Self-Care in Healthcare: How Boundaries Prevent Compassion Fatigue

Compassionate Love: Displaying Compassion for Those Who Struggle with Mental Illness   (c)2016  Nancy Virden, Always The Fight Ministries (As originally published  on CIA Medical at :  )

Self-care. When I first heard the term used in a mental health context it came across as selfish. After all, are not  the good guys supposed to focus on rescuing, saving, helping, and serving other people? To me, self-sacrifice was the holier route to achieving ‘good guy’ status.

Due to a variety of health events over the years,  there are many remembered kind faces of medical doctors, first responders, nurses, mental health professionals, aides, and volunteers  that fill me with gratitude. Never are we more vulnerable than when we cannot control scary things happening in our bodies and minds. The service these people provide is irreplaceable for our overall well-being as much as physical health.

What then, of healthcare staff who commonly face trauma and tragedy and want to be  difference-makers? How vulnerable are they to our pain, horror stories, and deep wells of need?

Compassion Fatigue is real

Compassion Fatigue is one term describing the Post Traumatic Stress Disorder experienced by some professionals who are in the thick of helping traumatized patients. Other terms are vicarious traumatization or secondary traumatic stress. Psychology Today reports a survey conducted by PBS Adult Learning Satellite, which reads, “86.9% of emergency response personnel reported symptoms after exposure to highly distressing events with traumatized people”*

Physical and psychological symptoms of Compassion Fatigue may emerge over time, including a growing apathy toward the work, patients, and other relationships. While it may be a struggle to admit, if left unchecked and unaddressed, a caretaker’s ability to help suffers, perhaps leading to an end of career. Talking to a mental health expert is the best recourse for prevention and healing.

F. Oshberg, MD,, author of “When Helping Hurts,” emphasizes the need for understanding Compassion Fatigue and its process. “Compassion Fatigue develops over time … Basically it is a low-level, chronic clouding of caring and concern for others in your life … Over time, your ability to feel and care for others becomes eroded through overuse of your skills of compassion.”**

Three lists to help sustain a long-lasting career in healthcare

I believe the key to maintaining effectiveness includes self-awareness and honesty.  My seminar, How to Help Hurting People Without Hurting Yourself, expands on this idea.  Gaining knowledge about Compassion Fatigue or any other such vulnerability is important, and awareness of one’s need for self-care is a grand beginning to sustaining a long-lasting career. It is honest exploration of exactly what are one’s priorities, strengths, and limitations that is crucial.

If you are in healthcare and work with traumatized clientele, consider creating three lists. In one column thoughtfully write out your commitments and prioritize them. Make sure your basic needs are at the top, and include those people closest to you.  In a second column write out your strengths –  work-related, psychologically, and otherwise. Then honestly and with careful self-awareness, list your limitations. These can include time constraints, temperament, and where your skills are weakest.

These insights will direct your boundaries. For example, such a list teaches me that while empathetic (strength), my work and relationships (priorities) are deeply affected by stress over what I cannot control. It is important to limit hearing detailed stories of abuse or else I may kick-off my major depression (limitation).  Clearly, I am not well-suited for a career working closely with traumatized people! Still, this provides a general idea of the type of analysis I’m suggesting you complete.

Drawing boundaries based on your lists is perhaps the kindest gift you can offer to yourself and to those patients who rely on you. Knowing and not crossing them prevent pitfalls of various kinds including Compassion Fatigue. Ultimately, boundaries preserve best care options because professionals are operating in healthy mindsets and not heading out the door.

Interestingly, your patients will learn from your choices as well. By watching healthcare providers practice personal and professional boundaries, I learned self-care is not selfish. These people retained the capacity to heal because they did not allow my troubles to overcome their sense of role and responsibility.  My self-care muscles grew because I was not unnecessarily rescued at every turn.

Are you taking care of yourself? A quiz

By answering a few foundational questions, you may gain some clarity on your need for self-care.

  • Do I have the facts about possible dangers to my mental health because of my work?
  • Do I understand my role in the lives of my patients?
  • Am I confused, even a little, about appropriate boundaries?
  • Do I know my priorities? Is self-care on that list?
  • Am I growing angry, apathetic, or emotionally exhausted?
  • Am I who I thought I’d be when I entered this profession?
  • Will I look into talking with a therapist about possible compassion fatigue?
  • Do I believe that I matter too?

Self-care is up to each person who deals with trauma’s aftermath in other people’s lives. Gaining knowledge about Compassion Fatigue, understanding one’s needs, and applying  healthy boundaries will make a difference between overcoming or being overcome.

Today’s Helpful Word

Psalm 23:1,2 

The Lord is my shepherd; I have all that I need.  He lets me rest in green meadows; he leads me beside peaceful streams.  He renews my strength.  



Comments are always welcome (see tab below).  NOTE: I am not a doctor or mental health professional. I speak only from personal experiences with and observations of mental illness. In no way is this website intended to substitute for professional mental health care.

If you are struggling emotionally today or feeling suicidal, or concerned about someone who is, please call the National Suicide Prevention Lifeline 1-800-273-TALK (8255). Hope and help can be yours.

*Babbel, Ph. D., Susanne. (2012, July) Compassion Fatigue: Bodily symptoms of empathy. Psychology Today. Retrieved from:

**”Compassion Fatigue. The American Institute of Stress.” The American Institute of Stress. N.p.,n.d. Web. 18 March. 2016.

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