What Every Nurse Should Know About Combating Compassion Fatigue: Insights from 27 Years of Nursing Experience

Compassion fatigue, the emotional and physical exhaustion resulting from continuous empathy and caring for others, is taking a significant toll on nurses. It not only affects nurse well-being but also impacts the care delivered by nurses, highlighting the need for resources to build compassion fatigue resilience.

ConceiveAbilities met with Kelly Rayburn, a registered nurse with over 27 years experience, to talk about her work with compassion fatigue. While receiving her Masters in Nursing, Kelly dedicated her research towards compassion fatigue. Below are her insights and answers to some commonly asked questions surrounding compassion fatigue.

Tell us about your academic work with compassion fatigue.
My research project when I was getting my Masters in Nursing was on Compassion Fatigue. Two group members and I were all experienced Labor & Delivery nurses and had only heard the topic in relation to other nursing specialities. We decided to see if L&D nurses were also at risk for compassion fatigue. After an extensive literature review, we were not finding much information on compassion fatigue in our area of nursing. We created our own research study. The end result? Yes, L&D nurses are at risk for compassion fatigue.

When people hear that I used to work as a nurse in L&D, they say, “Oh that must be so fun!” or “It must be so cool to hold babies all day.” Yes, it was fun. No, we do not hold babies all day. When things were good, it left one with a sense of pride and accomplishment. When terrible events occurred, however, which they unfortunately did, it left a traumatic mark on all involved. Our study identified L&D nurses were at risk for compassion fatigue and then focused on ways to combat it. Nurses are always supporting and caring for others, but who supports the nurse caring for others?

How have you experienced compassion fatigue in your nursing career?
For me, there wasn’t one clear event that led to compassion fatigue. An unresolved traumatic event, running a support group for bereaved mothers when you are grieving yourself, days of being in charge and making decisions for the unit, and being short staffed and working beyond your capabilities with no break all led to compassion fatigue.

My first insights into compassion fatigue surfaced when I realized that when I got home from work, I had nothing left to give my family. I felt empty, unable to make the simplest of decisions, unable to enjoy their company, so exhausted that I just wanted to sleep, and lying in bed not able to sleep as the days replayed themselves. My personality was changing. I would sit in my car every morning wondering if I really did need to go inside the building, pray that “nothing bad would happen today on my watch,” and feel just an overwhelming sense of anxiety entering the hospital. When my job became more about charting defensively “in case” something happened, and less about providing the nurturing competent care that I should have been focused on, I knew it was time to leave the bedside. I no longer felt the joy that each delivery brought; I no longer felt I cared enough, did enough, or was enough.

What are ways you decompress, relax, and recharge when experiencing compassion fatigue?
My family is the most important thing in the world to me. When I left the bedside, I wanted to make sure it was to do something that would allow me more time with them. I decompress by spending time with my grandkids, playing with them, laughing with them, and snuggling them. I’ve learned all too well that you don’t get that time back. They recharge my sense of balance in this world.

When I was in the deepest hole of compassion fatigue and depression, I sought solace and advice from friends. True friends that are there for the thick of it, including my bedside nursing friends who understood the fears and anxiety and my teaching friends who offered support when the pandemic hit and we all scrambled to find a new way of educating future nursing students. For me, talking relieved some of the burnout.

When I was too tired to talk, I used other avenues of comfort, including listening to Christian music, reading, riding my bike, hiking in the woods, and crafting. Twice a year I go with friends to a weekend scrapbook retreat. There I can create memory books, reminisce about pictures, share stories, and just laugh with no other agenda. It is my “me time.”

What communities have helped you navigate the highs and lows of your nursing career?
Absolutely my faith. I pray to a higher being and trust that He is always looking out for me; my faith has been instrumental in my ability to survive compassion fatigue. While I do not get to service often, I listen to uplifting Christian music that “speaks” my story; these songs inspire me to be a better person and to have faith even when things seem impossible.

My friends have also helped me navigate the highs and lows of my career. Their support, encouragement, advice, and time together helped me maneuver so much these past 30 years.

My hobbies are an escape from my career; a time for me to be something other than a nurse, an educator and a manager. Immersion in my hobbies is one time I can just be me.

What resources, products, and suggestions can you provide for other nurses struggling with compassion fatigue?
When we started our research project, we were looking specifically at Labor and Delivery, Postpartum, and NICU nurses. We understand now, especially in light of the pandemic, that no specific specialty is immune to compassion fatigue. It isn’t even exclusive to nursing. Anyone who provides care for someone else who has pain, suffering, and mental anguish can experience compassion fatigue.

My suggestions are:

1. Find someone that you can trust and confide in. Seek a friend or a counselor who has experience with compassion fatigue.
2. Journal your feelings and experiences.
3. Explore what it is that you need to do in order to get healthy. We can’t care for others when we cannot care for ourselves. Is it time away, time off, time with people, time alone?
4. Think about what makes you happy and do more of it! Even if it's scheduling a few minutes a day to start and working up from there.
5. I wouldn’t be a nurse if I didn't throw this in here: proper sleep, exercise and nutrition. Again, start slow. A walk around the house, the block, the neighborhood. Reconnect with nature.
6. Have a hobby that you have always wanted to try? Do it! A hobby sitting unfinished? Start it back up again.
7. Finally, accept that it is ok to NOT be ok. As nurses we are accustomed to giving care, not accepting it. We advocate for our patients, but not often enough for ourselves. Understand that compassion fatigue and everything that comes with it is normal. The ability to recognize it and treat it allows us to survive it.

Click here to learn more about how nurses are experiencing compassion fatigue, and how to support them!