Compassion Fatigue: 30 Warning Signs for Frontline Workers in 2021

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Compassion fatigue is a shock that takes over our emotional, physical, mental, and spiritual energy.

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Compassion fatigue refers a ‘shock’ that takes over our emotional, physical, mental, and spiritual energy. This condition can lead front line workers to a dark place should they allow.

Many refer to it as a ‘second-hand reaction’. This manifests from helping or wanting to help others that have been exposed to trauma or under severe emotional distress.

According to the Online Journal of Issues in Nursing, compassion fatigue was first recognized in 1992 by an emergency room nurse.

It is identified ‘as a unique form of burnout that affects individuals in caregiving roles’ (2011).

Taking care of others can take an emotional and physical toll on our health.

One may provide repeated care, physical labor, and worry to others suffering. This leaves the caregiver exposed to a highly stressed environment and continuous giving of one self.

And while we honor an oath in taking care of those in need, we are often times faced with overwhelming needs of our patients as well as their families. We may get yelled at, argue with demands, have little sleep, and put extra work on our bodies.


We experience this day in and day out, leading it to effect important activities in our daily and personal lives.

Some may worry about less important issues.

We forget to enjoy the small things that mean the most. In return, it takes away from happiness with our own family.

Putting others before ourselves is truly a gift.

But, it is important to recognize stressors that may lead to compassion fatigue.

This prevents us from leading to more serious concerns of our health.

When it comes to those whom are likely to experience compassion fatigue, most first think of the front line workers

Because we all have experienced the unimaginable during COVID -19.

And yes, I definitely agree and will focus on this more in depth.

This is why it is important to recognize symptoms as really anyone can suddenly experience this acute state of health.

Those whom spend a large amount of time helping or thinking of those suffering can develop compassion fatigue.

Anyone that is caring for others and constantly thinking about their pain and suffering can develop compassion fatigue.

Good Therapy describes several roles one may take that can feel this kind of stress and fatigue. One example is in those that may carry the ‘therapist’ role within their family or friend group.

  • Family members-anyone whom takes on the the ‘therapist’ role in their family, especially when trying to constantly mediate within a dysfunctional family
  • Friends-especially when your friend group involves 3 or more, disagreement can often occur. Compassion fatigue can be felt amongst that one that is always trying to play the ‘devil’s advocate’ role or that everyone comes to with their problems and concerns. While it is a duty to be faithful to those that come to you and cherish whatever their concern may be, it is also very important to recognize signs when this information may take a negative toll on your own mind, body, or soul.
  • Lawyers-ones that face systemic injustice on a daily basis. Lawyers are the spokesperson for their clients and while they may disagree, they still have to find ways to practice in their favor. They work on challenging cases, divorce cases, the emotional wear of child abuse, murder cases, and politics. And while trying to represent one that lose, they may continue to carry that burden should they had done more.
  • Caregivers-those hired by families or institutions to take care of the chronically ill patient. This may be cancer, dementia, or even a patient without arms and legs.
  • Teachers- they care, educate, and protect our most precious jewels everyday. They are with our children more than the parents in a days time and carry the weight of providing for their future. They protect them when faced with trauma such as fires, tornado, school shootings. Teaching is one career field I believe is not recognized or honored as much as it should be.

Teaching is one career I believe is not recognized or acknowledged as much as it deserves.

The Econofact Network recognizes essential workers as those whom “conduct a range of operations and services that are typically essential to continued critical infrastructure viability.” 

Based on the Department of Health Guidelines (DHS), there set guidelines in place to identify professions consider front line.

These frontline professions include:

  • Medical and Healthcare
  • Telecommunications
  • Information Technology Systems
  • Defense
  • Food and Agriculture
  • Transportation
  • Logistics
  • Energy
  • Water and wastewater
  • Law Enforcement

Frontline workers are referred to as a ‘subcategory of essential workers in occupation groups where a large majority of workers (over 70%) cannot feasibly work from home‘ (DHS).

