Health-care professionals who work with trauma survivors day after day are at risk of developing compassion fatigue and the way to prevent this is to reduce their workloads and have them work in clearly defined teams, a York University professor has found.
“The stress from working for 40 hours a week with people who have suffered catastrophes, war, childhood sexual abuse and domestic violence accumulates over time and can penetrate every aspect of a helping professional’s life,” says Kyle Killian, a professor in the School of Nursing, Faculty of Health, and a researcher and instructor for the Centre for Refugee Studies at York.
Left: Killian's study found that healthcare professionals who work with trauma survivors day after day are at risk of developing compassion fatigue
Killian’s study, “Helping Till It Hurts?”, was published in the journal Traumatology. He conducted in-depth interviews with 20 clinicians in the US and surveyed more than 100 about their caseloads, personal experiences of trauma, coping styles, work stress and compassion fatigue.
Burnout in a job is a result of emotional exhaustion, says Killian. However, in addition to burnout, helping professionals may experience compassion fatigue – a kind of vicarious or secondary traumatization experienced as a result of establishing an empathic connection with the patient’s trauma.
“This fear and anxiety may disrupt their beliefs about safety, security and trust in the world and in their interpersonal relationships,” says Killian.
Participants in the study reported a number of symptoms of stress, including sleep disturbances, becoming easily distracted, having difficulty concentrating and mood changes. Such symptoms are characteristic of post-traumatic stress disorder.
They also reported using a number of coping mechanisms, such as exercise, prayer, meditation and venting with co-workers. There was no evidence that these directly supported the professionals’ resilience or protected them from compassion fatigue and burnout, says Killian, but they may have had an impact on overall work stress.
"Social support and emotional self-awareness proved to be key ingredients in maintaining professionals’ resilience while doing this intense work with survivors,” says Killian.
Instead of focusing on individual workers’ coping strategies, agencies should proactively try to find ways to facilitate social support at work, distribute workload and process critical incidents so that the exposure of any one worker to trauma can be limited, says Killian, who is initiating a study on resilience in nurses.
“Agency administrators, supervisors and health-care professionals may have to ask themselves, ‘How many cases are too many?’”