Compassion fatigue? How mindfulness increases empathy and serenity in health professionals

compassion fatigue health coach mindfulness meditation

I come from a family of nurses – my sister, cousin, aunty and grandmother are all nurses. An abiding memory of my childhood is being transfixed by the case studies and photos in grandmother’s old nursing textbooks. The closest thing that we had to a medical text at home was the first aid manual!

The nurses in my family, and other health and wellness professionals will be quick to tell you that serving others is tough: emotionally, physically, and spiritually. That’s not to say it isn’t rewarding and satisfying, but it comes with unique challenges.

Caring is stressful

It’s well documented in the health literature that daily stress can lead to a variety of negative outcomes in health professionals:

  • burnout
  • apathy about their job
  • physical illness
  • poor mental health

In some cases, caring for others comes at the expense of caring for self, and often this continued self-sacrifice can lead to what’s been termed ‘compassion fatigue’.

In an innovative new approach to dealing with stress, health and wellness professionals are being encouraged to take up mindfulness themselves as a way to increase their levels of self-compassion, empathy, and serenity.

Mindfulness improves reduces stress and improves health

Mindfulness is often prescribed to people with health problems as a way of encouraging them to lead fuller and healthier lives. The emphasis of mindfulness is staying in the present moment, with a non-judging, non-striving attitude of acceptance, and is cultivated through the practice of meditation.

We’ve got plenty of rock-solid research to support the positive impact of mindfulness on health and well-being in a variety of patients. Three different meta-analyses show mindfulness based therapies:

(I like meta-analyses because they combine data from numerous different studies and provide a more powerful estimate the true effect of an intervention.)

Mindfulness increases self-compassion, serenity and empathy

Instead of focussing on patients, this new study looked at the effects of Mindfulness-Based Stress Reduction (MBSR) on health professionals.  Forty one nurses participated in an eight week course of guided instruction in mindfulness meditation practices, facilitated group discussion, stretching and yoga, work and home assignments, and individually tailored instruction and support.

For ‘homework’, each participant was given a copy of the book: Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness, by Jon Kabat-Zinn (1990).  The nurses followed a homework schedule of mindfulness, meditation, stretching and yoga, as well as readings Full Catastrophe Living.

The health and well-being of the nurses was surveyed at three points: two weeks before training, immediately following the program, and four months following the program.

Once the numbers were crunched, significant improvements were seen in various measures of health, stress, burnout, self-compassion, serenity, and empathy, both immediately after, and four months out from completing training.

Specific improvements were seen in the following areas:

  • vitality
  • mental health
  • serenity
  • empathy
  • measures of self-compassion: self-kindness, common humanity, and mindfulness
  • significant decreases on the three “negative” areas of self-compassion: self- judgment, isolation, and over-identification
  • perceived stress
  • burnout

“Mindfulness is defined as a self-directed practice for relaxing the body and calming the mind through focusing on present-moment awareness.”

Says lead researcher Dawn Bazarko,

“Health care workers present as a primary target audience due the nature of their work and the impact that mindfulness can have on patient care and the creation of safer, higher-quality care environments. However, the practice is ideal for anyone.”

The paper finishing with the following thought:

 “With time and intention, we each can use tools such as these to promote mindfulness and increased compassion and engagement to create a culture and working environment that benefits you and those you serve.”

Are you a health or wellness professional?  Do you practice mediation or mindfulness for your OWN health and wellbeing?  Leave a comment and let me know!

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Dawn Bazarko, Rebecca A. Cate, Francisca Azocar, Mary Jo Kreitzer. The Impact of an Innovative Mindfulness-Based Stress Reduction Program on the Health and Well-Being of Nurses Employed in a Corporate Setting. Journal of Workplace Behavioral Health, 2013; 28 (2): 107 DOI: 10.1080/15555240.2013.779518

Taylor & Francis. “Positive health technique for stressed nurses found.” ScienceDaily. ScienceDaily, 3 March 2014. 

Image credit: harold.lloyld

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19 Comments

  1. kathleen on March 21, 2014 at 7:46 am

    A) I can’t tell you how much I love your site, your information, your attitude — so happy I found it!
    B) I’m a wellness coach and a holistic nutrition counselor and I don’t know how anyone in any nurturing field (I include anyone involved in education) can thrive without a mindfulness practice. It enhances my ability to connect in a meaningful way with others; it enables me to check in with myself and my own self-care; it has definitely made me a more patient parent! Even if it’s only 6 minutes, that short amount of time spent in quiet allows for focus and stillness which permeates the rest of my day.
    In the last year my practice has developed into a devotion – a time that I truly miss if I skip a day.
    I was recently asked to speak about mindfulness and meditation to a group of educators, and to hospital staff – and was so pleased with the enthusiasm and interest from both of those groups. To me they are two of the most deserving and underserved groups out there.

    • Sarah McKay on March 21, 2014 at 1:49 pm

      Awhhh… thanks for your kind words Kathleen. Hooray and welcome on board!!

  2. Melanie on March 21, 2014 at 6:17 pm

    Hi Sarah, I´m a psychological coach and I do meditate every day for 30 minutes and more. It gives me a huge serenity und I think that therefore I can cope better with whatever may happen with clients.
    Thanks you for your site!