DHS classifies frontline workers as a ‘subcategory of essential workers in occupation groups where a large majority of workers cannot feasibly work from home.

These frontline professions include:

  • Healthcare workers
  • Protective services (Police, Fireman, EMT)
  • Cashiers in grocery and general merchandise stores
  • Production and food processing workers
  • Janitors and maintenance workers
  • Agriculture workers
  • Truck drivers

When you look at the increased stress these professions have experienced during Covid, it is apparent how easily one may become exhausted.

The demands have increased with little productivity, they are away from their own family, and live in a constant state of stress, worry, and tension.

“The same traits that make a [foreign service] profession good at their work – empathy, compassion for others and tenacity – can, when self care is negative, turn into compassion fatigue” -Kovia Gratzon-Erskine

Caring for and providing our services to others can lead to emotional, cognitive, physical, and behavioral decline.

Signs of Compassion Fatigue in Frontline Workers

When we become so absorbed with caring for others, living in constant worry, exposed to daily stressors, and the overabundance of demand needed, we have the tendency to lose our compassion due to exhaustion.

We forget to take care of ourselves and allow things that once inspired us to be stripped away.

So, what are some warning signs you may be experiencing compassion fatigue?

So, what are some warning signs you may be experiencing compassion fatigue?

EMOTIONAL FATIGUE

  1. Decreased empathy towards self and others
  2. Feeling of anger, easily irritable, sad, anxious
  3. Feeling overwhelmed, hopeless, helpless, vulnerable
  4. Detached physically and emotionally from things that you were once passionate about
  5. Intensified stress level, tension
  6. Insensitive to others problems, stories, opinions, ideas
  7. Difficulty concentrating and making decisions
  8. Questioning your purpose
  9. Questioning the meaning in life
  10. View self-care is selfish

PHYSICAL FATIGUE

  1. Dizziness, headache, fatigue
  2. Insomnia, nightmares, over sleeping
  3. Tension, agitated
  4. GI issues-nauseas, diarrhea, constipation, vomit, abdominal pain, indigestion
  5. Hypertension
  6. Depression, anxious, panic attack

COGNITIVE FATIGUE

  1. Constant over-thinking, worry, dwelling
  2. Self-blame
  3. Change in belief system
  4. Lack of empathy

BEHAVIORAL FATIGUE

  1. Withdrawn from things that were once interested in, social settings, family, friends
  2. Increased substance abuse
  3. Relationship conflict and instability
  4. Less productive at work, home, hobbies, schooling
  5. Chronic lateness
  6. Feeling of failure
  7. Decreased work satisfaction
  8. Decreased pleasure in activity
  9. Feeling not apart of the team
  10. Tension between front line worker and patient, customer, boss, peer

Compassion fatigue can easily be interpreted as burnout as well.

However, burnout usually occurs over time whereas compassion fatigue can be a sudden onset.

http://transitionalsupport.com.au/transitional-phase/compassion-fatigue-trauma/

Whether you are burned out or experiencing compassion fatigue, there are skills to help prevent and treat the overwhelming state of stress that your body is experiencing.

How do we prevent compassion fatigue?

  1. Adopt a buddy up mentality-one that you have confided your state of concern with and designated to watch out for certain signs or willing to be available at anytime to help
  2. Self-care-yoga, journal, meditate, massages, good hygiene
  3. Sleep-monitor sleep patterns, eliminate tv and electronics 1 hour prior to going to bed, go to sleep at the same time, white noise, use of scents that effect your sleep patterns. (In terms of scents, I prefer the use of washing your sheets or use of fabric spray in a detergent that is free of chemicals and provides plant based products that are known to impact the sleep cycle, Topanga Scents. The use of melatonin gummies, weighted blanket, sleep mask, and essential oils.
  4. Leave work at work, don’t chart at home
  5. Interact with family and friends
  6. Practice spiritual beliefs
  7. Focus on the good and accept the bad
  8. Set compassionate boundaries
  9. Do not exceed expectations more than what is considered reality
  10. Celebrate success
  11. Find things to look forward to
  12. Be aware of negative thoughts and work to finding the positive
  13. Therapy
  14. Headspace
  15. Learn to ‘bless and release’

Learning to recognize signs of compassion fatigue as a frontline worker takes time.

