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  • Karen M. Wyatt

How to Avoid Compassion Fatigue for End-of-Life Workers

I recently spoke with a hospice nurse who told me that she was suddenly finding it difficult to care about her patients and their families. While in the past she had been able to engage with patients on a deep level and could express authentic concern, she was now alarmed that she felt numb and detached whenever she made a home visit.


This nurse was suffering with the very real condition of “compassion fatigue,” which is often a precursor to full-blown burnout and a common occupational hazard for those providing care to others at the end-of-life. According to Colleen Breen, a psychotherapist and author of Making Changes: A Guidebook for Managing Life's Challenges, compassion fatigue occurs “when people become so overwhelmed by the needs and concerns of others that they forget to take care of themselves.”


Who is susceptible to compassion fatigue?


Compassion fatigue is actually common in any type of work that requires caring for others who are experiencing significant emotional pain and physical distress, such as nurses, nurse’s aides, doctors, social workers, psychologists, first responders, chaplains and police officers. Primarily, those who are better at taking care of others than taking care of themselves are at risk for compassions fatigue.


Common characteristics of those with compassion fatigue include being disconnected from personal needs, unable to ask for help from others, perfectionism, self-worth based on rescuing others, and needing to be in control of situations. There are also workplace factors that contribute significantly to compassions fatigue, such as inadequate training for the job, excessive overtime hours, lack of emotional support at work, and cumulative stress from an overload of difficult patients or clients.


(Find out if you are at risk for compassion fatigue: Download a Quick Assessment.)


What are the signs and symptoms of compassion fatigue?


The physical symptoms of compassion fatigue include frequent headaches, digestive problems, sleep disturbances, exhaustion, and vague cardiac symptoms. Emotional and mental symptoms include depression, anxiety, mood swings, anger, and lack of focus. These symptoms can progress to inefficiency or avoidance of work, frequent sick days, and overuse of substances.


What can be done to prevent or heal compassion fatigue?


The key to avoiding compassion fatigue lies in improving the approach to self-care on physical, mental, emotional and spiritual levels. Healthy self-care habits must be cultivated over time and require commitment and consistency so that they become ingrained. Here are some of the healthy habits that can eliminate the risk of compassion fatigue:

1. Regular exercise. Use a step counter or pedometer to keep track of your steps each day. Aim for 10,000 per day for maximum physical health and stress relief.

2. Adequate sleep. Try to get 6-8 hours of sleep per night. Avoid electronic devices before bedtime, practice a relaxing bedtime ritual (such as restorative yoga), or use natural sleep enhancers like chamomile, valerian root or melatonin.

3. Healthy diet. Add more vegetables and fruit to your diet by drinking a green smoothie each day, minimize processed foods, and use protein snacks (like nuts or cheese) to help balance blood sugar levels.

4. Journaling. Use daily writing to help express and process your experiences and emotions.

5. Deep breathing exercises can help relieve stress and anxiety. Practice at least 3 times per day with long, slow deep breaths in and out.

6. Mindfulness meditation. Learning to focus on the present moment can help you stay relaxed and cope with stressful situations.

7. Find meaning in your work by seeing the “big picture” rather than getting caught up in the daily challenges.

8. Prayer and contemplation can help you deepen your own resilience and coping ability.


In addition to these ideas, if you are at risk for compassion fatigue, try to find a network of support. You might seek out colleagues at work who are empathic, join a church or community organization, find a meet-up in your area, or even participate in a Death Café or online support group.



Ultimately, if you are at risk for compassion fatigue you must remember to take in as much love, support, compassion, and care for yourself as you give to others. Take the time to create your own “prevention plan” and implement it now. Not only will you benefit but your patients and co-workers will be helped, as well.

About the Author:

(Dr. Karen Wyatt is a hospice and family physician and the author of the award-winning book “What Really Matters: 7 Lessons for Living from the Stories of the Dying.” She is a frequent keynote speaker and radio show guest whose profound teachings have helped many find their way through the difficult times of life. Learn more about her work at

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