Are you an RN, LVN, Psychiatric Technician, CNA, administrator of a residential facility, group home or some other healthcare or human services worker? If so, you may be at risk for developing Compassion Fatigue. In order to combat compassion fatigue, it is important to understand what makes one healthcare or human services worker more inclined to succumb to the mental and emotional deterioration of CF than another. While are all susceptible, some have a combination of environmental factors and internal factors or unresolved trauma which leave them more vulnerable to the ravages of CF. Acknowledging your own personal weak points and the stressors that are unique to you will aid in your fight to remain strong against developing CF. Here are just a few examples of each of the three types of vulnerabilities for CF.

Environmental Vulnerabilities

Working in the field of medicine on any level requires living life at a higher pace. In any clinic or medical care facility, there can exist an atmosphere of low-level stress, hurry, and anxiety that permeates an entire shift. In a hospital or large care facility, this low-level pressure often ratchets up to mid-level or even high-level, and in an ER or trauma center, a shift can have you running in high gear for a full eight to twelve hours. The atmosphere in which you work and the number and length of shifts you work each week are the primary environmental factors influencing the onset of CF. Naturally, a person who works nine to five in a family practice clinic will have less chance of developing compassion fatigue than one who works 12-hour shifts in an ER. However, a nurse or social worker assigned to a clinic in the inner-city, where many clients suffer from a form of compassion fatigue, and where administrative practices may limit how much care is available, will see greater opportunity for developing CF than one who works the same shift and position in a suburban clinic. When assessing your own risk, look not only to the actual shift hours you put in, but other environmental factors such as the socioeconomic status of your clients, as well as how strict your administration is in its practice.

Internal Vulnerabilities

Traumatologist Eric Gentry identifies what he considers to be the primary weakness of most people who work in healthcare or human services. He calls it “other-directed care giving” and asserts that many of those drawn to the helping professions are taught from a young age to care for others at the expense of caring for themselves. He reports that very few caregivers have learned to practice faithful, customary habits of self-nurturing.There is nothing wrong with wanting to help or even putting yourself out for others. Most who work in the healthcare or human services profession have a core value for caring, and that is a good thing. The danger comes when your gift of empathy (being able to put yourself in another’s shoes) becomes a snare, and you find yourself unable to separate your own plight from theirs. Those with strong empathy gifts often forget to take oxygen for themselves before giving it away to others, landing them passed out on the ground while those around them suffer for it. It is simply vital to recognize how these very wonderful gifts and resources can leave you naked and exposed before the destructive forces of compassion fatigue.

Here is a list of a few of the general characteristics commonly found among those whose internal factors may place them at risk for developing compassion fatigue:

  • Being helpful, attentive and accommodating to the point of ignoring your limits and desires.
  • Deriving your self-worth from others needing you.
  • Defining yourself by the good you do for others.
  • Being drawn to rescuing/fixing people’s problems.
  • Focusing a lot of your attention on other people’s reactions, moods, and needs.
  • Focusing on pleasing others or getting their approval.
  • Feeling responsible for another person’s mood or happiness.
  • Emphasizing self-reliance to the point that needing others is not allowed.
  • Attempting to adapt and please others to ensure harmony.

Trauma-related Vulnerabilities

Many working in healthcare or human services are drawn to the field because they have experienced their own share of personal trauma. In short, “psychic trauma occurs when a sudden, unexpected,overwhelming intense emotional blow or a series of blows assaults the person from outside.” {1} If you have experienced such an assault, and this trauma is unresolved in your psyche, you may be more susceptible to compassion fatigue. Without intimate knowledge of your triggers, you may inadvertently relive your past trauma while caring for someone in a similar situation, thereby setting off your unconscious self-defense modes.

There is agreement among clinicians that a combination of the unique physical and emotional responses of the victim and the victim’s social group determines whether a traumatic experience remains unresolved. Trauma impacts the way a person thinks, learns, feels about others, views the world, and how they make decisions and behave. These coping patterns emerge quickly after trauma is inflicted and will remain firmly established until the psychological impact of that traumatic experience is healed and new coping methods are mastered.

As a medical professional working with the victimized, it is crucial that you identify and refute beliefs and fears based on outdated threats from your past, especially traumatic experiences and abuse or neglect. Living out of the past increases stress, undermines self-care habits, and increases the likelihood that compassion fatigue will creep in and overtake you.

NOTES: {1} Bloom, Sandra L., M.D. “Trauma Theory Abbreviated.” From The Final Action Plan: A Coordinated Community Response to Family Violence, October, 1999.

Angela Magnotti Andrews is a freelance writer who has co-written several courses for ClickPlayCEU.com, including “Compassion Fatigue”, “Hand Hygiene: Life & Death is in Your Hands”, and “Pain: Friend or Foe”.