Managing Compassion Fatigue

Compassion Fatigue

The COVID-19 pandemic has created unprecedented challenges and stress for many public safety personnel (PSP), impacting them in many facets of their lives including professionally and personally. One of the unique aspects of this pandemic is how PSP continue to operate in their roles while at the same time balancing stress about the risks that the pandemic poses to themselves, their families, and their communities. The stress of being infected with the virus is not the only issue facing PSP, other stressors may also include financial concerns, access to resources, disruption in operations, use and shortages of personal protective equipment (PPE), increased responsibility at home, as well as decreased socialization with friends and colleagues.

The continuous exposure to the cycle of information and news, hearing, seeing or witnessing the effects of COVID-19 and the operational, organizational, and community challenges can begin to contribute to one feeling overwhelmed. When left unaddressed these challenges and stresses can develop into something called compassion fatigue1.

Compassion fatigue is a condition reported most often in people whose role, professionally and/or personally, is caring for others. Compassion fatigue is known to impact individuals with both physical and emotional symptoms that decrease one’s ability to function in their normal way.

Some signs of compassion fatigue & stress2,5-8

  • Physical and/or emotional exhaustion
  • Emotional numbing, lack of emotion
  • Feelings of being overwhelmed
  • Feeling of powerlessness, especially in relation to causes of stress and suffering
  • Changes in sleep pattern, sleeping too much or difficulty sleeping
  • Physical complaints, such as headaches, nausea or stomach aches
  • Numbing using substances, either prescribed on not prescribed
  • Increases in anger, irritability or anxiety
  • Avoidance, withdrawal, or self-isolation
  • Decline in performance at work and home
  • Difficulty making decisions
  • Relationship difficulty with co-workers, friends and/or family
  • Reduced empathy for others
  • Cynicism
  • Reduced career satisfaction
  • Hypersensitivity

This is not an exhaustive list of potential symptoms, be sure to monitor your reactions, thoughts and feelings and reach to supports out if needed.

Burnout

Burnout is considered a lack of interest in work, exhaustion, and a reduction in work abilities in response to a period of high, stressful workload2. Burnout can be seen in many different careers, whereas compassion fatigue is seen almost exclusively in people who provide care to others, including police, firefighters, paramedics, caregivers, mental health workers, and other healthcare professionals. While it may sound similar, compassion fatigue is distinct from both burnout and moral injury. A large number PSP have paid on-call positions, with their primary job being unrelated. Burnout can occur in these none PSP roles and contribute to difficulties in all areas.

Moral Injury

Moral injury refers to a condition that can occur when someone does something that goes against their deeply held moral beliefs3,4. Most often moral injuries occur when a caregiver cannot act in the best interests of the patient, or when organizational constraints interfere with the best care possible or in accordance with the caregivers moral or professional convictions4. More information on moral injury can be found here: https://www.cipsrt-icrtsp.ca/covid-19/an-introduction-to-moral-injury/.

Understanding warning signs of compassion fatigue is critical, as it can negatively impact your personal, social, and occupational functioning. Early identification may be able to improve patient safety, job satisfaction, co-worker relationships2,5.

Strategies to Reduce the Symptoms of Compassion Fatigue, Burnout and Moral Injury

There are many different types of strategies that can be used to reduce the impact of the unique aspects of stress caused by the pandemic2,5,9.10:

  • Know the signs and symptoms of stress (e.g. fatigue, illness, fear, withdrawal, guilt)
  • Be compassionate and try not to judge yourself when recovering from responding to pandemic-related situations
  • Seek friends and supports you can confide in
  • Take time to understand your reactions and why you may be feeling stressed
  • Turn off social media and news about the pandemic if it becomes too much. It is helpful schedule access to media/news coverage
  • Make a list of coping strategies that work for you, and schedule time to use them. These could include:
    • Mindfulness
    • Physical activities
    • Creativity such as music or art
    • Reading for pleasure
  • Think about what you have control over and any positives for the day
  • Healthy eating – avoid falling into cravings and comfort food
  • Access your supports; be innovative and creative while at the same time respective social distancing
  • Know where to go if you’re feeling overwhelmed
  • Know what the resources are for you to access if you have questions about meeting the needs of yourself, your family or others due to the stress of the pandemic

As a member of the PSP you have an important role serving your community and family. It is okay to put your needs first at time times, it is not selfish. It will likely help you be available to respond to others in their time of need. Maintain as best you can the needs of others with your own needs, know your limits, and be okay with saying no to others if you need to.


References

1) Canadian Institute for Public Safety Research and Treatment (CIPSRT). (2019). Glossary of terms: A shared understanding of the common terms used to describe psychological trauma (version 2.1). Regina, SK: Author. http://hdl.handle.net/10294/9055.

2) Sinclair, S., Raffin-Bouchal, S., Venturator, L., Mijovic-Kondejewski, J., Smith-MacDonald, L.(2017). Compassion fatigue: A meta-narrative review of the healthcare literature. Int J Nurs Stud. 69:9-24. doi: 10.1016/j.ijnurstu.2017.01.003.

3) Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., & Maguen, S. (2009). Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clinical Psychology Review, 29(8), 695–706. https://doi.org/10.1016/j.cpr.2009.07.003

4) Canadian Institute for Public Safety Research and Treatment (CIPSRT). (2019). An introduction to moral injury: What is it & why should I care? https://www.cipsrt-icrtsp.ca/covid-19/an-introduction-to-moral-injury/

5)The Centre for Addiction and Mental Health (CAMH).(2017). Is there a cost to protecting, caring for and saving others? Beware of Compassion Fatigue. https://www.camh.ca/en/camh-news-and-stories/is-there-a-cost-to-protecting-caring-for-and-saving-others-beware-of-compassion-fatigue

6) Mathieu, F. 2008: The Compassion Fatigue Workbook. Françoise Mathieu: www.compassionfatigue.ca

7) Coetzee, S.K., Klopper, H.C.(2010). Compassion fatigue within nursing practice: a concept analysis. Nurs Health Sci.12(2):235-43. doi: 10.1111/j.1442-2018.2010.00526.x.

8) Jenkins, B., Warren, N.A.(2012). Concept analysis: Compassion fatigue and effects upon critical care nurses. Crit Care Nurs Q.35(4):388-95.

9)Boyle, D.A.(2011).Countering compassion fatigue: a requisite nursing agenda. Online J Issue Nurs.16(1)

10) Centre for Disease Control and Prevention (CDC). (2020, April 1). Stress and coping. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fprepare%2Fmanaging-stress-anxiety.html