In addition to wearing personal protective equipment (PPE) to avoid exposure to the coronavirus, health care providers should take steps to protect themselves from other risks of the COVID-19 pandemic — burnout and compassion fatigue.

Burnout is a combination of emotional exhaustion, depersonalization and a reduced sense of personal accomplishment. Burnout is the result of not being able to reach personal goals or achieve work results, which can feel like a loss of control.

When burnout is combined with secondary traumatic stress — repeated exposure to other people’s loss and suffering — the result can be compassion fatigue. With compassion fatigue, providers risk not being empathetic and sympathetic to other people’s experiences, which puts them at risk for negative clinical outcomes.

“It is critically important right now as providers that we’re protecting ourselves in order to be able to deliver the highest level of quality care to our patients,” said Elizabeth M. Archer-Nanda, DNP, APRN, a board-certified psychiatric clinical nurse specialist with Norton Cancer Institute’s Behavioral Oncology Program and member of a national working group that addresses burnout and compassion fatigue.

Exhausted even with fewer patients

Symptoms of compassion fatigue include anger, irritability, negative coping behaviors and exhaustion, even though the overall patient volume may be lower.

“I’ve heard a lot of folks talking recently about just coming home and being completely exhausted,” Elizabeth said.

According to Elizabeth, it is important that providers be mindful about avoiding such negative coping behaviors as alcohol and substance abuse. If you’re feeling out of control with changes in how care is being delivered, she shared, it’s vital to find ways to reduce nonurgent activities to allow for self-care. This means protecting sleep, getting good hydration, exercise and good nutrition — minimizing binge and comfort eating.

“As leaders, we’re often called to instill a sense of calm for our teams and our families, and we may not be feeling that calm ourselves,” Elizabeth said.

Talk to yourself as you would a friend

Not being able to achieve desired patient outcomes, especially during the COVID-19 outbreak, can lead to feelings of guilt and diminished morale. Providers who feel out of control need to remind themselves they are doing everything possible, which can help diminish feelings associated with helplessness. This balance requires both showing empathy and controlling challenging emotions associated with care delivery during this challenging time, according to Elizabeth.

“A tool I often use in therapy with patients is asking them, ‘I have to wonder what you might say to your best friend in this scenario, because I really think you wouldn’t be as hard on your best friend as you’re being on yourself,’” Elizabeth said.

She suggested that it is also important to recognize front-line staff who may be suffering from burnout and compassion fatigue and help them take a step back or give them the space to talk about the intensity and challenges of adjusting to the new, not-so-normal.

The coronavirus has created a time of stress and anxiety, which can lead to fear. All of this requires adjustment. This time of change also presents an opportunity for resilience. Elizabeth reminds health care providers that they need to focus on finding meaning and  purpose in every interaction by asking themselves a simple question:

“How can I be present in each moment, whether it’s a leadership moment or a moment in patient care, to be mindful and focused on the task at hand?”