Compassion Fatigue – It’s okay to not be okay
No one told me about Compassion Fatigue. I’d been working in the industry for five years before I stumbled across the mere notion of it on my own. I spent three years studying to become a veterinary nurse. We learnt all about how to care for animals; in medical nursing, surgical nursing and triage. We learnt how to talk on the phone to clients, how to serve them in reception. We were taught about the five stages of grief and how to support our clients through them. We were taught customer service and communication skills. But not once were we taught how to look after ourselves.
The term ‘Compassion Fatigue’ was supposedly coined in 1992 by a nurse by the name of Carla Joinson. It is defined as ‘exhaustion due to compassionate stress, the demands of being empathetic and helpful to those who are suffering; the stress that evolves specifically from the relationship between the professional and the patient and client.’ (Dobbs, 2014) Although the concept has been around for many years prior, it had only ever been looked at in the human health care community. In recent years however, we have begun to look and realise that it is also rampant within the animal care community. (CR Figley, 2006) In the US in 2003 and 2004, a survey of 200 veterinary practices was conducted and it found that over 30% of veterinarians and staff had an extreme risk of becoming affected with Compassion Fatigue. (Jones-Fairnie, May, 2008)
The general consensus seems to be that Compassion Fatigue cannot be cured. Once you have it, the potential of relapse is infinite. (Prendergast, 2015) However, as made clear by Mehelich (Mehelich, 2011), an important clarification is that Compassion Fatigue is not something that a person is born with. It is something that we contract due to the environment around us. Some people may be more susceptible to it than others. The most commonly affected would be those in health care and those in animal care, because they are surrounded by trauma and suffering on a daily basis. However any compassionate, empathetic person who is trying to help someone can be affected.
It is imperative to remember that not all stress is bad. Some stress is not only good for you, but necessary. Psychologist Kelly McGonigal, author of The Upside of Stress has even suggested that stress has the potential to make you smarter, stronger and more successful. (Women's Fitness Magazine, 2015) The trick, however, is moderation. Just like an occasional glass of wine can be beneficial, but a case a night is detrimental. With stress, the occasional twinge can be inspiring. Too much and it can take a serious toll on our health, both physically and mentally.
Compassion Fatigue is a real threat to those in the Veterinary profession, whether you’re a Veterinarian, a Veterinary Nurse or receptionist. And I find it alarming that there is still so little awareness out there. It seems as though there is improvement on the horizon. Mental Health has gained more recognition in recent years. However, I struggled to understand why learning about Compassion Fatigue and developing Emotional Intelligence isn’t a compulsory part of our training. As suggested by (Overfield, 2015), building emotional intelligence within a practice as a whole is the key to achieving a “successful and healthy practice”. So why do we have to look so hard to find more information on it? Recently the Veterinary Nurse Council of Australia hosted a webinar called Compassion Fatigue Pitstop, presented by Rosie Overfield. Overfield is a Veterinary Nurse also trained in counselling and is devoting a lot of time to the topic of Compassion Fatigue and mental health within the practice. It is becoming more popular in continuing education, which means it should only be a short step to including it in the primary veterinary education.
Interestingly, I haven’t found much research on the concepts of Chronic Compassion Fatigue and Acute Compassion Fatigue. In this area, I only have my own experiences to draw from.
I can remember my first episode of Compassion Fatigue extremely clearly. Mainly because it was horrific and mortifyingly embarrassing. It included a very public meltdown in front of my colleagues and it took a long time for me to get back on my feet. I should also point out that I while my occupation as a Veterinary Nurse most definitely contributed to my Compassion Fatigue, it was actually something that was happening in my personal life that truly triggered the attack.
I was looking after a close friend of mine. She suffered from mental illness and I had been struggling to take care of her for a number of years already. Things had progressed rapidly in our friendship, and before I knew it I was in an emotionally-abusive relationship.
At home I was moody and irritable. I am naturally introverted already, but I became antisocial. I stopped exercising, I stopped going out. I ceased taking part in my hobbies.
