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Op-ed: Nurses must practice self-care to prevent compassion fatigue

Sharon WilleyBy Sharon Willey, RN, DNP

It has been said that compassion is one of nursing’s most precious assets. Compassionate care is considered foundational to nursing practice. Giving compassionate care is what nurses do, it is who they are and how they identify.

Therefore, it is an expectation that this compassionate care is regenerated and given over and over. But this caring comes at a cost – compassion fatigue.

Compassion fatigue has been described as an emotional cost of caring for traumatized individuals or bearing witness to others’ trauma. It can happen when nurses provide prolonged care to individuals who have experienced traumatic events. The empathetic engagement required can take a toll on the nurse’s mental and physical well-being.

Compassion fatigue can appear to manifest itself suddenly, when in reality, warning signs were not recognized. Symptoms can manifest in behavior, emotional and physical changes.  The most common complaints:

  • Behavioral changes – chronic lateness, difficulty focusing, eating disturbances, substance abuse, calling in sick frequently, avoiding or dreading work, diminished work performance
  • Emotional changes – decreased sense of purpose, numbness, apathy, depression, anger, low self-esteem, less ability to feel joy, disinterest and detachment, borrowed stress, feeling overwhelmed, helplessness/hopelessness
  • Physical changes – chronic fatigue, exhaustion, frequent headaches, hypertension, sleep disturbances, anxiety, cardiac symptoms, muscle tension, gastrointestinal complaints

Nurses can’t always turn off the day. They still worry something was left undone. At times, a patient can remind the nurse of their own family, which sparks emotions that have a profound effect. They may be involved in a terminal diagnosis, code or death, yet still have other patients to attend to. At home, more energy and time is needed and deserved.

Who takes care of the nurse?

Self-care is important in helping the nurse achieve a work/life balance. Self-care activities have been shown to contribute to psychological strength such as resilience, emotional intelligence, personal initiative, optimism and motivation. They are a vital resource in overcoming and further protecting oneself from compassion fatigue. 

Self-care must be a priority in order for the nurse to be able to continue to give compassionate care. The method used to maintain a work/life balance is unique to each individual. A balance must invest time and energy into an activity that nurtures the self, brings pleasure, calms the mind and diminishes stress. The plan may include:

  • Monitoring emotional and physical symptoms
  • Identifying personal coping strategies
  • Knowing limits
  • Establishing boundaries with patients and families
  • Having a plan in place, such as counseling or support groups, to cope with ethical and moral dilemmas
  • Engaging in activities that bring peace, calm and rest

Compassion fatigue is commonplace in healthcare and, in the beginning, can be difficult to differentiate from general fatigue and daily stressors. Recognizing early signs of compassion fatigue is crucial in order to initiate self-care activities. The nurse must be aware of their own mental and physical limitation and negate the effects early. If ignored, the psychosocial and physical factors can impact the nurse, coworkers, and patient satisfaction and safety.

The nurse can see the person within the diagnosis or disease. Nurses are exposed to and involved in the most private aspects of a patient’s life. They are emotionally submerged in the patient’s experience.

The compassionate care given will be what the patient and family will remember from the healthcare received. Promoting and encouraging self-care can bring the common goal of delivering holistic care – a hallmark trait of healthcare.

Sharon Willey, RN, DNP, is an associate professor in Trine University’s RN-to-BSN program.