Compassion Fatigue Series

Have you ever been so overtaken with the emotion of a moment that the world around you blurs out of view? I think of moments when I've experienced a lifechanging event, either blissful or traumatic. That reaction is normal, when your body either wants to fully enjoy something without distraction or focus all its energy on surviving.  I knew I'd hit a personal limit my first term of nursing school when I felt that larger than life feeling on an average workday. That blur felt like resentment and an overwhelming frustration. 

I worked as a tutor, and while I normally enjoy helping students, I found myself so impatient with offering anything of myself, so empty of mental resources, that I had to abruptly excuse myself from my student to take an extra break and pray; in 5 years of work I've never taken extra breaks, and have even done my workaholic best to avoid the ones legally required. Tutoring isn't a demanding job, and this student wasn't asking anything abnormal, but I was tapped out. 

My mind was full of vulnerable patients, frustrated students, and a world of hurts that I couldn't even comprehend let alone nurse. I told God how incapable I was to carry these weights, how I couldn’t get out of the heaviness of these emotions; how I felt like I was failing because I wasn’t cheerful, or hopeful, or able to remove myself mentally from those environments even when my body was no longer there. How I was losing my patience with others over simple, nonvital, non life-threatening things like where to put a period, or how to construct a thesis; didn't they know someone's life was ending, while they sat here and expelled emotions of fear and frustration,  worthy of a much greater tragedy? Tragedies that I had seen in-person only days before? 

These simple, reasonable, requests were pushing me over past my capability of compassion because I was hurting and I wasn’t sure how my heart could handle the grief of this week let alone a career that showed me just how much pain I have the option to live blissfully ignorant of. I knew my response wasn't appropriate to the situation, but that just startled me even more. My heart was breaking and I didn’t know what to do to stop it, only that I was desperate to.

Compassion fatigue is a well-known term in the medical community. It's a result of "traumatic experiences [that] may bring to life a group of unpleasant feelings such as exhaustion, anger, irritability, diminished sense of enjoyment and impaired ability to make decisions and care for [others]" (Jarrad). I see it as another sign that we are made in God’s image, but not in his omnipotence; we are made to be compassionate, made to live in community, but we were never created to bear the heaviness of death and certainly not as endlessly as our jobs could demand.

As I sat outside, my head bowed into my helpless hands, I felt these thoughts speak to me: “Those things that break your heart are the things that are supposed to break your heart, so let them. Stop thinking they shouldn't, and letting shame be your primary feeling. Let them break your heart, let them make you angry, trust that hurt to Me; then ask Me what I'm doing about it. Because I am doing something about it. Let those things make you seek me. Let them make you hunger for a justice only I can provide and only I know when it will arrive. This is my heart, this is the hurt I feel also, let your heart know it too”. 

My occupational worldview as a healthcare worker is biased heavily towards those who are hurting, because the healthy will often have little reason to see me. I understand better the implications of Jesus’ statement, “It is not the healthy who need a doctor, but the sick. But go and learn what this means: ‘I desire mercy, not sacrifice”. He was talking about spiritual sickness, calling the vulnerable “sinners” to him rather than those everyone saw as “righteous". That phrase is powerful in many ways, one of which is the complexity of the burden he was calling himself to bear. Spending time with only sick people isn’t easy, and Jesus’ tears of blood before the cross are only one indicator of a level of compassion fatigue no one else has, or by His grace will, ever experience. I asked God, "how I’m supposed to carry such a heavy burden?" 

He prompted me to remember Mathew 11:30, “Come to me all you who are weary and heavy laden, and I will give you rest. Take My yoke upon you and learn from Me; for I am gentle and humble in heart, and you will find rest for your souls. For My yoke is easy and My burden light". 

Knowing those truths didn't necessarily help me put anything into practice right away, at least not beyond maintaining professionalism while still feeling internally ambivilant. All I knew at that moment was that battling my condition of being human looked a little like disciplining my thoughts to trust His way more each day, a little like grief over the days that still feel heavy, and a little like dancing for joy when the burdens weren't difficult to see as light. While they gave me enough relief to return to my shift, it wasn't for another half of a year that I was able to get a good foothold in fighting my compassion-fatigue, turned depression. And it will still likely be years before I’ve fully won that battle as well.

I'm going to explore the concept of compassion fatigue, and my attempt to fashion my practice after Jesus's method of healthy living. I'd be glad to have you walk along with me. 

Jarrad, R., Hammad, S., Shawashi, T. et al. Compassion fatigue and substance use among nurses. Ann Gen Psychiatry 17, 13 (2018). https://doi.org/10.1186/s12991-018-0183-5