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13/4/2019 1 Comment

Compassion Fatigue AKA Clinical Burnout


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Nothing is ever what it seems

My youngest memory of myself has always been me caring for someone and something, at the time I did not comprehend how powerful or debilitating being constantly compassionate, caring empathetic can be. I remember basing many of my decisions especially becoming a physiotherapist on this super power. I wanted to make a positive impact on a persons life. I chose to give because I wanted to and because I had the capacity too. What I did not realise when you enter a career that involves someone else having authority over your time on; what you give, how much you give coupled with a large complex case load, never ending tasks, poor or limited recourses and so much little time to complete them in., that it can lead to;


  • Clinical Burnout
  • Compassion/ Empathy Fatigue
  • Burnout Syndrome
  • Moral Distress
  • Occupational burnout
  • Secondary Traumatic Stress Syndrome (STSS)

If you had told me as a student being in a giving job could cause you to suffer this I would of said shut the front door why could doing what I love cause me so much pain. Little did I know the first person(s) or thing to teach you about love is also the first thing/ person(s) to teach you about pain.

The term burnout according to many can be understood as a collection of symptoms which include;
  • Mental, Physical and the less spoken about Emotional exhaustion
  • Stressed
  • Insomnia
  • Anxiety
  • Low mood some might even feel depressed
  • Low immune system aka a vulnerability to illness and the list could go on

Much to my surprise this is more common in women then in men, although I wonder whether this is because its under reported. It turns out being a more experience physiotherapist may also put you at a greater risk of developing compassion fatigue, I also wonder whether this is because of mileage and longer exposure to an unforgiving fast paced work environment. I have to admit at some points in my career I have definitely felt a state of emotional exhaustion due to intensive empathic involvement with people who were or are in distress.

When I look back, I did not once remember being taught to be; aware, recognise and or leans to manage clinical burnout. I was so preoccupied after graduation from university feeling unprepared and rushing to get myself up to scratch. Which is very common almost all under grads who graduate feel like they know nothing. The is is usually heighten when you become land your first role as a fresh junior band 5. I remember being thrown into a VERY busy MSK clinic, which felt like I was being put through the conveyor belt. Not only are you expected to know everything (all knowing all seeing god),but you are also expected to have your whole initial assessment complete within 30-40 minutes max, hands washed, diagnosis, prognosis, treatment plan explained, taught and your notes written up in a timely fashion. Because your next patient is already sitting in the waiting room waiting to be seen by you. You then rush to grab the notes from the new patient draw introduce yourself and observe your patient walking down the corridor while you rush to read the notes (try and figure out asap what the hell they are here for and start thinking of what your diagnosis could be). All this should be done while trying not to looked stressed out and rushed off your feet. ​

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​This concept is well documented, known and understood by many yet no mention of this topic at university, or by your colleagues. Until YES you've guessed it when you start showing signs of cracking.
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Their are various challenges with inpatient and outpatient work. But I have to admit outpatients msk I have found to be the most rewarding but also the most mentally, physically and emotionally labouring / draining.

I believe one of the reasons I experienced bur out is partially due to nature and circumstance. Since I can remember I’ve been a carer for my nan and now my mum, it was only natural I that I should end up in a caring role. In addition to this because I care and sometimes self doubt myself I will tend to DO ALL MY I’S AND CROSS MY T’S. What might some might not consider as MSK remit and a falls assessment for instance as non msk. I would consider as patient centered care and as a must especially if they are a falls risk. As a health care professional that works in the NHS we all know how much it costs the NHS should a person’s fall and require treatment. But I also know how significantly traumatising and most often life altering fracture due to a fall can be. I also know how long it takes to get someone who is a falls risk unit a falls prevtion group. So every patient/ client I encounter I see them as someone’s mum, nan, dad, brother, sister. I will endeavour to go above and beyond, because If someone I cared for ended up requiring care then I would want them to also be treated well.

However this kind of work ethic is a double edged sword beucase you need to care to do your job and do it well. What it also means, is this kind of work ethic and characteristic can either be a concoction for beautiful story or a complete disaster.

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1 Comment
Abigail link
20/7/2021 12:45:31 pm

Nice article! Thanks for sharing this informative post. Keep posting!

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    Sevda Onder

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Less than 10 years of post graduate physiotherapy
experience.

60 min £100
45 mins £80
30 mins £65