May 10, 2019


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Interviewer: Nursing can be such an emotionally draining job at times because not only are you taking care of patients but you have to be empathetic and a lot of times, you get emotionally involved with those patients. Is there ever a time where a nurse just kind of burns out on that and isn't able to do that anymore?

Patricia: There really is and we've coined the term "compassion fatigue" to talk about that. And we talk to our students about that so that they understand that's a possibility and what they may do to prevent it. But remember, nursing is very physically demanding, it's emotionally demanding, not only are you expected to be compassionate and care for patients but you're constantly drawing upon your knowledge of physiology and science so that you are caring for those patients, preventing complications, detecting early changes. So you're pulling really from all sides of your brain.

Interviewer: Yeah, that could be very exhausting. So what are some of the signs that compassion fatigue might be setting in? What are some of the things to look for?

Patricia: Well, what I have seen in my career is some people then begin to shut down their emotions as a way to protect themselves. And unfortunately, then, that shut down can come across to a patient and their family as, "I don't really care about your situation." Sometimes, it comes into nursing when they feel compassion fatigue that they've become angry or bitter and so what I say to my students is, "If you begin to feel that way, you have to really pay attention to those signs."

You have to get help, you have to talk to your colleagues, you need to take a break and recharge your own battery and know in your life what does recharge your battery and be attentive to that. You can't let compassion fatigue continue because it's a detriment to the patients and families, but it's a detriment to yourself because you're not being true to yourself.

Interviewer: Is this something that most people can recognize when it happen to themselves or is it hard to recognize when you're actually going through it? Because I think it would be easier to recognize externally with somebody else.

Patricia: I have seen that it's hard for some people to recognize in themselves.

Interviewer: But not all?

Patricia: Not all.

Interviewer: Okay.

Patricia: But sometimes, people don't know what's happening to them? Why are they suddenly not feeling fulfilled in this position? Why do they suddenly feel angry? Why are they suddenly going home and feel like they didn't have a good day at all? What's going on? And so I've had colleagues where you sometimes just take on my side and say, "You just seem very burned out. How can I help you? Do you need a day? What can we do? Shall we have a group session?"

I can remember being a brand new nurse in the intensive care unit. We had 11 patients in our intensive care unit for Christmas Day. By New Year's Day, all 11 had died and I was a new nurse and I was trying to cope with that, that I helped every one of those patients have a Christmas Day with their family in the ICU. But each day after that, one by one, 11 people died and working with their families and helping them through it. And I remember saying to myself as a new nurse, "How am I ever going to do this?"

And it was then that our unit brought in our hospital chaplain to meet with all of us as nurses to help us through that, and I just remember how key it was that people recognize how hard losing 11 patients in one week at the holidays, how hard that was for the nurses and that they brought in help for us. I'm worried that we're not helping nurses enough when they're experiencing compassion fatigue.

Interviewer: How can we fix that? Because I mean I guess to some extent, I do get why other people that aren't nurses might not notice that. We're all very busy, we're trying to keep these hospitals running, we're all trying to keep these patients healthy. What's your thought on how we fix that?

Patricia: Well, I think we have to be much more attentive to it. As leaders in units and in hospitals, we have to really recognize it may be happening and be proactive and bring in maybe facilitators of support group discussions. Have other ways that might be meaningful to the staff to have some relief time, have fun time together to build the team back up. And it's not unique to nurses. I'm sure it happens to physicians, your colleagues, in physical therapy, occupational therapy, all of our providers who are dealing with very difficult situations. Think of EMTs out in the field, what they deal with, trauma providers.

Interviewer: Because it's like for some people, it might be going out and running for 6 miles. Somebody else it might be I just need to talk to somebody about it, somebody else it might be I just need to go home, have a hot meal, go to bed, get up, I'm fine.

Patricia: But you have to find what is it that's going to recharge your battery and not let your battery run dry for long periods. And so you have to be careful and really know yourself. What is it that's going to bring renewal? We have to have that for nurses.

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updated: May 10, 2019
originally published: April 22, 2016

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