    • Sarah McKay on March 21, 2014 at 10:07 pm

      Great to hear from a coach who does meditate! We could all learn to be a little more serene (I could learn to be a LOT more serene) x

  3. Shirley on March 22, 2014 at 5:43 am

    Love it and yes I do meditate daily actually am off now to take some time for me- hugs

    • Sarah McKay on March 22, 2014 at 6:22 am

      me-hugs! LOVE it!!

      • Maria Bell on September 15, 2022 at 9:58 am

        I am a Midwife and have been meditating every morning, first thing l do, 30 minutes five days a week and twenty minutes two days a week, the shorter times are on my early shifts. I have found meditating to be a valuable part of my day. Benefits include calmer, although l am a calm person, less reactive, better listener, more patience with my patient’s, more patience with my Husband who has Alzheimer’s. I started a veggie garden in lock down, and make sourdough, both very grounding. The meditation helps me be more organized and at work l have found it helps with efficiency, l have also found it helps with more filtering of things said, therefore in conversations more listening occurs. I paint watercolour so l have always been observant but meditation does enhance that, lt is such a strong part of my life. I started with Mindful in May course five years ago, and l have been meditating everyday now for four years, l have been an admirer of Jon Kabat Zin’s work for years. I listen to audible books on my way to work and have listened to a several books on Neuroscience and meditation and gut health. Daniel Siegel, Thich Nhat Hahn, Norman Doidge, Flow by Mihaly Csikszentmihalyi, Michael Mosley. In the Mindful in May course which l did three years in a row. There were many lectures and interesting books most of which l read. The mind such a fascinating subject.

  4. Claire Noonan on April 1, 2014 at 9:53 pm

    Hi Sarah, I am a GP and my stress levels can rapidly escalate with devastating consequences! I use mindfulness in bite sized amounts between patients, before making phonecalls, or as a mini-space of calm during the paperwork storm at day’s end. This acts as a quick release valve for all that tension. I am sure my patients are better cared for as a result.
    Thank you for the always inspiring posts. Look forward to seeing you at AMWA 2014.

    • Sarah McKay on April 1, 2014 at 10:32 pm

      Hi Claire – ‘bite-sized’! I like! Afraid I’m not coming to AMWA this year … I’ll be Italy at my cousin’s wedding. But I’m on the organising committee and we have some great workshops and speakers. Keep getting excited about it, then remember I won’t be there.

  5. John McBurney on April 2, 2014 at 1:44 pm

    Hi Sarah

    I am a neurologist and integrative medicine physician in the US. I have had a regular meditation and yoga practice for over 4 years and it has changed my life.

    My wife, Jill who is a wonderful yoga teacher, and I are going to present a 2 hour didactic and experiential session on April 9th entitled “The Neurobiologiy of Stress and Resilience (please don your own oxygen mask before assisting those around you) to our hospital chaplain residents.

    It has been truly eye opening to learn what these residents go through…attending 4-5 deaths a day, most marked by anguish and family strife. They seem to experience many markers of distress, gaining 20-30lbs. During the year and many becoming depressed and emotionally exhausted.

    There is a robust literature regarding burnout in many types of health care professionals but I’m not finding a lot for chaplains. This seems like a needed area of research.

    John

    • Sarah McKay on April 2, 2014 at 2:15 pm

      Hi John. Wow – it’s amazing what you and your wife are doing So interesting about what you’re seeing in the chaplains. Makes me think of an old friend of mine who left the ministry – one reason he gave was that noone ever asked him how HE was. Definitely a neglected area of research.
      Wish I was closer to hear you guys speak!
      Cheers
      Sarah

  6. Jo Cooper on May 18, 2014 at 12:57 am

    Hi Sarah-
    I’m the online communication director for The Center for Mind-Body Medicine, and a big fan of yours 🙂 Just wanted to mention that the Center has been training health professionals for over 20 years in mind-body medicine, both here in the US in professional training programs and in traumatized regions around the world, including Kosovo, Israel, Gaza, New Orleans, and Haiti, and with the US Military, through our Global Trauma Relief program. Our findings in our peer reviewed, published research are astounding, and exactly what you would expect. The use of mind-body medicine skills significantly reduce the effects of stress and trauma — for health professionals, as well as the people they serve. A major focus of our trainings has been helping health professionals heal themselves and recover resiliency in themselves and their practices. The Center has pioneered a supportive small group model of teaching and learning, and published research studies show positive results with our model among graduates of our trainings, and medical students at Georgetown University and University of Washington, for example. To read about our programs and research, please visit our website at http://www.cmbm.org. And thank you for the terrific information and inspiration you provide!

    Jo

    • Sarah McKay on May 18, 2014 at 12:09 pm

      Hi Jo

      Thanks for sharing your details – hope others find your centre helpful too.

      Sarah

  7. Jane on July 22, 2014 at 11:51 am

    Hi Sarah

    I am a health professional (naturopath and RN) and I too work with mindfulness and with meditation, seeing them as different practices (though do at times ‘stray’ – humanness effect!). My latest leaning has been encouraging clients to take up some of Eric Harrison’s 5-minute techniques, as a gentle introduction for those with no experience or exposure.

