Most of us are motivated to have compassion for those in need, but sometimes it can feel like the tank is running on empty. In this episode, wellness expert Kim Bambach, MD gives insight into compassion fatigue and strategies to thwart it.
Guest Bio: Kim Bambach, MD is an Assistant Professor of Emergency Medicine at The Ohio State University and Assistant Director of the Kiehl Resident Wellness Endowment
We discuss:
What is compassion fatigue?
- Compassion fatigue is profound emotional and physical exhaustion stemming from exposure to the suffering of others. It is the “cost” of caring for others who are suffering.
- It leads to a diminished ability to manifest empathy compared to your normal baseline (this is important- it does not mean you are no longer a compassionate or empathetic person!)
- It is a cumulative process.
- Also called “secondary traumatic stress”.
- The prevalence of compassion fatigue in EM is not really known- there is data suggesting high prevalence in other acute care settings like the ICU and in other caring professions such as nursing and social work.
What are the signs and symptoms of compassion fatigue?
- The sense that you cannot “extend”.
- Depersonalization, cynicism, physical symptoms like fatigue/headaches/poor sleep.
- You may notice changes in your behavior, or notice them in a colleague. For example, you find yourself without the urge to console someone who’s crying because you’re emotionally saturated.
How is compassion fatigue different from burnout?
- Compassion fatigue is distinct from burnout. Burnout comes from factors in the external environment that are not necessarily related to empathy, such as increased administrative burden or lack of autonomy. CF is unique because it includes secondary trauma.
- There are many similarities, including depersonalization, a reduced sense of personal accomplishment and meaning, and physical exhaustion.
- In a study of PEM docs, burnout score was the most significant determinant of CF.
The “dark side” of empathy.
- Friz Breithaupt is a Professor of Cog Sci and Germanic Studies at Indiana University and an expert on empathy. He wrote a fascinating book called “The Dark Sides of Empathy”. We generally think of empathy and compassion as healthy responses that bind people together, but there are actually many dark sides. In the case of people in caring professions that includes overextending.
How can we combat compassion fatigue?
- Introspection- what needs do you have that are not being met? Sleep, nutrition, relationships (incl counsel, camaraderie with other docs about what you’re experiencing).
- Cultivating compassion satisfaction: the pleasure and satisfaction we get from helping others, the “antidote” to compassion fatigue. Ask yourself: what about your job is nourishing? How can you incorporate more of that into your practice? How can we build systems that minimize secondary trauma that we experience?
Compassion fatigue references and resources
Overcoming Compassion Fatigue | AAFP
5 things doctors should know about compassion fatigue
Compassion Fatigue: The Toll of Being a Care Provider | AAMC
Does Empathy Have A Dark Side?
Does Empathy Have A Dark Side?
Compassion Fatigue in the ER and Beyond: When caring leads to an inability to care
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