At work I became distant. I cried regularly, and even publicly, much to my humiliation. I couldn’t handle any form of criticism, every mistake I made felt as though it ought to be grounds for dismissal. My self-esteem and self-worth plummeted. My health deteriorated rapidly. I became physically ill. I developed an auto-immune disease called Tietze Syndrome; sometimes called Costochondritis. I was in unexplained and agonising pain for nearly two years. I struggled to perform my daily duties, further enhancing my lack of self-worth in the workplace. I developed stomach ulcers, stopped eating and became an insomniac.
As I mentioned before, it took me a long time to pull myself together and recover. I had amazing support from my colleagues, particularly with my physical illness. However, I believe that had I had more training, my attack of Compassion Fatigue would have been far less extreme. I was so unaware of my mental health that it was months before I could even acknowledge there was a problem. By the time I did I had what I consider a chronic form of Compassion Fatigue.
After this episode, I developed my own Emotional Intelligence (EI). Emotional Intelligence can be defined as an awareness of one’s on emotional and mental state. It is the “capacity to perceive emotions, assimilate emotion-related feelings, understand the information of those emotions and manage them”. (Timmins, Volume 33, Issue 1, 2006). With my newly developed EI, I became finely tuned in to my emotions and I was able to recognise red flags. I began to realise that my ill health was very closely connected to my level of stress. I didn’t recognise that I had Compassion Fatigue until nearly 6 months later when a lecturer mentioned it in passing during a short online course run by the Crampton Consulting Group.
These days, over two years on from that first attack, I still occasionally succumb to Compassion Fatigue. However they tend to be a more acute form. They’re brief and fierce, tending to only last 1 or 2 weeks. The more I learn about Compassion Fatigue, and the more I learn about myself, the easier it is to identify when I have it and, more importantly, the easier it is for me to correct it. Even reading the research for this paper enlightened me enough to be able to notice when my colleagues were struggling with Compassion Fatigue.
Compassion Fatigue is not something that should be fought on one’s own. The secret to a happy working life in the clinic is a firm grasp of Emotional Intelligence. Building EI with in the clinic is a great way to ensure that everyone in the clinic is being looked after. Develop your own coping methods, as everyone recovers differently and what might work for someone else might not work for you. Leave work life at work and establish a healthy home life. Exercise is a key component to relieving stress and can aid you in both a healthy body and a healthy mind. Sometimes you need to accept the fact that you are not okay and you need to devote some time to healing. You cannot care for others if you cannot care for yourself. It is okay to feel sad, but don’t let it consume you. Educate yourself about Compassion Fatigue. Develop emotional intelligence. Prepare yourself.
“Sadness belongs to your patients and families, it’s not yours to take away.” (Huggard & Huggard, 2008)
CR Figley, R. R. (2006). Compassion Fatigue in the Animal Care Community. Washington: The Humane Society of the United States. Retrieved from Compassion Fatigue Awareness Project.
Dobbs, K. (2014). Compassion Fatigue. In L. Ackerman, Blackwell's Five-Minute Veterinary Practice Management Consult (2nd ed.) (p. Section 6.24). Blackwell Publishing.
Huggard, P., & Huggard, J. (2008, May). When the Caring Gets Tough: Compassion Fatigue and Veterinary Care. VetScript, pp. 14-16.
Jones-Fairnie, D. H. (May, 2008). Book Review: Compassion Fatigue in the Animal Care Community. Australian Veterinary Journal, 186.
Mehelich, C. (2011, September). Compassion Fatigue: Emotional Burnout in the Animal Care Field. Bella Dog Magazine.
Overfield, R. (2015). Building Emotional Intelligence In-Practice. Australian Veterinary Nurses Journal, 22-23.
Prendergast, H. (2015). Stress, Burnout and Compassion Fatigue. In H. Prednergast, Front Office Management for the Veterinary Team (2nd ed) (pp. 143-144). Las Cruces: Elselvier.
Timmins, R. P. (Volume 33, Issue 1, 2006). How Does Emotional Intelligence Fit Into the Paradigm of Veterinary Medical Education. Journal of Veterinary Medical Education, 71-75.
Women's Fitness Magazine. (2015, December). Turn Bad Stress Good. Women's Fitness Magazine, pp. 30-31.
