Sleep. You need at least seven consecutive hours of rest; usually more when we are stressed. Catching four hours here and three hours there will catch up with you quickly.
• Healthy body healthy mind. Eat right, exercise, or meditate. Take care of yourself as a whole being.
• Make laughter a must. If you cannot find something to laugh about today you are already in a danger zone. Laughter is to maintaining a balanced perspective as oxygen is to life – essential. Avoid the news. Watch cartoons.

Healing takes time. Be patient with yourself as you heal that special part of you that finds joy in helping another human being.

Dr. Phyllis Quinlan has practiced nursing for 30-plus years and has held leadership and education positions in emergency services, acute and long term care. She started her Firm, MFW Consultants in 1994 and has promoted balanced living as a Feng Shui Practitioner since 1999. Phyllis is a public speaker, contributing author for 7 books within the Professional Woman Network anthology dedicated to empowering women, and has been featured in numerous publications on Nursing, Feng Shui and Personal Coaching.