Learning to recognize signs of compassion fatigue as a frontline worker takes time.

Even more so, in terms of preventing and treating this overwhelming sensation. Sadly, many may never realize or admit they are in this state or even refuse to set boundaries.

This may be due to the belief that putting their needs above others is selfish.

Or, because they have become so consumed with their duties that compassion fatigue is not recognized.

After all, aren’t we taught to do and treat others as we would want to be treated?

Yes, but there also comes a time when we must realize that we cannot tend to others when we cannot take care of ourselves.

Whether you are burned out or have reached the severity of compassion fatigue, you may become unable to have the strength to provide the best care possible.

One way in helping to attract your mind back to focusing on itself is to say the serenity prayer to yourself.

One way in helping to attract your mind back to focusing on itself is to say the serenity prayer to yourself.

“Grant me the serenity to accept the things I cannot change;

courage to change the things I can;

and wisdom to know the difference.”

As a Family Nurse Practitioner, I not only experience compassion fatigue myself, but I see it everyday both in my colleagues as well as patients.

Working in healthcare has many rewards.

However, this can also put an emotional, mental, spiritual, and physical strain on our daily living.

We work long hours, witness tragedy, experience death, over-worked, and at times feel undervalued.

And, we may develop doubt within ourselves as well as our career choice.

As a Family Nurse Practitioner, I feel blessed that I have this gift of caring for others and knowing that I’m making the best decision possible.

As a Family Nurse Practitioner, I feel blessed that I have this gift of caring for others and knowing that I’m making the best decision possible at that particular time.

I have learned a lot in my nursing career. From working in the Pediatric Intensive Care Unit as well as an Organ Procurement Coordinator, these entail long hours and a lot of stress.

Both, of which, are very stressful work settings.

This experience and education I received from these two areas are what have molded me into whom I am today.

The patient’s health and safety weigh heavily on my shoulders.

I determine which medication I feel they should take and offer my advice on how to manage their mental capacity.

Furthermore, I hold more authority and responsibility.

But, I am also accountable for the outcome, both good and bad.

However, working in this role is not always glorious.

I am over worked at times, yelled at and demanded by patients expectations.

There are even times I wake up at 5 a.m. to chart, so that I don’t get behind on medication refills and completing charts.

And yes, I will admit I still have to care for those that I may rather see not that day.

However, I have no control of my time nor schedule because it consists of everyone else’s wants, needs, desires, and expectations.

I also cherish the many celebrations, respect my patients, and love being with my work family.

We have a great team that works hard to provide the best care.

And we live by the moto that laughter is the best medicine.

On stressful days, there are times we may become irritable to each other. And so, we play rap music during lunch and act as goofy as we can.

It is about the simple things that can have the biggest impact on our health.

While going through this emotional rollercoaster, I admit that I too have been guilty of recognizing signs of compassion fatigue.

And by not realizing, it sometimes becomes more difficult in treating. fatigue.

When Covid 19 first began, policies were constantly changing on a daily basis.

My team was trying to understand what we were challenged with and how to provide the best care for others.

In doing so, we also had to take particular measures in treating patients as safe as possible .

We worried that we were bringing this virus home to our families due to exposure.

And like so many, we were also unsure if the clinic doors would even stay open.

And many of us worked such long hours that we didn’t see our families for days.

Healthcare was sucking the life out of me!

The stress of working in healthcare eventually led me to feeling as if it was sucking the life out of me!

I became exhausted, fearful, stressed, over-worked, and even became bitter towards my administration. I felt that myself and my peers were not appreciated and I became distant mentally and emotionally at home.

This went on for months, getting worse day by day.

I even began yelling at my family when home.

I lost a desire to be with my friends.

