Nov 6, 2017 in Nursing

Compassion Fatigue, Caregiver Burnout

Phenomenon of Caregiver’s Burnout

Caregiver’s burnout is a common phenomenon with nurses since they work directly with traumatic victims. There are various concepts associated with this type of occupational stress which may affect the caregivers emotionally, psychologically and also physically. Discussed below are various warning signs for the concepts associated with compassion fatigue. Their nature and causes have also been explained. In addition, the emotional, physical, and spiritual needs of the caregivers outlined finally how to cope with the situation as caregivers.

One of the key virtues that drive caregivers such as nurses to this profession is empathy. If the caregiver is able to understand the sufferings of his patient, he is, therefore, likely to care for him in the right manner. However, too much caring for others without one practicing self-care may be harmful and affect the caregiver psychologically, spiritually, and emotionally. Caregivers need to understand several concepts and resources to help themselves cope with burnout while caring for patients.

Burnout may be understood as exhaustion of a person’s emotions leading to loss or deprivation of his or her personality. The individual suffering from this disorder may have a feeling of not having accomplished what he or she ought to. Caregivers’ intention and wish is to give a complete care for their patients, but sometimes, they get frustrated and disappointed when they feel that they have not accomplished what they hoped for. The warning signs of burnout include lack of sleep, headache, physical daringness, change in weight, and lingering colds. In addition, a person suffering from a burnout may also experience the following emotional symptoms: he or she may be easily irritated from time to time; a feeling of anger; a feeling of loneliness or sadness; decrease in self-esteem; depression; feeling of being emotionally drained.

Caregiver burnout may occur as a result of having difficulty in seeking help from other people and having high expectations of oneself. The caregiver may also have difficulty in reflecting things that he or she is not comfortable with. Self-giving also leads to burnout, or one having the feeling as though he or she is the only one who can provide care to the patient.

Concept of Compassion Fatigue

Compassion fatigue is another concept that refers to secondary traumatic stress. A person experiences this natural emotion when he or she learns about a traumatizing event experienced by others. These are stresses that caregivers experience in an attempt to help or care for a suffering person. This situation is prone to individuals who have a high level of empathy towards a suffering patient. The symptoms of compassion fatigue include excessive blaming, bottled emotions, isolation from others, substance abuse to mask the feelings, compulsive behaviors, poor self-care, legal problems, apathy, and sadness. In addition, one no longer finds activities that he used to enjoy pleasurable; he or she is mentally and physically tired and difficulty in concentrating. Compassion fatigue is caused by sympathetic feelings towards patient’s pain by the caregiver. The desire to give care or to get rid of patients suffering makes the caregiver suffer from secondary traumatic stress. Empathy, which leads to extra care, is also a cause of compassion fatigue.

Vicarious trauma is another concept used to describe the psychological stress that a caregivers experience as they give care for their patients. This disorder leads to permanent cognitive disruptions of the victim. Vicarious trauma occurs when the healthcare’s intention to treat or care for the patient is placed on a higher value than the intention to care for the caregiver. This leads to the caring process becoming somehow difficult especially when the patient takes long to heal thus leading to vicarious trauma to the caregiver. The reasons that may lead to the vicarious trauma include personal life stressors or training background of the healthcare professionals. Other factors that influence the disorder include life-threatening nature or a disease with a long time effect. The personality of an individual influences the way the sign of vicarious trauma is expressed. Some people may experience it through illness, pain, or lack of sleep while others may show it by being irritable.

Since vicarious trauma is caused by spiritual and psychological disruptions that affect the way people perceive the world or see themselves, it, therefore, has psychological, spiritual and behavioral signs: spiritually, the victim suffering from the disorder may start questioning the beliefs and the purpose of life. His/her faith changes, and he/she becomes hopeless; the identity also changes. One changes in the way he/she perceives identities such as friends, family members, or professionals. The physical or psychological signs include nightmares, lack of concentration, repeated memories of traumatic events, numbness, cynicism, anger, fear and disgust; the behavioral and relationship signs include difficulty in separating personal life from work, a feeling of lack of energy, relationship problems, social withdrawal, irritability and sexual difficulties.

