Compassion Fatigue in Hospital/Pre-Hospital Providers

Do you remember your first day of EMT/Medic/Nursing school? Perhaps you were nervous, maybe even excited. More likely than not you believed that medicine was your calling and that you were going to save lives. However many years later and I suspect that you feel differently.

Those of us who pursue emergency medicine face a unique and challenging calling. We entered this profession to save lives, yet now face the reality that most of our patients do not require the life-saving procedures we trained on. Not only are our patients frustratingly healthy, but there are fewer of us to treat them. We are burnt out.

I do not know exactly how compassion fatigue occurs. I suspect that it’s a culmination of the reasons listed above although I suppose that a singular event could lead to a sudden adoption of apathy. Recently I had a conversation with a flight paramedic who I work with and greatly respect. I mentioned how nervous I am about nursing school and that I was particularly nervous about compassion burnout. His response was essentially that we cannot afford to view our patients as people, and that first and foremost they are medical problems that require a solution. At first, this sounds exactly like the very compassion fatigue that I am trying to avoid. To view our patients as not human? This dude must be crazy. And maybe he is crazy, but I think there’s a point here to be had.

I think that while treating patients like organ bags is probably decently damaging to mental health, there is something to be said about separating patient’s from people or humanity. When we treat patients, especially the critically ill, we do things to them that we would never do to a “normal” human being. Chest tubes, IVs, intubations and IO’s are just a handful of procedures that we do on patients in an effort to prolong their lives. I think separating patients from people protects our mental health as providers and therefore actually benefits our patients. While the bare minimum might be obtainable in terms of patient care with burnt-out providers, I think that everyone would rather their patient care team is not full of a bunch of burnt-out assholes.

Maybe what I put forth is ultimately wrong, but I do think there is truth to be had. What is undeniable, however, is that burnout is a serious issue in medicine right now. It’s impossible to find a healthcare-driven career that does not suffer from unreal amounts of burnout and gigantic gaps in employment.