Health care professionals are known for their honesty, their ethics, and their trustworthiness. For 20-years running, nurses have received the highest ratings in honesty, ethics, and trust than any other profession, according to Gallup's annual polls. They show up with a level of compassion unheard of in most other industries, and that compassion for their patients is what helps to enhance the quality of care.

At the beginning of the COVID-19 pandemic, nurses didn't let that compassion falter. They sacrificed their time—and sadly for some, their lives—to take care of a growing number of sick patients during an unprecedented time. They worked long hours and double shifts to meet the growing demand for health care workers in short-staffed facilities. They gave up time with their families and exposed themselves to the coronavirus every time they went to work, especially when personal protective equipment was so scarce at the time.

After weeks, months, and years of this, you can imagine how the exhaustion and overwhelming need to be always-on started chipping away at their compassion. This is the new reality nurses are facing. And if you're a health care executive, this is the reality for your staff.

What can we do to help fight compassion fatigue in our assisted living communities, long term care centers, and skilled nursing facilities? It is our responsibility as leaders.​

Understanding Compassion Fatigue
In order to address compassion fatigue in health care, leaders must understand exactly what compassion fatigue is. In short, it's an extreme malaise that develops from caring for patients throughout their entire care journey. Over time, this “cost of compassion" results in strain and exhaustion. It starts with feelings of discomfort, transitions into stress, and then ends in a state of fatigue, which is much harder to recover from. This is why early detection and preventative measures are so important. If not addressed right away, it can permanently hinder a caregiver's ability to provide compassionate care to patients.

The extreme empathy nurses feel for patients and their families coupled with the grief they experience on the job leaves them vulnerable to compassion fatigue. They're so enmeshed in their patients' lives and, ultimately, their recoveries, which can lead them to feeling guilt, impotence, anger, or even blaming themselves when a situation doesn't have a happy ending.

How to Fight Compassion Fatigue 
Health care workers are at a unique disadvantage for two reasons. The first is that there hasn't been much global recognition about the negative impacts of working in the industry—until the COVID-19 pandemic. Second, health care staff provide ongoing care to patients and their families and experience trauma on a consistent basis. They can't just walk away from these situations, which makes preventative measures and support even more critical.

Prioritizing Work/Life Balance
COVID-19 not only exacerbated the problem of compassion fatigue, it resulted in a nursing shortage crisis, which hasn't yet resolved itself. The staffing shortage only leads to more compassion fatigue, thus trapping them in a vicious cycle.

While nurses are viewed as caring and nurturing individuals, many find caring for themselves difficult. Facilities must promote a culture where work/life balance is important and give workers the necessary time to invest in themselves. When your employees have the time to focus on non-work-related activities that make them happy, it helps to alleviate the weight of work they carry on their shoulders every day.

It's difficult to leave work at work when you work in health care, so as leaders, it's even more important that we not only instill a work/life balance in our facilities, but that we model it as well.

Ongoing Training/Education
A lack of training and ongoing education can be part of the reason why your employees are struggling at work. By giving them strategies for how to better support their patients, communicate with families who are under stress, and deal with complex situations, you're helping equip your employees with the necessary skills to excel.

Nurses who feel they lack these skills may believe they're incompetent, which leads to more severe anxiety and depression. It's important for leaders to make ongoing training and education a part of their mission, especially when it comes to how to emotionally support patients and families. In skilled nursing facilities and long term centers, for example, training that's centered around end-of-life care will help prepare employees to feel adept in their roles when these situations arise.

Workplace Interventions
Making workplace interventions available to employees will help lessen the emotional strain that nurses feel. Facilities that implement these interventions experience less turnover and generally have happier staff as a result. The sooner we focus on these initiatives, the quicker the health care industry can begin healing itself.

If your facility currently has no offerings, or your menu of interventions is limited, here are three ideas you can start implementing:

• Peer support groups. No one understands what your employees are going through better than their colleagues. Peer support groups are an easy but meaningful way to address emotional difficulties within your facility.
• On-site counseling. Peer support groups are impactful, but inviting in a trained therapist or counselor takes mental health support to the next level. Encourage employees to take advantage of these counseling sessions when they're available, and make sure they're accessible to everyone.
• Debriefing sessions. These sessions are an opportunity to share and explore an employee's thoughts after a certain event has taken place at the facility, usually one that's traumatic or concerning. These are not formal reviews, but rather should lead to genuine conversations with staff and senior leadership. 

While compassion fatigue is commonplace in the health care industry, we should not accept it as such. Leaders must step up to the plate and devote their attention to combating compassion fatigue in the workplace. If we don't, we're failing our employees. 

Bent Philipson is the founder of Philosophy Care, a consulting firm providing a range of services to skilled nursing facilities throughout New York and New Jersey.