Sharon Ufberg, DC discusses how caregivers can avoid compassion fatigue and remain emotionally healthy.

by Sharon Ufberg, DC

Have you ever heard of compassion fatigue? When I recently heard a group of social workers talking about this condition I was fascinated by the phrase alone. Most often it is used in discussions regarding nurses and counselors, particularly those that work with populations who experience traumatic events or work in highly stressful environments. But what about the practitioners who have jam packed schedules and need to be compassionate every day? How do we—as caregivers—avoid this fatigue and remain emotionally healthy as we stay present to our patients needs?

Compassion fatigue is thought to be the result of delivering too much bad news or having prolonged time periods dealing with difficult patient issues such as terminal illness, anger or psychopathology. Figley writes in 2002:

    “Compassion fatigue is a phenomenon that occurs when a caregiver feels overwhelmed by repeated empathic engagement with distressed clients.”

The concern is that when a practitioner experiences compassion fatigue, their ability to function professionally becomes compromised.

The most common coping strategy recommendations include setting boundaries, introducing humor and consulting with colleagues. But perhaps there is another alternative. The following story proposes a very different coping mechanism and strategy.

A dear friend and colleague, Barbara Glickstein, related this true story to me, and a longtime physician shared his story with her. This particular doctor performed surgery on very seriously ill patients. For years he worked hard to stay detached to their personal pain and remained committed to just being the best surgeon he could be to his patients. He was a senior neurosurgeon, and because of his high skill level, he often took the most difficult patients. The ones that were told “there is nothing else to do” or “the brain tumor is too deep” etc. Because the patients were so compromised, and the risks of surgery were so great, many of them died. He wrestled with guilt and a sense of failure that he couldn’t save them. He never over-stated the hope, nor understated the risk and felt that he went into surgery with patients who were fully informed and consented. This high risk, high mortality rate patient care was a significant burden to this doctor and kept him distant from the very human pain of loss, fear of death, and held him back from being able to be outwardly loving and caring for his patients and their families.

In the midst of this illustrious career, he suffered a severe heart attack. After his brush with death, his awareness shifted.  It wasn’t that the patient population and level of acuity changed, nor that fewer of them died. It was just that he would cry with them, mourn them, sometimes attend their funerals or even pay a visit with the widow or widower after the death. This was all new and he felt he could do it in ways he never imagined he could.

During his own recovery he recognized after much soul searching that by staying detached from the pain and suffering of his patients he in fact carried a much greater burden. When he began allowing himself to be open to his patients’ authentic experiences of pain and fear, sadness and suffering, he was able to be openly compassionate. His openness was the key to his recovery and lead to a much more enriched experience and deeper level of satisfaction with his work. It transcended the compassion fatigue that he most wanted to avoid.

Those of us who choose this strategy walk the fine line of engagement versus boundaries with our patients every day. I believe it is worth it.


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