Overcoming Compassion Fatigue for Hospice Care Workers

January 19, 2021

Being in an industry where compassion is woven into the framework presents its own set of challenges.  Health care providers who care for patients with serious illness need to have a well-developed sense of empathy, however continuously providing compassion for others without also providing adequate care for oneself can be harmful to even the best-intentioned healthcare provider.  Multiple negative emotions can commonly result when a patient is nearing the end-of-life, including grief, fear, conflict and desperation.  Healthcare professionals are not immune or exempt from these emotions that can easily be contagious during such difficult times.  

Signs of Compassion Fatigue

According to an article published in Family Practice Management, compassion fatigue is defined as “a deep physical, emotional and spiritual exhaustion accompanied by acute emotional pain,” (Pfifferling, et al., 2000). It can appear differently in each individual, but according to the authors, common symptoms of compassion fatigue include:

  • Anger
  • Depression or anxiety
  • Gastrointestinal problems
  • High blood pressure
  • Addictive behaviors
  • Difficulty sleeping
  • Physical or emotional exhaustion
  • Irritability
  • Diminished self-esteem

Self-Care and Coping Strategies

Ideally, healthcare professionals should possess what researchers call “compassion satisfaction” which is defined in an article published in the Journal of Psychiatric Nursing as “the pleasure you derive from being able to do your work well, creating new life values” while compassion fatigue is defined as “a negative consequence that occurs when helping with the pain and trauma of the individuals being cared for,” (Yilmaz, G. & Ustun, B, 2018).  Self-care can improve the element of compassion satisfaction.  Other than the typical stress-eliminating techniques (exercise, creating boundaries, etc.), some other methods have shown to help compassion fatigue specifically, such as self-awareness and rituals.


Research that was reported in the Journal of the American Medical Association has shown that engaging with patients and situations in a highly conscious, and aware state—specifically moment to moment—could assist in preventing compassion fatigue with healthcare providers.  The idea is to practice mindfulness by paying close attention to one’s own emotions and reactions (their internal reality), while consciously working to meet the needs of others (their external reality). The researchers identified that this mindful approach to working, combined with mindful meditation and journaling, has shown to reduce stress, enhance well-being and increase empathy in healthcare providers, (Kearney, M. K., et al., 2009).


In an online survey of hospice staff across 38 states, 71% of respondents reported using personal rituals such as lighting candles, praying, attending funerals and calling patients’ family members. The results were published in the Journal of Palliative Medicine, and showed that professionals who developed rituals around the death of their patients, scored higher on a compassion-satisfaction scale and lower on a burnout scale, (Montross-Thomas, L. P., et al, 2016). 

Make sure to maintain the usual antidotes to compassion fatigue, such as eating well, resting well, and exercising.  Additionally, before taking on the role of the rock that everyone else leans on, implement some mindful activities to keep yourself on an even keel.


Pfifferling, J-H., & Gilley, K. (2000). Overcoming compassion fatigue. Family Practice Management, 7(4), 39-44. https://www.aafp.org/fpm/2000/0400/p39.html?printable=fpm

Kearney, M. K., Weininger, R. B., Vachon, M. L. S., Harrison, R. L., & Mount, B. M. (2009). Self-care of physicians caring for patients at the end of life. Journal of the American Medical Association, 301(11), 1155-1164. https://jamanetwork.com/journals/jama/article-abstract/183563

Montross-Thomas, L. P., Scheiber, C., Meier, E. A., & Irwin, S. A. (2016). Personally meaningful rituals: A way to increase compassion and decrease burnout among hospice staff and volunteers. Journal of Palliative Medicine, 19(10), 1043-50. https://www.liebertpub.com/doi/abs/10.1089/jpm.2015.0294

Yilmaz, G. & Ustun, B. (2018). Professional quality of life in nurses: Compassion satisfaction and compassion fatigue. Journal of Psychiatric Nursing 9(3), 205-11. https://jag.journalagent.com/phd/pdfs/PHD-86648-REVIEW-YILMAZ[A].pdf

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