When I joined the nursing profession, I never imagined sharing my most vulnerable thoughts and emotions as a nurse and a human just a few years into my career, nor how the experiences ahead would change me. I graduated from nursing school in 2015, bright-eyed and 22 years old, ready to take on the known physical and mental fatigue ahead. I wasn’t prepared for how exhausting it is to continually see so much pain, hurt, and suffering. Just a few years later, I now realize how deeply I have been impacted by compassion fatigue.
Figley (1995) said it well: “We have not been directly exposed to the trauma scene, but we hear the story told with such intensity, or we hear similar stories so often, or we have the gift and curse of extreme empathy and we suffer. We feel the feelings of our clients. We dream their dreams. Eventually we lose a certain spark of optimism, humor, and hope. We tire. We aren’t sick, but we aren’t quite ourselves.”
I’ll never forget my first day in patient care as a newly licensed nurse. My patient’s mother was loving, kind, and grateful, wanting to capture our moment together with a photo. Hours later I found out that she had been bouncing from shelter to shelter because her boyfriend tried to kill her. She had nowhere safe to go. The beautiful and frustrating thing about nursing is that I experienced a life-changing, perspective-changing moment like that with my patient’s mother, and went into another room minutes later, trying to hold it together, while a parent screamed at me because I didn’t get in the room fast enough. That parent then complained about minute details and asked a seemingly low priority question from my perspective. I used to become frustrated and judgmental in situations like this. I would often forget to consider that the parent or family member who is so upset with me has no idea how his or her question fit into the context of my day.
Beginning on my first day, compassion fatigue weaved its way into my nursing career. For me, compassion fatigue was going through the death of my first patient soon after completing orientation and working the night of their funeral so my peers could go instead. Compassion fatigue continued that same night while swamped at work, grieving and wondering what experience I was missing. Compassion fatigue was experiencing trauma after trauma, death after death, and starting to feel numb. Compassion fatigue was looking at my peers who were visibly shaken while feeling nothing myself.
How can I grieve and give excellent care at the same time without suffering from compassion fatigue? How can I bridge the gap between the family that can’t understand that their newborn baby needs to eat more than three times a day to the family who is back in the hospital for their kid’s birthday for the third time? How can I grow to truly appreciate the educational needs and concerns of all of my patients and families?
I meet them where they are. I had to accept that people simply don’t know what they don’t know. They are doing the best that they can with who they are, what they have learned, and what they have experienced. I had to acknowledge that every patient is equally important and that no matter how small their diagnosis is in comparison to my patient’s diagnosis next door, their whole world is still being rocked. I had to recognize that when my patient or family was yelling at me for something small, they likely learned this from their own family and have never been taught how to appropriately communicate when they are angry, tired, and upset. Not everyone has learned the coping mechanisms I have learned. As a nurse, I often take for granted my education and how my career inevitably makes me understanding, empathetic, and compassionate.
After realizing how deeply I was suffering from compassion fatigue, I looked to ways to grow and heal, so I could build resiliency a nurse. I have spent time finding the best ways of processing through this fatigue for me. I have used mindfulness, journaling, prayer, and conversation with others to heal. I have combated compassion fatigue by having fun at work and being present in the moment.
As you can see, I used to get frustrated with families that would get upset with me for trying to help them, but I am so grateful that I’ve grown to understand that their perception of the world and what’s happening in the now can be much different than mine and that I don’t need to internalize their frustrations. I simply must meet them where they are. I hope that learning a little bit about my journey helps you to combat compassion fatigue and build resiliency in your own practice.
Julie Gardner is a clinical nurse at Riley Hospital for Children at Indiana University Health in Indianapolis.