Suffer from Compassion Fatigue?
by Lisa DiFalco
Everyone has their limit. Many nurses and physicians got into the field of medicine because they wanted to heal and help serve the needs of patients. However, in areas such as Chicago, with unusually high numbers of shootings that can overwhelm the resources of a hospital, how are healthcare professionals supposed to address the emotions and stress that they undergo? Compassion fatigue appears to be an issue in specific areas and it is rare that a nurse of 35 years does not experience it as some period during their career.
Compassion fatigue appears to be a new form of burnout impacting nurses and physicians in trauma units and the ER. Understand more about this condition and how healthcare professionals feel.
What is Compassion Fatigue?
Trauma nurses are some of those on the front lines of care. Working in trauma units and addressing the needs of patients on a regular basis can result in a type of burnout often called compassion fatigue. Researchers consider the condition to be a mix of traumatic stress and burnout. Kristin Laurel, a flight nurse from Waconia, Minn., shared:
“Some calls get to you, no matter who you are.”
She has been one of the nurses that has had to tend to her feelings and combat this situation. Writing became a way to “acknowledge her darker experiences in the ER while also taking care of herself.” Laurel said:
“It’s a way of letting go. I acknowledge their life as well as let go of my grief. There’s definitely power and healing in that.”
She won the Sinclair Prize for poetry and followed up with Giving Them All Away, a collection of poems. Feelings of burnout are explore in the poem, Afflicted. You can listen to an audio of the poem on NPR. Laurel has found one avenue to processing her grief and the despair surrounding the experiences she has had while serving in the ER. However, many healthcare professionals have yet to discover a way to communicate their grief and to even articulate the events that occur while on their shift.
Compassion fatigue does not only occur at work but can often continue at home as well. Many trauma physicians and nurses have trouble sharing the experiences about their day with partners and hold back the information instead. Dr. Catherine Humikowski, director of Comer Children’s Hospital, shared:
“’Tell me about your day,’ he’ll ask, and I’ll be like, ‘I can’t. I can’t even begin to bring you into it. What do you talk about if that’s what you’re doing 80 hours a week, and you can’t even talk about it at home because it distresses you so much?”
Compassion Fatigue in Chicago Trauma Units
As the issue continues unaddressed, healthcare professionals may turn to alcohol or other substances to self-medicate. In addition, some develop depression and anxiety. A 2017 report from the Retention Institute at NSI Nursing Solutions reported a turnover rate of approximately 19 percent in individuals working in emergency services. Kate Sheppard, a clinical professor at the University of Arizona College of Nursing, said:
“It’s devastating to see that over and over. You lose hope. You ask, ‘When is it going to stop?’ And no matter how hard you work and how good you do your job, (the shooting victims) just keep rolling through the door.”
This issue is felt by those serving the needs of patients in trauma units and the ER of Chicago. In 2016, over 4,300 people were shot and there were more than 760 deaths. As of this January to mid-April of 2017, the homicide total is at 166 and over 915 people have been shot. The amount of despair witnessed during weekly 12-hour shifts without sufficient resources to handle the many shooting victims often becomes difficult to process without intervention and support. Adults are not the only victims. Many children are brought in for treatment as well.
It can be difficult to treat children injured during a shooting. Humikowski finds it easier for her to treat a child in a medically induced coma than in a less severely injured child. She said:
“That sounds bad, right? That I’d rather take care of a more injured child. If they’re in a coma, I don’t have to see that look.”
According to her, the impact of trauma on staff is that they have difficulty seeing patients as injured children and compassionately addressing their pain.
Renew and Recharge
There can be a surprising difference in those new to critical care. How can these early feelings be recaptured? There must be a way to better support those professionals dedicated to caring for trauma patients and help them retain some of their enthusiasm. In response to an exchange with a new resident physician, Humikowski said:
“That’s what someone at the beginning of a career in critical care looks like. Smiley, excited—that’s how we all started out, right? We wanted to help the sickest kids.”
Nurses and physicians need to take the time out to find the resources to recharge. Some may choose to take a sabbatical and return to their career with new energy. Even small things like sharing a meal with family at home or spending quality time together can help. It is also advised for caretakers to take a four-hour break from cellphones, pagers and devices that ring or beep. Some may feel a sense of guilt for unplugging but the experience may help health professionals provide a better quality of care and allow them a window in which to practice some self-care and put their mental health needs first.
Mental health professionals, nurses and doctors need to understand this common condition and look for ways to process the variety of experiences that take place in the trauma unit or in the ER. Talking about feelings and events, writing about them or taking breaks may be ways to help the healer keep healing and stay healthy.