Contesting the term ‘compassion fatigue’: Integrating findings from social neuroscience and self-care research

Abstract

Background: Nurses describe work-related distress and exhaustion as compassion fatigue and burnout. However, neuroscientists confirm compassion does not cause fatigue. Aim: This discussion paper explains contemporary social neuroscience evidence about empathy, emotion regulation, and compassion, then discusses evidence-informed strategies to cultivate effective self-care practices and compassion. Methods: The argument draws on relevant empirical evidence and literature to raise awareness, improve understanding, and spark dialogue and reconceptualisation of these critical issues within the nursing context. Findings and discussion: Functional magnetic resonance imaging studies show the debilitating condition known as compassion fatigue should be called 'empathic distress fatigue'. This distinction matters because the strategy to ease empathic distress fatigue is compassion training. The capacity to remain clear about the 'self-other' distinction is called emotion regulation. Without emotion regulation skills, our 'self-other' distinction is blurred so we absorb another's suffering and negative emotions as our own and experience empathic distress fatigue. Yet, much of this knowledge is not implemented within the nursing context. On the contrary, the topic of compassion fatigue continues to dominate education and research. This knowledge gap is significant because healthcare leaders cannot address the distress of its workforce and strengthen cultures without understanding its causes. Conclusion: Evidence from social neuroscience and self-care studies offers promising new knowledge to design strategies to foster self-care, self-compassion, emotion regulation, and ease empathic distress fatigue. These strategies and practices for renewal support the raison d'être of nursing which is to provide quality, safe, compassionate care for patients and their families by resilient nurses.

Promotion of professional quality of life through reducing fears of compassion and compassion fatigue: Application of the Compassionate Mind Model to Specialist Community Public Health Nurses (Health Visiting) training

“…However, the main beneficial relationship appears to be in regard to moderation of risk of burnout; the position seems more complex in relation to secondary traumatic stress. This study therefore also lends support to suggestions (Hofmeyer et al, 2019; Sheppard, 2015; Stamm, 2010) that burnout and secondary traumatic stress are related but distinctive components of compassion fatigue.…”

“…The further finding that ‘Years since qualifying’ was linked only to secondary traumatic stress also supports burnout and secondary traumatic stress having some different mediators or moderators during the cumulative development of compassion fatigue. Duarte et al (2016) have suggested that ‘empathy sensitivity’ might moderate secondary traumatic stress, and Hofmeyer et al (2019) have also proposed ‘empathy distress fatigue’ as a better conceptualisation of compassion fatigue.…”

“…Stamm (2010) identifies burnout and secondary traumatic stress as the core elements for screening practitioners’ at risk of compassion fatigue, though this concept is increasingly contested. For example, Hofmeyer et al (2019) suggest that an alternative term, ‘empathic distress fatigue’, would locate the concept better within the neuroscience evidence for clinical symptoms arising from cumulative impact. In contrast, Gilbert (2018) suggests that ‘compassion fatigue’ is better considered as ‘systemic fatigue’ since systemic issues within the workplace are more likely to be causative than is witnessing suffering.…”

Teaching empathy and resilience to undergraduate nursing students: A call to action in the context of Covid-19

“…Mastering empathy is a vital ingredient for teamwork, collaboration, accommodating difference and diversity and ultimately safe patient care. For more information and a lengthy discussion on the associated social neuroscience evidence please see Hofmeyer et al, 2019 , and Singer and Klimecki, 2014 .…”

Protective Factors in Resilient Volunteers Facing Compassion Fatigue

“…A large body of research has shown the negative effects faced by professionals working with distressed groups, thus pointing to the difficulties that volunteers might also encounter. Professionals who work with traumatized populations may share the emotional burden of the people they are trying to help [6][7][8][9]. This process may lead to unwanted changes in emotions, cognitions, and behaviors [10].…”