by Barbara Waldorf BSN, MPH

Throughout my career as a nurse, I have been “burned out” at various times. Along with the impulse to find spiritual freedom, this journey of burnout and creating resilience has brought me to learning and teaching compassion meditation for nurses and other healthcare providers.

There is a particular moment of burnout that can be identified as “hitting the wall”. These moments are the crux point, when things get to be too much and something has to change. My memory of these moments is graphic, even many years later. Handing the tiny silver bracelets of a baby who we had been unable to resuscitate to her grieving parents. Realizing that the patient I had been working with in a community mental health program was not going to stop undermining my every effort to help. That moment of knowing that I needed something more, to find the inner resources, education, time and space, to be able to cope with the work I wanted to do.

These experiences led me to ask many questions. How can we retain the core motivation that inspired us to enter this field of caring? How can we restore ourselves? How can we tap into the resiliency that I knew existed, within the profession and within each of us?

Some of the challenges faced by those working in mental health (and other fields) can be described as compassion fatigue, empathic distress or burnout. Compassion fatigue has been characterized as the “cost of caring” for those in emotional or physical pain (Figley 1982). Because we care, because we have empathy for the suffering we see on the job every day, we are susceptible. These effects are physical, emotional and can result in work related stress. The impact of compassion fatigue and burnout on both providers and patients has been well documented (Lombardo, Eyre 2011).

There are many strategies suggested for nurses on how to reduce the tendency to burn out and the effects of secondary trauma. Lombardo and Eyre write;

“Developing positive self-care strategies and healthy rituals are very important for a caregiver’s recovery from compassion fatigue. Healthy rituals are those activities that one participates in on a regular basis and that replenish personal energy levels and enhance feelings of well being.”

Compassion can be defined in many ways – one is: loving, empathetic concern for someone who is suffering, and wishing him or her to be free and deeply well. Compassion is a core value of all healthcare professions (Baur-Wu, Fontaine 2015)

Meditation is one of the ways that we can learn to evoke our natural compassion. Sustainable Compassion Meditation is such a practice, a means to cultivate the innate capacity to find our own inner resource for replenishment, to cultivate resiliency, and a sustainable source of compassionate presence to others. We are not seeking to find it outside of ourselves, in a better ‘strategy’, but rather to reveal to our self our innate capacity for care and compassion.

The basic understanding of Sustainable Compassion Training is that we are all compassionate by nature. However, our habitual patterns of thinking and judging obscure the free flowing power of care. The purpose of Sustainable Compassion Training meditation is to interrupt these mental patterns with the loving energy available to us in moments of care and connection, so that our innate compassion can manifest.

This involves training in three aspects of care: receiving care, extending care and deepening oneself in the field of care. The practice allows us to touch in on the rich and sustainable source of loving care that surrounds and sustains us all whether we are consciously aware of it or not. It cuts through the essence of burnout, which is the sense that we have no more to give, no place to draw from by creating pathways to that loving energy that is within.

After studying various forms of meditation for many years, I was introduced to Sustainable Compassion Meditation. I am continually impressed by the impact that these seemingly simple practices have on my ability to be present for my patients and myself. They have helped me to access a deeper vulnerability and understanding of the web of humanity that connects us all and allows us to give from a well that truly has no bottom. These practices have great potential to address the epidemic of burnout in the healthcare community.

Thank you to Tamara Daly RN and Ilona O’Connor RN for their contributions to this essay.

Bauer-Wu, S; Fontaine, D. “Prioritizing Clinician Wellbeing: The University of Virginia’s Compassionate Care Initiative.” Global Adv Health Med. 2015;4(5):16-22. DOI: 10.7453/gahmj.2015.042

Figley, C.R. (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. New York: Brunner-Mazel.

Lombardo, B., Eyre, C., (Jan 31, 2011) “Compassion Fatigue: A Nurse’s Primer” OJIN: The Online Journal of Issues in Nursing Vol. 16, No. 1, Manuscript 3.