• Recognizing the problem is the first step. Are you feeling overwhelmed, exhausted, unsympathetic, annoyed, or hopeless? Have your sleeping, eating, or exercise habits changed? Do you tend to blame others when things go wrong? Are you trying to cram several activities into every precious moment? Any combination of these symptoms may indicate compassion fatigue.
  
  
• Remember you're not alone. Although doctors may be reluctant to discuss it openly, compassion fatigue is very common in today's multi-tasking world.
  
  
• Take some time off. By the time the problem is advanced enough to recognize, the solution is no longer a "quick fix." Although time off seems "impossible," you're doing yourself and your patients a disservice by continuing work once you've reached this point. You'll need some time to retrain your system – to replace the get-along bad habits with productive, healthful behaviors.
  
  
• Prescribe healthy activities. If you were your own patient, what would you recommend?  More exercise, more balanced (and relaxed) meals, increased time with family and friends, even having fun!
  
  
• Talk with someone. Seek a compassionate listener – a support group, counselor, clergy or colleague who can understand and help you gain perspective on the issues you're facing.
  
  
• Take time for yourself. One of the most consistent symptoms of compassion fatigue is lack of personal time. Restoring health means carving out time for yourself: time to read, write letters, go to a movie, take a walk or do absolutely nothing.
  
  
• Postpone critical decisions. If possible, put off big life changes for a while. When you're deep in the throes of compassion fatigue, the lure of a new job, new spouse, or new motorcycle may seem like the perfect balm. It isn't.
  
  
• Step back from complaining and blaming. If you seem to be surrounded by incompetence, resist the temptation to cast blame on those around you. Consider the possibility that if your life were more balanced, you might be more accepting of others' human-ness.
  
  
• Set some limits. Identify the elements of your life and your practice that are most rewarding and create a working/living plan that will allow you to reach those goals. Establish priorities and set limits on your time. Use these guidelines as you make decisions about new commitments and the direction of your life and career.
  
  
• Once you've returned to work, watch for recurring symptoms. Compassion fatigue crept up on you the first time and relapses can occur. If you find yourself taking refuge in drugs or alcohol or experiencing symptoms such as depression, anger, physical distress (headaches, hypertension, gastrointestinal problems) or reduced self-esteem, break the cycle again and pay more attention to your healthful habits.
  

Your choice of a career in medicine identifies you as a high-achieving, compassionate, hardworking individual. It is exactly these qualities that make you vulnerable to the undermining effects of compassion fatigue. Whether you're experiencing its very first symptoms or are already feeling that all is lost, it is not too late to regain your life and your career. Take action today - for the lasting benefit of yourself and your patients.

Dr. Coleman is on the Board of Trustees of the Mutual Protection Trust.

Copyright © 2005 Marlene M. Coleman, M.D.

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