Compassion Fatigue

A relatively new term I’ve come across, something that was mentioned briefly at uni by my lecturers. Only recently when I began work in the public health sector did I accept it as a disturbingly common phenomenon.

The scene — it’s 2015; big ideas and hopeful prospects lay before me as a new graduate. Limitless energy to start making a difference and earn a living by doing so. Graduation was over and the real life was ahead of us. Naturally I couldn’t take a break just yet. Head down, applications are written and sent, replies are received. Several template apologies down the line and I recieve a satisfyingly individualised one. Congratulations! A month abroad prior to my escape from central NSW and I am eager to begin the next leg of life in Victoria.

Fatigue is something we all deal with. Muscular, emotional, mental. The occasional sun-burnt, day of adventuring, alcohol driven nap. We’ve all likely been there. We know the feelings. Heavy in the limbs and eyelids, lacking motivation, soreness, dry eyes and a sunken chest. In a nutshell, you need some me time — naps, baths, hugs, chocolates; all remedying interventions.

Compassion fatigue means what it says. The state someone reaches in which, apologies to younger readers, you are no longer able to give two shits because of all the shits you HAVE been giving in the past x (days/weeks/months). I’m sure you’re looking at a screen right now, thinking of a time where this is a #me moment.

“Yeah, last Saturday when I was out with Alex he kept complaining about all the work he has left at the office. Sick of hearing about it to be honest. Just have another drink and shut the hell up.” — or some other nonsense.

And that is a valid example. I’m sure your own personal one is valid too. Being able to show compassion for someone over and over, or show compassion for someone in a groundhog day like scenario, is bloody hard to do. Especially if that someone is a person you care about — as opposed to talking Alex down after his drunken rambles with kind and balming words last Saturday night.

But what if I told you that this form of fatigue is an epidemic in the healthcare industry? And I don’t mean souly in a practitioner’s social life, but with their clients too. What if I told you that your current GP, the one you trust with your aches, pains, lumps and assorted bodily dysfunctions was sick to death of hearing the same stories from the same, or similar people? And it isn’t just doctors who are affected; nurses, physiotherapists, psychologists, even dentists. If they aren’t in a state of compassion fatigue right now, they certainly have been or will be at some point in the future.

As a health professional I can tell you it is a frightening thought. There was that sudden heavy realisation, that this happens to people, to my colleagues and to me.

Working in my field — allied health — I see many people, with many problems, presenting in many different ways. I’ve met men with broken toes who are able walk normally. And I’ve met men who have broken toes who can’t talk secondary to how hard they have to grit their teeth to shunt the pain. Now, this isn’t a medium for me to scoff at the “high pain tolerance” of these blokes, it is however a good example as to why you, someone in the community, may be met with a somewhat apathetic response from your treating practitioner from time to time.

My field, in most cases, tends to be much more broad than that of the regular GP or community health worker. And this is due to the nature of graduate programs; operating on rotational rosters through various areas of hospitals. One day I could be working with someone who has had a stroke, the next I am explaining, in explicit detail, the importance of the male pelvic floor to an otherwise healthy young guy. My point being (despite my passion for the male pelvic floor) that upon reflection of how I managed these two clients, I got that feeling — I had subconsciously treated the latter of the clients with a much more blasé approach.

Understandable? It shouldn’t be. I haven’t taken an oath to treat every client as seriously as the next, but I do hold that ability as a core value in my practice. So why didn’t it happen? One likely answer is Compassion Fatigue. It’s hard to show empathy for a healthy guy with minor pelvic floor dysfunction after just telling a man and his family he will need to use a wheelchair for the foreseeable future.

We operate in a society that is 1) aging, and is 2) increasing in the rates of access to healthcare. Because of these factors, and others that shall remain unnamed for the sake of preserving a succinct feel to these posts, the demand on healthcare is skyrocketing. As a new grad I don’t feel or see this increase; all I’ve ever known since beginning work is that there are ALWAYS more patients to see. I’m always busy. There’s always a wait list. And there’s always someone worse off than the hemiplegic lady I’ve just met.

With trends in the population such as these, it is understandable that health professionals are going to get overwhelmed on occasion — thats what mental health days and employee assistance programs are for. But that doesn’t always alleviate the issue.

My grandfather was recently diagnosed with lymphoma, my best friends mother with leukaemia. A still born to the woman who is a close family friend. All these warrent tears, grieving acts, alcohol at least? But considering my work and the clients I see, how am I meant to feel knowing there are things far worse and more imminent to my current situation? I feel for each of my patients. I feel for each of my family members and friends. I have feelings. It’s just that from time to time apathy waters them down, usually in my social groups.

So for example, excuse the meme culture here; patient with end stage lung disease, much sadness, such cry = inability for myself to appropriately digest feelings required in other social/professional/family scenarios. It makes me look like an ass to those involved. It makes me feel even worse once I’m allowed to stew over my own internalised fear of my lack of emotion. Sigh.

Frankly I’ve had to accept that getting sick and tired of hearing about other people’s issues from time to time is going to be a reoccurring thing in both a professional and social sense. Even with the aforementioned supports in place. Speaking for myself, I feel a huge sense of guilt when taking leave because of the stunted condition I leave my team, and the now FOUR week long wait list. Again, another can of worms not for today. But can you see my point here? Look back to the first paragraph, my eagerness to help a community once graduating from uni, and see me now; able to be numbed to client presentations and incidents in my own life.

Apathy is a wondrous thing when it’s meant to be drawn upon. A self defence, a self preservation tactic in its basic sense. A hindrance, and then some, when it isn’t.

A week off and I’m all gooey and feely and ready to cry again. Restock the tissue box holder, housemates, I’m coming home.