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A hospital-wide approach to combating compassion fatigue

February 8th, 2012

by Teresa L. Deshields

There is growing recognition of compassion fatigue as a challenge to healthcare professionals engaged in difficult clinical work. Certainly, exposure to patients who are suffering increases vulnerability to compassion fatigue. Some have even suggested that clinical researchers can be vulnerable to it.

How can you tell if compassion fatigue is a problem for you, your coworkers or your colleagues? Here are a number of "symptoms" of compassion fatigue:


Physical symptoms include:

  • Feeling "not well"
  • Feeling exhausted
  • Feeling "hyper"
  • Suffering from insomnia

Psychological symptoms include:

  • Feeling numb
  • Having work-related bad dreams
  • Growing cynicism or pessimism
  • Not enjoying things that were previously enjoyable

Emotional symptoms include:

  • Increasing anger or irritability
  • Dread going to work
  • Feeling overwhelmed
  • Feeling nervous

Professional symptoms include:

  • Inability to get work out of your head
  • Desire to quit work
  • Reduced productivity at work

Barnes-Jewish Hospital, a 1,200-bed academic medical center with about 9,500 employees, developed a Compassion Fatigue Resiliency Program after being approached by nurse managers from oncology treatment areas. The managers were concerned about what they perceived as sagging morale among their staff.

From an organizational perspective, the program aims to increase staff engagement, reduce turnover and increase patient satisfaction. From a staff perspective, the goal is compassion satisfaction, or the ability to derive meaning and satisfaction from your work.

Our program focuses on giving staff skills to recognize signs and prevent compassion fatigue. It also addresses compassion fatigue in those already suffering from it.

The program is presented as a one-day, all-day workshop. The elements of the program are:

  1. Education about compassion fatigue
  2. Instruction in and practice of self-regulation/relaxation
  3. Discussion of personal mission and covenant for work
  4. Education in self-care strategies for management or prevention of compassion fatigue

According to the feedback from our participants, the most effective elements are the education about compassion fatigue, the peer support involved in learning that others struggle with the impact of the work we do, the reminder of personal mission, as well as the introduction to the specific coping strategies.

One interesting aspect of our program is that after being piloted on the oncology floors and the emergency department, it was opened up to all hospital employees--a recognition that even if employees are not giving direct clinical care or treatment, they still may be involved in caring for the hospital's patients, and are vulnerable, too, to the cost of caring.

Teresa L. Deshields, Ph.D., is a licensed clinical psychologist and the manager of Psycho-Oncology Services for the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis. Her clinical practice is devoted to treating cancer patients and survivors and their family members, and her research is focused on issues related to psychological adjustment and quality of life in cancer patients and survivors.


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