Caregiver Fatigue Affects Everyone

Much is being researched and written on the subject of Physician/Nurse compassion, empathy, and care fatigue.  Just a few examples on the subject from the past few months are the following:

If you’re anything like me, if and when feeling fatigued, you may notice that you feel more irritable, moody, easily frustrated, less optimistic.  Moreover, you may find that your ability to listen, focus, be present, give freely (without expectation of anything in return), express compassion and empathy, and the like are somewhat or even severely impaired.

As a hospital chaplain intern several years ago…

As a hospital chaplain intern several years ago, I was assigned primary responsibility for the spiritual support of the clinical staff, patients and their families in the Medical Intensive Care Unit (MICU) and on a pediatrics floor at the University of Rochester Medical Center, Rochester, NY.  Although a stressful role, I managed it and coped very well.  However, three patients and their situations over a 2-day period created the “perfect storm” for acute caregiver fatigue on my part.

Despite her bald head, “Jamie’s” smile, positive and optimistic attitude, and genuineness created a radiant beauty.  On the one hand, this 7-year-old cancer patient was inspiring and motivating!  On the other hand, the fact that such a beautiful young girl was fighting for her life was taking its toll on her loving and ever-present parents.  Putting myself in their shoes over several days, I had started to tap into what they felt, and it was heart-wrenching.

At the same time, I was attending to a 43-year-old mother in the MICU who was dying.  I had followed her medical progress for weeks, and she had just been informed that her condition was worsening and she had just days to live.  The staff was most concerned for the patient’s 14-year-old son (“Matt”), who was the patient’s only family.  Social work was involved, the patient (as a mother) was trying to remain strong for her son but quickly losing out to her rapidly diminishing strength, and I felt a growing burden to support Matt in the shocking and devastating news that his mom was dying.  My resolve was breaking and inner reserves felt parched!

I went home that Thursday evening hoping for a break but all I kept thinking about was Jamie’s parents and Matt, who would soon be without his mother (his only family).   My sleep was restless at best that night.

The next morning, as I made the long, sunny, and warm walk from the employee parking lot toward the Chaplain’s office, I thought to myself: “Doug, it’s Friday.  If you can make it through this day, you’ve got the weekend to recover.  Hang in there.  It can’t get any worse.”  (Or, so I thought.)

As soon as I entered the room where we did our morning rounds as chaplains, a senior chaplains handed me a note with a patient’s name on it and said, “Doug, she’s twenty-one and suffered an aneurysm.  Her mother and other family members are in the private waiting area down the hall from the MICU.  You need to go up there immediately.”  My heart sank; I had nothing left to give!  To make the situation even more difficult, the patient’s religion and/or her mother’s forbade blood transfusions.  Because of the religious dimension, the surgeon included me in his conversation with the mother about treatment options.  The patient died later that day.

My story is certainly not unique; it’s fairly common – whether the caregiver is “professional” (doctors, nurses, social workers, chaplains, etc.) or other (spouse/partner, sibling, parent, or friend).

I learned two important lessons that day.  First, I had an untapped reservoir – another dimension – of human strength that I had never known was there (because I had never needed it).  I believe we all possess this and it’s there when we need it most.

The second lesson learned that day is this: the same compassion, empathy and care within the caregiver that is given to others is  needed to help the caregiver him/herself replenish and heal.  It’s the yin and yang.  Giving to others — even one’s own strengths — if not given back to oneself leads to fatigue.  Therefore, compassion, empathy and care for oneself is critical to prevent and heal caregiver compassion, empathy and care fatigue.

As a caregiver — professional or otherwise — are you regularly tapping your own compassion, empathy, and care and applying it to yourself?

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