Compassion Doesn’t Have to Hurt, in Nursing or Otherwise

Albert Einstein wrote:

A human being is a part of the whole called by us “Universe,” a part limited in time and space. He experiences himself, his thoughts, his feelings, as something separate from the rest—a kind of optical delusion of his consciousness. The delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest to us. Our task must be to free ourselves from this prison by widening our circle of compassion to embrace all living creatures and the whole of nature in its beauty. Nobody’s able to achieve this completely, but striving for such achievement is in itself a part of the liberation and a foundation for inner security.

There’s a lot of talk in nursing, and in the literature about “compassion fatigue.” I just did a Google® search for the keywords “compassion fatigue in nurses” and came up with 46,700 links…46,000! You’d think that we’re all suffering from burnout, which can’t be possible…or, is it?!

I’ve been there, you may have too. I’d just cared for my umpteenth patient, walked out the door, and said, “why the hell am I still here?!”

There’s No Such Thing as Compassion Fatigue!

I’ve written a lot about my belief (very strong belief!) that there’s no such thing as compassion fatigue!

The notion that compassion can cause fatigue gives me cause to pause, how about you? Can compassion really lead to fatigue, can caring so much for another cause burnout? Or, is it a matter of not caring for ourselves, or not realizing that within each of us there is a wellspring of compassion, unlimited by the duration that we serve others, or by the amount of suffering that we witness. Have we lost the connection to that part of ourselves that can heal as Mother Theresa healed, to care as Gandhi cared, to give as selflessly as those we admire have done?

Why do we burnout? Why do we experience fatigue when we’re caring for others? Why do we feel that to be compassionate has to take its toll, rather than lift us up? Is there something that I’m missing when I feel burned out after caring for another, something that I’m doing, or some way that I’m being that is preventing me from feeling uplifted by what I’m doing?

There’s actually plenty of evidence that shows the contrary, that helping others can actually make us happier. And research into practitioners who use compassion meditation techniques has shown that we can actually modify the neural (brain) pathways that control our emotions – please see post from Meditation Increases Our Ability to Be Compassionate.

So, how do we get from here to there? I tend to learn things more easily when they’re numbered or put into lists. Acronyms work well for too. For those inclined to lists, here’s an easy-to-remember list of things that we can do to remember to keep our heart in our work, while keeping our mind in ease.

A Simple List of Things that We Can Do to Maintain a Compassionate Presence at the Bedside:

1. Remember to give ourselves the same love (or care if that’s an easier word to work with) that we want to give to our patients. Don’t we deserve that much care? Where have we gone wrong where we’ve equated selfishness at the expense of others for a genuine love for ourselves, compassion for ourselves? Why do we believe that caring for ourselves is any less important than caring for our patients?
2. Recognize others, those who we care for and those around us, as wanting the very same things that we want, to be happy and to be free from suffering. This can be essentialized when we say, see others as being “another me.” When we think about it, those we care for are like us in their desire to be free from suffering and wanting to be happy.
3. We need to remember, repeatedly, that whatever we’re feeling at the moment will eventually dissipate, and that we’ll be feeling something different within a matter of minutes, days, or even weeks. That is, everything that we experience and feel is impermanent, so if we can remain present in the moment while we’re attending to another, without letting the thoughts and feelings of the moment distract us, we can mind the bedside more easily.
4. We need to remember our connection with others. Like Einstein’s quote, “[we] experience… [ourselves], [our] thoughts, [our] feelings, as something separate from the rest—a kind of optical delusion of [our] consciousness. The delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest to us.
5. Finally, and I stumble on this one constantly, is to forgive ourselves each time that we find ourselves standing knee-deep in mindlessness. Each time that we remember that we’ve forgotten to be present is an invitation to return to our mind and to our intention to care.

Loving Kindness Practice

There’s a practice, you could call a “meditative” practice, called loving kindness that helps us to work with these points. Please feel free to download this Loving Kindness Practice and use it as a support. You can even carry it in your pocket and read from it during your breaks at work, or at home. And, let me know if you need something else to work with; I know that I’m constantly using different tools at different times to support my inescapably distracted mind!