COVID-19: Navigating the Compassion “Burden” – Supporting Providers Giving their Best Under Stress

Melissa R. Thornburg, MA
Senior Performance Improvement Coach

As we sit in our living rooms and anxiously await news that our respective states will start to lift restrictions and slowly reopen, many will sigh with relief upon hearing the plan, as others will feel a sense of uncertainty and dread. As healthcare leaders, we still walk with trepidation as speculation of another “surge” is discussed, and news of large groups of people ignoring social distancing and safety precautions are presented by the media daily.

As healthcare staff in the hardest hit areas continue to battle the virus, the uncertainty of what the next day will brings and the mental, physical and emotional exhaustion of showing up every day not only to the hospital but in their daily lives can take a toll. Taking on all the stress COVID care while making sure everything else in their lives is not just moving smoothly, but productively – the demands of homeschooling; taking care of a family; and ensuring there is food on the table for everyone – is a challenge to say the least. Our daily lives and the responsibilities that often come with it are busy, hectic and even chaotic without the pandemic and stay at home orders; but with this added challenge, the stress, anxiety and exhaustion that accompanies this unprecedented experience can be emotionally crippling. defines Compassion Fatigue as “fatigue, emotional distress or apathy resulting from the constant demands of caring for others”. Caring for others. Nothing is mentioned about the added burden of caring for self. Compassion fatigue, also described as “vicarious trauma” in situations where caregivers are directly exposed to life-changing emotional, physical, and psychological events experienced by those they are caring for, has been a long-standing black cloud hanging over healthcare employees. We read articles and see newscasts about prominent and successful physicians and other caregivers that have left the profession because of burnout and stress that is so debilitating that they can no longer safely and effectively perform the duties of their profession.

The COVID-19 pandemic certainly qualifies as a major stressor that is likely causing compassion fatigue and vicarious trauma in caregivers. So how do we recognize it, and what can we do to take care of ourselves and our coworkers?

First let’s identify some of the signs and symptoms likely experienced by a caregiver with compassion fatigue or vicarious trauma. Sometimes we are unable to identify these in ourselves but can recognize them in others. A sample of the most common signs and symptoms to look for are:

  • Absolute emotional and physical fatigue
  • Headaches
  • Body Aches (likely resulting from exhaustion)
  • Insomnia
  • Weight Loss or Gain
  • Feelings of being detached from the body or thoughts (like observing symptoms in yourself, but not being able to address them)
  • Frustration or irritability
  • Self-deprecation or criticism; feeling like you are “not enough”
  • Worry or feelings of hopelessness

Looking at this list, it is likely that every single one of us has experienced one or more of these signs and symptoms during this world pandemic. However, when these signs and symptoms persist as a direct result of the caregiving, causing distress that interferes with daily life and work performance over time, that is an indication of compassion fatigue and/or vicarious trauma.

Taking care of ourselves and coworkers that may be experiencing compassion fatigue or vicarious trauma is complicated during the COVID-19 experience because we cannot easily remove ourselves or our coworkers from the stress and trauma that is causing these extreme symptoms to persist. What we can do, as leaders, is identify these symptoms in ourselves and our staff members and ensure that they have opportunities and resources to take care of themselves. Knowing how you can care for yourself and being willing to reach out to staff to help care for them is the first big step towards recovering and eventually healing.

Below are some simple suggestions for self-care in the moment to use for yourself and to facilitate for your staff:

  • Temporarily exit the stressful situation and breathe deeply for 3-5 minutes with repeated slow and deliberate breaths in…hold…and a slow breath out.
  • Take a short walk.
  • Spend 5 minutes talking to a calm, trustworthy support person.
  • Cool compress to back of neck or forehead
  • Retreat to a quiet room devoid of any outside stimuli to re-set your senses (dark, quiet, clean, etc)
  • As a leader: validation of current state of distress or feelings, “permission” to share feelings and request support, and an invitation to decompress or debrief.

For longer term, ongoing self-care to manage stress, consider the following:

  • Set a daily structured schedule and keep to it for some consistency and “normalcy”
  • Take a day off. Spend that day doing things that will help you rest, de-stress and center yourself like sleeping in, taking a hot bath or shower, or watching a movie or TV show
  • Plan healthy and balanced meals and snacks (even meals “on the go” if necessary), that are intended to help with boosting energy and metabolism and providing a balance of protein, carbs, fruits and vegetables for optimum performance
  • Follow a consistent exercise routine (can be a walk, morning run, stretches, calisthenics, weight training, etc.)
  • Hydrate your body to keep your body cool, your mind clear, and your joints and muscles strong and healthy
  • Practice meditation, positive affirmations, or some other type of emotional relaxation
  • Spend time, even if it’s “virtual” time over Zoom or another platform, with your support system and accept their offers of help
  • Engage in hobbies and activities that have previously brought you joy, even if you don’t feel like it! Some examples: watch a movie, read a book, have a Zoom dance party, watch the sunset, make a scrapbook, or paint a picture.
  • Try “grounding your senses” by “dismissing” current worries and stresses that are bothering you temporarily to be intentionally “in the moment” using your senses to be purposefully aware of what you are seeing, smelling, touching, hearing or tasting. This practice helps to keep you focused and clear your mind.

As we stand united to face this pandemic and the “new normal”, we must take care of those who are most affected. Compassion fatigue and vicarious trauma are real. Having one or both is a possibility we must acknowledge. Ignoring symptoms or self-care can lead to dangerous levels of stress that may lead to critical mistakes, poor decision making, and impaired treatment of patients. Regular monitoring of staff, granting consistent break times for a few moments of respite, providing healthy snacks and water for nourishment and hydration, and working in a culture of psychological safety for validation of emotions and physical symptoms of stress can not only help prevent compassion fatigue and vicarious trauma from occurring, but can also help effectively manage symptoms if they do occur.

We are not yet over this pandemic. Some states are still battling hard, while others are slowly reopening. We are unsure of the path this virus will take in the near future, so we must plan support now that will be maintained as the weeks go on. Equipped with the information above, we can prevent compassion from being a problem, and allow it to continue to be a solution!

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