Enjoy the simple things in life.

I forgot to enjoy the simple things in life that matter most.

I forgot to see and enjoy the simple things in life that matter most.

And in fact, I cried profusely when 2021 arrived.

There was a feeling of relief when the new year finally arrived.

And I prayed for it to be better!

I remember the moment that I told my husband I needed to do something for myself.

Seeing 30-40 patients per day takes an emotional strain on your mental, physical, and emotional health.

You listen to their problems and concerns, hoping to recommend the right thing. And you tend to more than one problem usually.

I was giving myself to others and forgetting to think of what I needed for my own health and happiness.

And I realized I had a desire of wanting to do something for myself with long terms goals and revenue.

It also opened my eyes to realizing that there were other opportunities and dreams that I have in building a successful business with Topanga Scents.

This discovery has put new purpose in my life and new goals to work towards.

In return, it has brought back excitement in my life which reciprocates to my patients and peers.

What I recommend to my patients.

Not only do front line workers experience compassion fatigue, patients do as well.

They may be a front line worker themselves or overly stressed as they are just trying to survive.

I see anxiety, depression, worry, fear, PTSD, and anger everyday.

And as COVID has continued to worsen, so have the number of patients with these concerns.

One thing that I often times recommend to patients is learning to practice a gratitude journal. Many often times don’t know how to begin or don’t understand how this can help.

I suggest keeping a journal on a bedside table and every night, start by writing two sentences of what occurred that day to be grateful for.

As we are all prone to focusing on what pisses us off or makes us worry, this gradually retrains the brain to focusing on the positive aspects of that day.

For those that find it difficult learning to journal, I recommend Getting to Good: A Guided Journal. It provides a roadmap for feeling better and learning to become more present through exercises and journal prompts.

And Then We Flow also provides ’10 Journal Prompts for the New Year’ should you need more assistance.

You may become surprised to see that once you get started on writing, your mind may eventually carry off to writing pages worth of certain feelings or view on life.

This, my friend, is very therapeutic.

Always remember to make self care a priority!

Having a strong desire to make a difference in someone else’s life is certainly a gift to cherish.

As front line workers, it is imperative to know the warning signs to entering a state of compassion fatigue.

Practicing self-care does not make one look weak or as if they are deserting another in need. To not practice self-care can become a hazard to ones health.

” Taking care of myself doesn’t mean ‘me first’. It means ‘me too’. -L.R. Knost

Practicing self-care allows us to let go of what cannot be controlled and limit perfectionism.

And in return, we are able to enjoy the little things, provide better care to others, and find the meaning, purpose, and joy in life.

Having love and compassion for others

Whether a doctor, fireman, or state employee, we serve on the frontline because of the love and compassion we hold for others.

It is our duty to help, guide, provide, and protect for those in need.

And while one may agree that it is a noble virtue to hold this compassion for others, it can eventually effect personal factors in your life, leading to increased stress, burn-out, and compassion fatigue.

It is important to become more aware of the signs and symptoms of compassion fatigue in order to learn personal boundaries and interventions for self-care.

In return, you continue to enjoy what you do each day and most importantly, loving each day.

If you or someone you know is demonstrating signs of compassion fatigue, I urge you to reach out.

Whether you talk to a colleague, friend, therapist, or online assistance, it is imperative that we practice self-care.

This provides us an avenue in providing better care towards others.

There are also workbooks available, such as Reducing Compassion Fatigue, Secondary Traumatic Stress and Burn-Out by William Steele, that can be useful.

This workbook provides activities and interactive learning tools to help identify personal self-care needs and to develop an effective plan to preventing compassion fatigue.

I hope that this has helped to open your eyes and your heart in becoming aware of the physical, emotional, and mental factors faced as frontline workers.

We all have this one life and it is important to take care of our own health to prevent developing compassion fatigue.

I hope you will join my email to not miss out on future blogs.

And, of course, feel free to follow me on social media.

Cheers,

Jessica Berry, APRN


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