How to Keep Caring Without Breaking

Recently, a nurse asked publicly how others cope with empathy fatigue.

It struck me that the question itself was brave.

Empathy fatigue (more often called compassion fatigue) is easy to mislabel. It can present as irritability, detachment, or impatience. It can look like burnout. It can feel like failure. But often, it is something quieter and more specific: the accumulation of caring deeply for a long time.

The subtle internal shift signaling empathy fatigue.

The most dangerous part of empathy fatigue isn’t exhaustion. It’s the subtle shift.

It’s the moment you feel yourself pulling back. The internal eye roll that surprises you. The thought you don’t like having. The faint edge of resentment where compassion once felt natural.

That shift is uncomfortable. But it is also a signal.

In oncology, relationships are not brief. We see patients repeatedly. We learn their children’s names. We know when scans are coming. We recognize the weight in their voices before they say anything at all. Over time, that proximity to suffering accumulates. Grief does not arrive all at once. It layers.

Empathy fatigue is not evidence that we care less. It is often evidence that we have cared continuously.

Left unnamed, however, it can harden into something else. Resentment is not dramatic; it is […]

In Nursing, Empathy Is a Practice to Cultivate

Empathy as one reason nurses are so widely trusted.

Last December, nurses were named the most honest and trusted profession in the U.S. for the 17th year in a row. In order to build trusting nurse-patient relationships that can help improve health, nurses must understand the needs and circumstances of patients, families, and communities. One way nurses arrive at an understanding of these needs is through practicing empathy. This may explain why nurse empathy has been found to be a major factor in hospitalized patients’ satisfaction with their care.

photo credit: EKGTechnicianSalary

The word empathy is not very old, as words go. It appears to have been a translation into English, using a combination of Greek roots meaning ‘in’ and ‘feeling,’ of an early 20th century German psychological term, Einfűhlung (‘feeling-in’).

In health care, we generally define empathy as the ability to enter a patient’s frame of reference (thoughts, emotions, circumstances, etc.) and sense the meaning in her or his inner world, as the concept was described by Carl Rogers, one of the founders of humanistic psychology. 

Are we becoming less empathetic?

These days, empathy can often seem to be in short supply. Much-publicized study findings suggest that […]

2019-06-13T07:49:55-04:00June 13th, 2019|Nursing|1 Comment

The Invisible Nature of Grief

Most nurses know the stages of grief by heart: denial, anger, bargaining, depression, and acceptance. We know the stages do not occur in an orderly, linear fashion. People flow in and out of each stage, circling back around to earlier stages as needed.

But I’m not aware of anyone discussing the invisible, insulating environment grief surrounds its survivors within. An acquaintance described it like this:

“We had just taken our son off of life-support, and sat with him as he passed. Our entire family had gathered to say goodbye. After leaving the hospital, we went to eat. I sat in the café, marveling at the world outside, that people were going about their daily lives, and I had just lost my son.”

When grieving periods were the norm.

collage by julianna paradisi/2018

A cultural understanding of this phenomena developed during the Victorian era, and still exists in period romance novels: People of means, after suffering the loss of a loved one or recovering from traumatic illness or injury, were sent to live with relatives in the country or at the seaside. There, they had no household responsibilities beyond taking long walks through the forest or along the shore, keeping journals, or sketching. In romance novels, the grieving heroine gets the added bonus of discovering a Fabio-like love to heal […]

A Place for Faith: Despite Chronic Illness, a Return to Bedside Nursing

flickr creative commons/by krassy can do it

Relearning the Details of Clinical Nursing

After being away from bedside nursing for over 11 years, I recently returned to this role on the same medical-surgical floor I’d worked on 11 years earlier. The impetus behind such a drastic transition was, in part, my return to nursing education as a clinical nursing instructor. As an educator, I felt the need to update my own clinical skills as I instructed young nurses eager to enter my profession.

The other reason for returning to clinical nursing had to do with a spiritual pull I felt in my heart, a hope that I’d be able to to show patients the compassion, empathy, and patience they all deserved. I’d come to realize that I’d sometimes lacked these qualities when I was a younger bedside nurse. Now I felt that God was giving me a kind of ‘do-over’—and I had to at least try to live up to this expectation.

Within the first week of orientation, I quickly realized how different things had become in the nursing world. The last time I’d worked as a clinical nurse on this very unit in 2005, the hospital was still using paper documentation, private community physicians still rounded on their patients, and there were no ‘computers on […]

2017-03-08T11:17:02-05:00March 6th, 2017|career, Nursing, patient experience|5 Comments

10 Good Things About Being an Older Nurse

Alice Facente, MSN, RN, is a community health education nurse in Connecticut. Her Reflections essays, “At Her Mercy” and “The Dirtiest House in Town,” were published, respectively, in the August 2009 and January 2010 issues of AJN.

Puddle Reflection/by joiseyshowaa, via Flickr Puddle Reflection/by joiseyshowaa, via Flickr

I recently passed a professional career milestone: 40 years since I’d graduated from nursing school. When I began my career, nurses still wore white starched caps and white uniforms. I don’t know how we accomplished everything we did with those impractical caps perched on our heads. The shocking realization that four decades had so quickly passed forced me to think about all of the benefits of being a mature, experienced nurse. Right off the top of my head, I thought of 10 things (and yes, these are generalizations and exceptions exist).

1. Older nurses are often more empathetic. Chances are that in the last several decades every older nurse has been a patient, undergone surgery, become a parent and possibly a grandparent, encountered personal financial challenges, experienced the death of a close friend or family member, and much more.
2. Death is not so frightening. Nurses have cared for people at all stages of the life cycle and know that, with planning and preparation, […]

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