Compassion fatigue: Running on Empty
By: Judson Smith, MHA, Paramedic
Fire and EMS professionals often choose our profession because we are attracted to public service. We believe that we have something to give back, and want to be part of a team that contributes to the communities we live in and the citizens we serve. But seeing trauma and suffering as much as we do can have a very deep and emotional impact on us.
If you have been in this business for a while, there has certainly been a time when you felt disconnected while caring for a patient. You were either exhausted, sleep deprived or just running on empty! Compassion fatigue is something we have heard about, but nothing we have ever been trained on.
Charles Figley first identified compassion fatigue by the phrase, “the cost of caring.” He defined it as “the stress resulting from helping or wanting to help a traumatized or suffering person.”
Compassion fatigue can lead to emotional exhaustion or scarring, and even physical pain. After repeatedly seeing and hearing the pain that our patients experience, we can begin to lose our ability to be empathetic. We start losing enjoyment in the work we do and in some cases, compassion fatigue can develop into depression, PTSD, and even stress-related illnesses. We can mistakenly think a co-worker is having issues at home when we see these changes, when in fact their entire demeanor could be directly related to what I like to call, “Running on Empty”, because this career is so demanding emotionally and physically.
Signs & Symptoms
You may notice yourself or a colleague becoming increasingly mood or irritable. They may try to avoid contact with patients or co-workers as much as possible.
You may also notice colleagues who used to be engaged and now seem to be apathetic and spend more time by themselves while at work. They have a reduction in productivity or they no longer finish assignments like truck checks, restocking the equipment, run reports or even conversations with colleagues about the calls they have run together.
Compassion fatigue is real. It is ok to raise your hand and ask for help. With personal support, social support and professional counseling, it can be managed. I know that is easier said than done considering fire and EMS providers tend to keep all of our feelings inside.
If you are suffering from these signs and symptoms, know that you are not alone. Compassion fatigue may be the feeling of running on empty, however it is not something you have to go through alone.
“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.” “Rachel Naomi Remen”
 Figley CR, editor: Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. Brunner-Routledge: New York, p. 268, 1995.
Judson Smith brings more than 20 years of experience in emergency medical service to his role as Vice President of Continuing Education at Career Step,the parent company of Medic-CE. A licensed critical care paramedic, heal so currently serves as an officer in an Air Force Reserves aeromedical evacuation squadron. In 2014 Judson founded Code3 CME, an education company focused on providing live, instructor-led training with online flexibility. His goal in founding Code3 CME was to provide EMT, paramedic,and critical care transport training with a level of educational support he felt was lacking in the industry. Career Step acquired Code3 CME in 2016, and Judson joined Career Step at that time. Judson holds a master’s degree in Healthcare Administration from Lindenwood University.