Rutgers expert explains how health care workers can be affected by empathy and compassion

Compassion fatigue is just one of many consequences of working through the pandemic as a health care worker, according to Shari Munch, an associate professor at Rutgers School of Social Work.

“Dealing with constant suffering and trauma, on top of the double-edged sword of empathy and compassion, the cost of caring can manifest itself in undue stress for anyone working within a health care setting,” she said.

Munch, who researches clinical social work practice in health care, describes the cost of caring and how we can help affected health care professionals.

What is compassion fatigue and why does it happen?

Compassion fatigue is the natural, negative consequence of direct involvement of helping a traumatized or suffering person. Health care professionals like nurses, physicians and social workers have had high contact with suffering and traumatized people during the pandemic. Additionally, compassion fatigue can impact all health care teams such as administrative staff, patient transporters and housekeepers. These staff persons are not administering life-saving medical treatment but often answer questions and try to calm frantic patients and family members. All of these workers are at risk for becoming indirect victims or secondary casualties. While some have come through relatively unscathed, others may be just starting to experience the effects of compassion fatigue. 

What are the costs of caring?

In the case of the pandemic, health care professionals and others have felt emotional distress daily. As a result, they experience a range of reactions such as sadness, anger, disbelief and sorrow. Typically, they manage these feelings well, but COVID-19 has magnified already high-intensity environments. Health care professionals have served as surrogate family members for sick and dying patients whose loved ones were restricted visitation per safety protocols. Consequently, over the last year, some workers have felt heightened fatigue, depression, insomnia and experienced “feeling the pain” of others, excessive thoughts about their patients, chronic negativity, low morale, diminished empathy, feelings of helplessness, poor concentration and vulnerability to substance abuse.

In order to provide optimal care, health care professionals must be empathic and compassionate. But it’s the empathic engagement that contributes to compassion fatigue and why it is referred to as an occupational hazard. The good news is that compassion fatigue is treatable if not preventable. 

How can we help?

Be aware of the overwhelming pressure and anxiety that health care professionals and staff experience and continue to endure. Try to be more patient with providers whose hospital and office routines were upended, not to mention offices dealing with possible staff shortages due to illness and death. 

More so, research suggests that health care organizations should create a culture of caring for health care professionals such as offering paid time off, team backup protocols, debriefing sessions and reassuring supervisory and collegial support. We must be far more aware of creating a culture of caring for the carers. Organizations should explore dispersing the acuity and quantity of traumatic patients on one’s caseload. All can help restore the health and well-being of the health care professionals and keep good workers in the field.

What can individuals do to manage it?

Health care professionals should feel no shame in seeking professional support such as therapy or peer support groups. Stress management and self-care strategies should be a priority. Laughter and humor can remedy the effects of compassion fatigue in the short term. Above all else, remember that compassion fatigue is not a sign of weakness. More is being written about the notion of self-care as a “competency” and by association as an ethical duty. Bottom line: self-care is one aspect of competence and it is our ethical duty to be competent professionals.

In light of the last year, what potential positives may we see for those affected?

It has been a harrowing year for health care teams, and compassion fatigue reactions may only be presenting now. However, there is potential for personal and professional growth that can arise from adversity. Compassion fatigue is the negative aspect of helping those who experience traumatic stress and suffering. However, compassion satisfaction is the other side. Compassion satisfaction is the notion that helping traumatized people is gratifying. These are feelings of fulfillment derived from caring for others. Additionally, vicarious resilience is the notion that health care professionals can become more resilient by witnessing their patients' and their families’ strength in the face of adversity.


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