Faculty of community services students susceptible to compassion fatigue

 

By Allison Ridgway

Far from home and working at a residential treatment camp for youth with mental health issues, Leena Chudasama felt a sense of helplessness slowly creeping in.

It was the Ryerson child and youth care student’s first program placement, now three years ago, and she enjoyed the work — it  was what she was training to do. But at the same time, as she spent each day learning more and more about the difficult lives of the 12- to 18-year-olds she worked with, their traumatic experiences began to haunt her.

Even worse were the times when she couldn’t help them, either because they refused to respond to her help, or their situation was simply out of her hands. Those moments ate away at her.

“You feel very helpless when that happens,” says Chudasama, now co-president of the Child and Youth Care Course Union. “I started putting myself in these young people’s shoes. I took all of their experiences and piled them up inside me. It became unhealthy.”

Chudasama is not alone in her experience. Caring for others can be rewarding, but it can also be heart-rending. Many of those employed in the caring professions — social work, nursing, child and youth care and others — hear a plethora of horror stories throughout their daily professional lives.

And as much as a worker may want to care deeply about each patient and client’s story, such stories of trauma can easily become overwhelming — exhausting even. That’s when compassion fatigue sets in.

When psychologists speak of compassion fatigue, they’re often talking about world-weary professionals who’ve become emotionally drained after many years of working the front lines with sick and traumatized people. But compassion fatigue can also affect students, says Faculty of Community Services counsellor Joanna Holt. Particularly, students are affected when they’re faced for the first time with clients who’ve experienced trauma, abuse and grief while working at placements or internships.

“I started putting myself in these young people’s shoes. I took all of their experiences and piled them up inside me. It became unhealthy.”

— Leena Chudasama

“Community services students who work in their field during a placement will likely hear about or witness the impact of trauma on their clients and patients,” Holt explains. “The problem occurs when the overall enormity of loss builds up inside you, when it increases your anxiety and you begin to feel hopeless.”

Many of the symptoms of compassion fatigue are similar to those of depression: exhaustion, sleeplessness, social isolation, loss of interest in activities you once enjoyed, irritability or anger, increased use of drugs and alcohol, hypersensitivity or insensitivity to emotional materials and intrusive negative thoughts and imagery.

Compassion fatigue also exists within a continuum, affecting a student or worker at various times in their lives and in various ways. It’s influenced by many different personal, professional and life circumstances.

“Normal stress can tip into compassion fatigue,” says Holt. “You might feel stressed but still be managing, and then one more stressful thing hits — life happens — and you feel completely overwhelmed.”

When this happens, she explains, it is easy to fall into patterns of self-neglect.

When she realized the effect that working at the camp was having on her, Chudasama realized that, in order to take care of her young charges, she’d have to work harder at taking care of herself.

“I’d never really taken the idea of self-care into consideration,” she explains. “I’d just figured these feelings were a part of the placement process because I’m working with kids who are at risk.”

But by Chudasama’s fourth week at the camp, she knew she had to find a way to distance herself from the difficult stories she heard, or else risk her own health. So, she began to set aside time in her busy schedule to do things for herself, like reading, listening to music, even colouring. Her solution may seem simple, but it worked.

“I did anything that could get me disconnected from the world around me for a little while,” she says. “I focused on what I like doing and what I needed in the moment.”

The practice of self-care is imperative for students completing demanding and emotional placements, says Chudasama’s co-course union president, Kimberley Slimming. The child and youth care student says her professors have played a big role in emphasizing this in class.

“Students will come in and you can just tell that they’re thinking about something that happened, that they’re distraught,” she says. “They’ll bring the scenario to class and with the help of other students and the professor, it becomes a collaborative effort in figuring out how they can make a change at their placement or how they can just let go of the situation a little bit.”

Unfortunately, this may not be the case in every community services department.

“I feel like our entire program should have more of an understanding (of compassion fatigue),” says Eleanor Yip, president of Ryerson’s Nursing Course Union.

Betty Wang, the course union’s vice-president, agrees that the program is too theoretical.

“We learn about different people’s theories on things like stress and grief, but we don’t really learn how to deal with it ourselves.”

During their first-year orientation, both students remember their instructor and counsellor discussing where to find mental health help on campus. But after that initial lecture, their classes rarely mention how to deal with strenuous, 12-hour work shifts and the emotional turmoil of losing a patient.

Although nursing is by definition a caring profession, to care too much or get involved with a patient is considered unprofessional. Students are taught to keep a distance: no visiting a patient outside of work hours or getting too involved in the patient’s personal life. In a way, it can also act as self-preservation: create a professional barrier and you won’t start taking your work home with you each night.

Yet sometimes, Wang says, the ability to get a patient the extra help they need is just the morale boost a worker needs to combat feelings of helplessness.

“We learn about different people’s theories on things like stress and grief, but we don’t really learn how to deal with it ourselves.”

— Betty Wang

During her second placement at a downtown Toronto hospital, one patient in particular affected her.

“He had a lot of social issues — drugs, homelessness — and there were a lot of things going on in his life,” Wang remembers. “I felt extremely bad for him. He had no family and no one to rely on. I felt compelled to do something.”

As Wang learned more about the patient’s life, she took this information to another nurse. Together, they found him a social worker.

Even after her placement at the hospital was over, Wang visited the man a couple of times. She found out that he’d gotten the resources he needed, including social assistance, community housing and support, thanks in part to her.

However, she hasn’t seen him since.

“I know there are certain boundaries that have to be maintained now,” she says. “And I know that personally I can’t keep going back and forth, worrying about him. There are too many other patients.”