Compassion Fatigue

If you poll a hundred different health care professionals and ask for the greatest issue facing health care today, you may get a hundred different answers. But I believe you can narrow it down to ground zero of the health care crisis – compassion fatigue. We have lost the care in health care.

Though often used interchangeably and share some mutual characteristics, compassion fatigue and burnout are not the same. Burnout refers to the environment, not the trauma. It’s the nurse who is exhibiting alarm fatigue in the ICU and no longer “hears” the alarms of her patients. The accountant whose demanding job leaves them with dwindling job satisfaction. Compassion fatigue on the other hand, refers to the act of caring itself, or the inability to care and connect. The slow erosion of one’s ability to experience the human connection due to secondary traumatic stress or distress causes a ripple effect throughout the health care system.

Picture a man who is a quadriplegic due to a motor vehicle accident. For a year and a half, his care team worked to have his electric wheel chair approved. Not only would it improve his quality of life, it would reduce health care costs. No more ambulance transfers to and from dialysis three times a week.

Progress was halted as a check box got missed in his physician’s office during prior authorization. This claim was denied, and appealed, and denied again, because of the same missed box. A physician, three nurses, and various support staff saw the request come in repeatedly throughout the course of a year.  There were dozens of phone calls made from the family, pleading for approval. How did this happen? Compassion fatigue, depersonalization; to them this was a case, a review, a chart. No one pulled back to say, “This is a human being who is suffering. Let me help”. I’d contend that they were not always like this. At first, they probably took the time for the peer-to-peer review, to make the call, to refax requests, and have a more personal touch.

We could fill pages in a book of more examples of how compassion fatigue affects health care. From the individual at the front desk who no longer sees the patients checking in as people, only their diagnosis, to the doctor whose family life has fallen apart because he or she has built up an emotional wall the last 15 years of clinical medicine.

When we as a health care system see people as a diagnosis, a claim, a number, a box to check – we are missing an opportunity to create positive and lasting change. The system continues to degrade and our work becomes automatic. It is a task, rather than a patient focused process. Those suffering from compassion fatigue often do not realize the extent it has on themselves and their work. They lack the ability to concentrate, they are apathetic, and their work no longer has the purpose it once did. Simply put, they cared, they cared too much, and their compassion fatigue is the cost of caring.

At UnitedHealth Group all our employees are encouraged to walk in the shoes of people we serve and those with whom we work. By offering mental support to all employees, we make sure we can continue to celebrate our role in serving people in an area so vitally human as their health.

Learn more about our culture, including the role Compassion plays at our organization.