We need to talk about compassion fatigue

Compassion fatigue, or “the cost of caring” is a phrase that has been spoken about more recently in the last few years, particularly among mental health and psychology experts. However, with millions of people working in UK healthcare fearing to be suffering in silence and trying to reduce hours or even looking to quit the profession, it is something healthcare professionals, recruiters and high-profile people in the industry need to be talking about.


Naomi Rachel Remen, an American medical reformer and educator, describes compassion fatigue as: “The expectation that we can be immersed in suffering and loss daily and not be touched by it, is as unrealistic as expecting to walk through water without getting wet”. With the ongoing effects of the covid-19 pandemic and the subsequent exposure of the nature of frontline work for nurses, doctors, AHPs, porters etc has increased support, donations, and adoration for these individuals from the public. From the NHS clap during lockdown to window displays of rainbows, to Captain Tom, these displays of support has propped up frontline staff through the most challenging moments of their career. However, this camaraderie amongst staff and the public can sometimes act as a mask for a deepening compassion fatigue issue.


Pressures on the NHS are at an all-time high, and despite some minor fluctuations in demand for staff, beds and ambulances, this pressure has remained at a critical level for over 2 years, with backlogs reaching astronomical levels. On bad days, where staff may experience the loss of a patient, delivering difficult news or dealing with an anxious parent, it would be suggested that they take some time off, and allow themselves to feel upset, process emotions and rest. The simple lack of time and resources available to healthcare staff means that they are feeling fatigued, burnt out and often experiencing mental health issues such as anxiety, but in such a vocational role, staff feel there is little time for how they are feeling, and they simply get on with the job because everyone else is. In 2014, NHS employers revealed that stress and mental health issues have overtaken musculoskeletal disorders as the main reason for sickness absence.


The reality is high quality patient experience cannot be achieved – ethically or sustainably – at the expense of staff. We must show the same care and compassion for healthcare staff as they do for patients, there are many ways in which we can do this, starting with increased discourse around the issue. Whether you are a friend, colleague, manager or recruitment consultant, asking each other how they are, and offering available support resources and advice can make a big difference in combating the feelings of isolation and autopilot caused by compassion fatigue.


Below are some simple ways in which you can help, based on your relationship to those that may be having trouble:


  • As healthcare staff: think about setting some time aside after a difficult shift to process your emotions, let them happen and do not beat yourself up for feeling the way you do, your feelings are completely valid. Chat with your colleagues after a tricky shift, 9 times out of 10, they will be feeling exactly the same, and validating these feelings will help you to process them.


  • As a colleague: if you see a colleague looking upset, stressed, or distressed, take them aside, or offer the prospect of a coffee/breakfast/drink after their shift and an opportunity to chat.


  • As a family member or friend: check in with those you know working on the frontline, a simple “are you okay” may help them release some pent-up emotions.


  • As a manager or a recruitment consultant, offer a line of communication and a balanced view that is open any time, point them in the right direction to resources that are available, and encourage discussion of their feelings post shift.


Below are some resources to share, use or keep for a rainy day:

NHS mental health guidance


Mental health and support services

5 steps to mental wellbeing

Wellbeing apps

Workforce wellbeing resources

Wellbeing resources for adults