Five Stages of Compassion Fatigue Process 

  1. In the zealot phase, which is the first stage, the caregiver shows commitment and willingness to go an extra mile. He also works voluntarily without waiting to be asked to.
  2. In the second stage, which is referred to as irritability phase, the caregiver begins to avoid his patients and mocks his coworkers and clients. Mistakes become common, and there is a loss of concentration. The caregiver also starts to keep distance from friends and co-workers.
  3. In the third stage, this is the withdrawal phase, the caregiver views patients as being irritants. Complaints about work and personal life are common at this stage. The caregiver neglects the coworkers, friends, and family members. He also loses value for himself.
  4. In the zombie phase, the caregiver becomes rage and starts to hate people. He gets some misunderstandings of being of other people’s attitude about him and feels that he is ignored. The sense of humor disappears, and patience diseases.
  5. The final stage is the pathology and victimization versus maturation and renewal phase; during this stage, the caregiver becomes overwhelmed and quits the profession. He may develop somatic illness; however, if appropriate measures are taken, the caregiver may be transformed and be able to cope with the situation.

Care giving can affect one’s health due to the effect associated with burnout healthcare professionals face. Therefore, it is important to recognize the physical, emotional, and spiritual needs of the caregiver that will help him maintain his health. The physical needs are addressed by taking balanced diet and exercising. Fighting fatigue may also serve as a physical need. Caregivers sometimes get busy handling their patients to an extent of forgetting to it. Some of the caregiver’s rush for fast food or snacks to save time. These things may be okay in a while, but it may become a bad habit. People’s bodies need nutritious food to keep them going. Caregivers should, therefore, follow a well balanced diet, cut down on fatty foods, sugar, and alcohol, and drink enough water. Another physical need for a caregiver is fighting fatigue. A caregiver may spend much of his time caring for a patient and deny him-/herself to sleep or relax. Therefore, having enough rest is important to restore the body and mind. The caregiver should, therefore, rest when tired and avoid caffeine before bedtime. He should also seek assistance from other people in case the patient he/she is caring for is awake most of the time. Exercise is also important as a physical need of a caregiver. Caregivers face several emotional and physical stresses thus they require exercise to ease their mind.

Giving much energy to the patient may result to a situation whereby the caregiver forgets that he/she needs practicing self-care. When caring for their loved one, it is common for one to experience emotions of sadness, anxiety, and frustrations. Therefore, the caregiver needs to have an emotional support. The emotional support enhances the caregiver’s coping mechanism with the burnout he experiences in his work. Spending time while talking with other people in similar situations and being listened to gives a caregiver the emotional support. The caregiver should also spare some time for him and seek more information about the patient’s disease.

The understanding of the term spirituality differs from one person to another: to some, it deals with donations of religion and faith while to others, it is a sense of someone’s personal life. Spiritual issues are important to both the caregivers and patients. An illness may disrupt an individual’s value for life or even change his/her beliefs and faith. It is, therefore, important for a caregiver to address spiritual needs so that he/she could cope with the burnout. When a person is caring for a loved one who is in pain, he/she may question God as to why he has to let his/her loved one suffer and spend a lot of time seeking for explanation of the suffering. Whether the caregiver is religious or not, it is good to find faith in his/her beliefs and God. It is important to take time to pray, meditate, and try to find meaning of the role of a caregiver. It is also important to try to identify something positive that has come out of the situation and see the lessons that can be learned from it.

From the above discussion, it is obvious that, for a caregiver, it is very difficult to escape burnout. However, various mechanisms can be used to cope with the situation and become effective in our work as caregivers. Such professionals should seek support from other caregivers. By talking with them, they may help each other to relieve the feelings of guilt, isolation, and hunger. Resources such as support groups are also very important to connect with for support. Another coping strategy is recognition of the signs of stress which include a feeling of exhaustion, lack of sleep, lack of interest in activities which one used to enjoy in past, among other signs. After recognizing these signs of continuous stress, the caregiver should find new ways of providing care or seek help from other people. The caregiver should also learn to be kind and patient to him-/herself and make time for other occupations and relationships. All these strategies are aimed at preventing physical, emotional, and psychological harm to a caregiver when faced with burnout in his caring process.

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