Compassion as an antidote to Burnout in Healthcare Professionals

Can we use up all our compassion until we’re emotionally drained? Should we ration empathy to protect ourselves? We look at Stephen Trzeciak’s theories on the ‘compassion crisis’ in healthcare and which interventions might help to resolve it.

In his book ‘Compassionomics’ (Trzeciak and Mazzarelli, 2019), Stephen Trzeciak examines the relationship between compassion and burnout in healthcare professionals and how research should guide the interventions we put in place to help reduce burnout.

Typical interventions might include anything from reducing working hours to taking a holiday to connecting with nature – all of which are beneficial to wellbeing – but, Trzeciak argues, they have only a modest impact on burnout in the healthcare workforce. What these things typically have in common is that they build resilience through escapism. He looks at the evidence for ‘leaning in’ instead of pulling away.

It might be logical to assume that when you are regularly faced with human suffering, you need to shield your heart and mind by reducing your empathy and staying dispassionate, to avoid being overwhelmed with the pain of others.

It’s true that decades of research has shown a direct relationship between burnout and compassion, but it’s an inverse correlation. The higher the levels of compassion, the greater the wellbeing and the lower the instances of burnout. In fact, studies suggest that compassion may have a protective effect against burnout. People aren’t getting drained by frequently demonstrating compassion, they are emotionally exhausted from being prevented from doing so. Might then compassion be the antidote to burnout?

Trzeciak and Mazzarelli realise the world may need a bit of convincing, so they compiled a wealth of studies that seem to support their theory.

Most of the studies mentioned here are observational studies looking at associations between compassion and burnout… the most compelling evidence comes from research with an experimental design where prescribed interventions are tested. – Compassionomics (Trzeciak and Mazzarelli, 2019)

How do we even quantify wellbeing or burnout? Self reporting is typically used to gauge levels of these things. However, the research cited in this book has also included measuring pleasure responses to compassion for others – for example, brain scans showing reward centres being activated by compassion – and testing for stress responses, such as hormones found in the blood. Other studies have measured endorphin levels (‘helper’s high’), as well as symptoms of depression. Patient satisfaction surveys have also shown to be a reliable indicator of compassion levels amongst caregivers – people notice.

if more compassion truly does mean less burnout, then nurturing compassion will not only lead to a better patient experience, it will also mean better patient outcomes, fewer medical errors, less staff sickness absence, higher retention rates and an increase in both job satisfaction and wellbeing.

So once it’s found lacking, how do we increase compassion in order to enjoy these benefits? It could be – and frequently is – argued that part of the problem is that healthcare professionals don’t have time to demonstrate compassion to the extent they would wish to in their patient interactions. However, a 1999 study by John’s Hopkin’s university of 210 patients concluded that it took less than a minute of extra time for caregivers to interact in such a way that people felt ‘enhanced compassion’. Just 40 seconds, on average. This enhanced compassion was conveyed through eye contact, active listening, choice of words and fewer interruptions.

Relationships matter.

So what interventions have worked in the studies that Trzeciak and Mazzarelli cite?

Work life balance is important, but only part of the story.
An important part of healing our ‘compassion crisis’ comes at the point of care.
Focus on quality human relationships, and making meaningful connection – with patients and also with one another.
Colleagues should care for one another to reduce loneliness and isolation at work.
Compassion training can have a significant impact in a short amount of time.
A workplace culture should value and reward compassion.
Meditative practices that focus specifically on relieving human suffering can bring results event after a few minutes. (One study showed 1.7 hours a month was effective.)
Facing suffering with the knowledge that you are able to help relieve it builds resilience.

You can find out more about Trzeciak and Mazzarelli’s work here: Compassionomics | Evidence That Caring Makes a Difference

Compassion as an antidote to Burnout in Healthcare Professionals