Compassion [kuhm–pash-uhn] noun
A feeling of deep sympathy and sorrow for another who is stricken by misfortune, accompanied by a strong desire to alleviate the suffering.

Compassion Corner is a series from Patient Worthy that will focus on the subject of compassion in the healthcare and rare disease space. In this series, we explore the role of compassion in this field and what it means for caregivers, patients, and others.

It can be called Compassion Fatigue.

According to a resource from the US Department of Veterans Affairs, burnout rates for doctors are now over forty percent. When nurses, mental health groups, and social workers are surveyed, the burnout rate increases to eighty percent.

It seems that the qualities that help the patient most, such as controlling emotions and outcomes, are the factors that bring about clinician burnout. The negative effects impact work performance and patient recovery.

Three other factors were outlined as well, such as numerous bureaucratic tasks in addition to a physician’s daily responsibilities, long hours at work, and experiencing a lack of respect from administrators.

Three goals were outlined in 2008, pre-COVID, by the former administrator of Medicare, Don Berwick. He offered that improving the experience of medical care and reducing costs were key to better health; However, these goals did not include the well-being of the people who are heavily involved in fulfilling these missions.

How and Why Does Burnout Occur?

When a healthcare worker neglects their own self-care, when their life is unbalanced and the burden of their work is out of control, they are at risk of burnout.

The term burnout originated in the 1970s. Herbert Freudenberger, a psychologist, coined the definition, stating that burnout may be caused by a person’s professional life.

Burnout is not a buzzword. It is real. The symptoms affect personal and professional relationships, and result in compromised quality of care. This article is not only intended for healthcare workers. One of its goals is to help patients recognize that a short response to their questions by a nurse or physician may be the result of a lapse under the heavy burden of their well-intended patient care.

Maslach Burnout Inventory creator Christina Maslach defines burnout as erosion of the soul. She claims it is a decline in a person’s dignity, values, and spirit.

If not addressed, burnout may last for weeks or months.  The most common indicators are:

• Emotional exhaustion: burnout numbs the healthcare worker in situations where they previously had been able to show compassion and empathy
• Depersonalization: In simply trying to get through their daily assignments, associates and other staff become objects rather than patients and colleagues
• Low self-esteem: Physicians and nurses experiencing burnout are not able to recognize the benefits they provide to their patients
• Low personal achievement: a feeling that they are not producing substantive results. This includes continued negative feelings about their work and about themselves.

Although anyone is a target for burnout, burnout occurs most frequently in medical care personnel.

A 2018 survey of fifteen thousand physicians from twenty-nine specialties found  (depending on specialty) forty to sixty percent of physicians reporting burnout. Women physicians are 1.6 more likely to experience burnout than men.

Medical students begin feeling the burden early in their training. Students at seven medical schools were surveyed reporting a fifty-three percent burnout rate.

Those training for a medical fellowship as well as residents (doctors in training) have up to eighty percent in certain specialties reporting burnout.

Over 7,900 surgeons were included in a study with the following results:

• Forty percent reporting burnout.
• Thirty-two percent reported extreme fatigue
• Twenty-six percent reported depersonalization (thinking of patients as objects)
• Thirteen percent were displeased with their level of accomplishment
• Thirty percent were found to screen positive for depression, and
• About six percent acknowledged suicidal thoughts
• Nurses and Burnout
• Nurses report more burnout than most professional groups.

A total of 9,959 nurses were surveyed.

• Only two-fifths of nurses in nursing homes and two-thirds of nurses in hospitals reported being satisfied with their work.

Cause and Effect

The traits that produce a dedicated clinician and may also cause burnout are:

• Motivation: Offering a service under certain circumstances may lead to self-deprivation and then compassion fatigue.
• Dedication: A desire to offer excellent care bordering on perfectionism leaving no room for error; in medicine, there is little room for error.
• Conscientiousness: A clinician has every intention to be reassuring and competent. These attributes demand that the clinician controls the outcome. It is an indication that he or she must always be successful which in many cases may not be humanly possible.
• Responsibility: Compassion can lead to isolation. Witnessing suffering on a regular basis can cause emotional dissociation if the healthcare worker is not able to cope.

External and Internal Factors

Other factors to be considered that are responsible for burnout would be higher productivity demands while being exposed to lower resources.

In Conclusion:

The three main factors that affect a well-meaning physician’s patient care are emotional exhaustion, depersonalization, and the feeling of minimal personal accomplishment.

Resilience is the key to reversing or even preventing burnout. Healthcare workers themselves should seek professional care, reflect on values, promote self-care and mobilize resources in and out of the workplace.