    My colleague/friend and I facilitate resilience workshops and I incorporate mindfulness activities and discussion in these. When we were providing resilience workshops on behalf of the Cancer Council we worked with over 600 health professionals who worked in oncology and palliative care (in a 3 day residential) – enough material to induce compassion fatigue just in a day or two, let alone over the course of a career. What struck Maxine and I was that whilst people were exhausted, struggling and at times burnt out, the grief, sadness and loss were important factors, but not the biggest factor affecting their well-bring. Rather, if we had to drill it down to one focus, it was the context: the challenges of working with people and the flawed health systems they were trying to provide excellent within. Hmm, you just made me think maybe I should try to upload the conf paper were delivered at COSA a few years ago. Regardless of the nidus of their angst, it did impact on their capacity. Interestingly, the Cancer Council had a question in their workshop evaluations about whether the workshop helped them ‘find meaning’ in their work – this often elicited quite a spirited response! People were clear that the ‘meaning’ had always been there, their ‘care’ had always been there, just that the organisational and interpersonal (with colleagues, managers, staff etc) made it at times the stuff of nightmares. Indeed, that they still found meaning and still cared was the impetus to seek support about managing stress, so they could perform to the level they wanted and still be well themselves.

    Good grief, sorry for the rave. I love this area and really like connecting and helping people find ways through the obstacles. Another interesting area for compassion fatigue is those who work in torture and trauma, and in rape crisis centres; the woman who manages the clinical services at NSW Rape Crisis (?Jackie) has developed some really good programs of support their staff and prevent compassion fatigue

    Great blog, thank you

    Jane

  8. jacqui newby on November 24, 2014 at 10:00 am

    Hi Sarah,

    I really enjoy your blog.

    I am 64 and started meditating at age 24.

    I started with T.M then tried many other types of meditation but at age 50 found Vipassana Meditation,learned the technique and did 3 silent retreats of 10 days duration.

    I nursed for over 40 years and spent the last 20 years in the Cardiac unit of a major Melbourne
    hospital in an environment where cardiac arrests and cardiac arrhythmias were commonplace.

    The stress was phenomenal at times and I don’t think I would enjoyed my challenging job without a
    daily meditation practise.

    I do Yoga stretches and a single meditation sitting of 35 -60 minutes most days

    I cannot imagine a life without the daily time I spend with myself.

    Best wishes to you and thank you for the information you impart.

    Jacqui

    • Sarah McKay on November 24, 2014 at 10:03 am

      Thanks for taking the time to comment Jacqui (and apologies for my late response … I think I missed your comment). I’ve heard a lot of stories like this now. Did you learn about meditation etc IN the workplace, or did you have to go looking elsewhere?

  9. jacqui newby on November 24, 2014 at 4:22 pm

    I think I was looking for something from about the age of 14 but I didn’t know what that something was.
    I remember at 14 buying a book called ‘Better and Better Every Day’ by a French psychologist called Emile Couie at a second hand book shop..an unusual choice for a 14 year old.

    When I returned from working in the U.K , I caught up with a nursing colleague and noticed a marked difference in her. She had been a prickly person, not so easy to get on with , but she was more peaceful and much easier to be around. She had learned T.M. and I thought ‘that’s for me’. My teacher taught Hazel Hawke also around that time.

    From the first meditation my face was more relaxed ,I remember driving home after moving my jaw around marvelling at how mobile it felt,(I was teeth grinder in my sleep back then).

    Early in my meditation I began to regularly see the colours violet and green which made the
    experience very pleasant and easier to still my mind .I did 20 minutes twice a day .

    My job then was in the Intensive Care Unit at Prince Henry’s Hospital Melbourne and there was a Doctor and another critical care nurse who also practised meditation .We would sit in the staff tea room at lunchtime and meditate .

    I feel that the gains I have had through my Vipassana meditation practise of the last 10 years is more than equal to what I did over the preceding 30 years.

    It is a technique that encourages you to sit cross legged and to maintain the position if you are able for the duration of the meditation. What it teaches you is to try to maintain equanimity of the mind even as the body becomes uncomfortable.

    Mindfulness is no doubt very helpful as a defuser of stress and many times I have taken the opportunity to do Yoga breathing whilst visiting the loo during a very busy shift.

    The terrain you travel over in meditation practise is difficult which is why people give up easily,
    the first road block to go around is called boredom, then there’s discomfort , anxiety and many more obstacles before you even get near to climbing the mountain …but every step changes you in the most subtle and extraordinary way as you journey to yourself.

  10. nitten mahadik on September 3, 2019 at 5:38 pm

    Very helpful article. This year I conducted a few mindfulness workshops for teachers and now the focus is to bring it in health care. Given the quantum of the population we have, there are a massive number of patients in every well-known hospital and the hospital staff faces massive burnout issues and therefore a decrease in empathy and compassion.

  11. rob on October 21, 2021 at 10:42 am

    Love your work Sarah, superb information thank you.

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