By Holly N. O'Reilly, Ph.D.
Dec. 9, 2020

PHCoE graphic

2020 has been a year like no other. For many of us, our "normal" lives have been overshadowed by a global pandemic, historic wild fires, civil unrest, a divisive election and social distancing. Life as we know it has changed considerably since March. Perhaps nobody has felt the impact more than health care providers who have experienced unprecedented levels of physical and emotional strain. As the year draws to a close, it may be wise to revisit the sister concepts of burnout, vicarious traumatization and compassion fatigue.

A Quick Review of Definitions

Burnout may be experienced in any profession and is often described as a general fatigue or weariness and feeling overwhelmed or disenchanted with one's work.

Vicarious or secondary traumatization can be described as indirect exposure to traumatic events through first-hand accounts or narratives of the events, and may be experienced by professionals who work with trauma survivors. Symptoms of vicarious trauma include intrusive imagery, decreased trust in others, feeling disconnected, a sense of loss of control and/or increased safety concerns, typically with a sudden onset or awareness of these issues.

Compassion fatigue is often described as "having nothing left to give" or as an erosion of one's level of compassion. Any of these related phenomena may lead to a decrease in empathy for patients and subsequently a decrease in the quality of patient care.

Tips for Preventing Burnout

• Minimize isolation. Given the current guidance on social distancing, you may need to consider new ways to connect with others.
• Fully utilize healthy coping skills. Get an adequate amount of sleep, exercise regularly and engage in self-care practices. You may need to significantly increase your self-care routines or incorporate new strategies.
• Check-in with yourself or someone you trust regularly. Recognizing issues early on will allow you to intervene more effectively if necessary.
• Maintain a reasonable work-life balance. When your day is filled with obligations (without leisure activities) it is easy to feel overwhelmed or burned out.

Tips for Treating Burnout

• Consider joining a support group.
• Consider psychotherapy with an experienced clinician.
• Engage in healing activities such as journaling, artistic endeavors, religion, spirituality and exercise.
• Take some time to be grateful. During times of great or prolonged stress, it can be very easy to focus much of your attention on the tasks of daily living. Take time each day to be grateful for something, no matter how small. It may be helpful to look outside of yourself and your immediate surroundings.
• Make a change in your routine. If you have been working out regularly, consider a change in your workout. Perhaps you can try a new type of exercise or consider an online exercise platform or app in order to incorporate variety in your routine.
• Practice mindfulness which allows you to be fully present in the moment without judgement or distraction. Research supports the notion that mindfulness reduces stress and anxiety while improving focus. Numerous practices cultivate mindfulness including meditation, yoga, and tai chi.
• Take time to do something that you truly enjoy. Any interest, hobby or activity that brings you joy or helps you to feel refreshed would be a great use of your time.  When you do find time for your hobby, focus on the enjoyment of the activity, not the finished product.

Resources

Military mental health providers can find information and resources on compassion fatigue, burnout and self-care on the PHCoE website.

The Provider Resilience mobile app is designed to help providers build resiliency against vicarious traumatization, burnout and compassion fatigue. This resource includes a variety of self-care tools as well as a self-assessment rating so that one can monitor progress over time. Find more information and download instructions on the Defense Health Agency Connected Health website.

The Center for Deployment Psychology offers COVID-19 Behavioral Health Resources to help providers support military-connected patients, including other health care and frontline workers, during the pandemic.

The Professional Quality of Life Scale (ProQOL) is a self-assessment tool developed to measure the positive and negative impact of working with traumatic stress survivors. Sub-scales include compassion satisfaction, burnout and compassion fatigue.

The National Center for PTSD Clergy Toolkit provides easy-to-use resources to aid clergy in their work with service members and veterans who have or are at risk for developing PTSD.

Dr. O'Reilly is a clinical psychologist and sexual assault/harassment SME at the Psychological Health Center of Excellence. She specializes in the consequences of psychological trauma and women’s mental health.