Holding Humanity: Compassion Fatigue, Burnout, and the Cost of Care for Emergency Workers

Perhaps the symptoms are vague: a little fogginess, more irritability with those you love. They slip in subtly and you think, “Only one more shift…”

Perhaps they’ve progressed, and you’re having difficulty concentrating, sleeping, or enjoying the things you once did. You think, “Of course I’m tired, I’ve worked three in a row.”

Maybe these symptoms have escalated to the point of headaches, panic attacks, or other physical ailments.

So often, we as emergency workers override our own needs to care for others. We can squeeze ten more minutes out of a full bladder. We can eat our lunch one bite at a time over the next two hours. We can go another hour without refilling our water—especially if it means our patients get what they need.

But what happens when the effects of all this self-sacrifice compound? What happens when caring becomes too heavy?

Society’s Secrets

Those of us who have worked as emergency responders or in the emergency room know the secrets of the world behind closed doors—the stories most people never see, the truths few want to speak aloud.

We have borne witness to both the tenderness and the tragedy of being human: the aftermath of violence, the quiet strength of survivors, and the unfathomable moments we call “freak accidents.”

We have cared for the guilty, the innocent, and everyone in between.

And while we show up again and again, we rarely pause to ask: What toll does it take to hold these stories? To witness the harm one person can cause another? To see life slip away from someone? To observe unbearable suffering or pain?

At what cost do we continue to carry the weight of what others cannot?

Defining the Invisible Load

The three most common words I hear related to the effects of stress in the emergency workplace are burnout, compassion fatigue, and vicarious trauma.

I want to clarify their differences while acknowledging that anyone working in emergency or healthcare settings is at risk for these experiences—if not already coping with them.

• Burnout is a state of physical, emotional, and mental exhaustion caused by long-term involvement in emotionally demanding situations. Symptoms may include depression, cynicism, boredom, loss of compassion, and discouragement.

• Compassion fatigue is a combination of physical, emotional, and spiritual depletion associated with caring for others who are in significant emotional pain and physical distress.

• Vicarious traumatization is a negative reaction to trauma exposure and includes a range of psychosocial symptoms that providers and responders may experience through their work with those who have experienced trauma. It can include disruptions in thinking and changes in beliefs about one’s sense of self, safety in the world, and trust in others, as well as shifts in spiritual beliefs. Individuals may also exhibit symptoms that can have detrimental effects both professionally and personally.

  
  

Signs and Symptoms

Just remember: your body is working to protect you and to cope. Two of the most important things to know are that there is nothing wrong with you—and that you are not alone.

Everyone is different, and symptoms can vary, but these are some signs that the load may have become too heavy:

• Emotional: irritability, cynicism, numbing, guilt for not “caring enough.”

• Physical: fatigue, headaches, insomnia, immune changes.

• Behavioral: withdrawal, decreased empathy, mistakes at work, self-blame.

• Relational: less patience with loved ones, emotional disconnection.

The Compounding of Emergency Culture

We all know the inadequate debrief—the feeling of having to keep going through our shift. We walk into the next room with a not-sick patient and are still trying to shake what happened next door.

Not to mention the abuse we sometimes endure from patients, families, or even colleagues: the verbal assaults, threats, or dismissive remarks that accumulate quietly alongside the trauma we witness. The tradition is to keep moving, keep working, keep giving.

I wonder: has this silent suffering and stoicism become ingrained in us so that we continue working through understaffed shifts and essentially become the make-up kit for the systemic lack of mental health resources in our communities?

Has it become antiquated yet that the “badge of the strong” belongs to those who don’t let what happens in those rooms affect them?

All these lapses in the system seem to somehow land on the shoulders of emergency workers, compounding the stress we experience. What can we do to go on?

Reclaiming Compassion

Most of us in emergency medicine enjoy people, love the skills we get to use, and want to keep working in the field. To heal, we must make small, attainable goals and frame our work from a place of self-compassion.

Some key steps include:

• Name what you carry. Recognizing what is happening to you is key.

• Peer debriefing and support. Reach out to understanding co-workers and leaders.

• Creative expression (art, writing, movement). Expression is a form of release. Creativity can take pain and transform it into something processed and beautiful.

• Connection to nature, ritual, or spirituality. Nature is a co-healer, and spiritual practices can reconnect us to something larger than ourselves.

• Therapy or counseling. Many workplaces offer EAP or other therapeutic services, especially after traumatic exposure.

How Therapy Can Help

Within a therapeutic relationship, you can explore the consequences of caring as well as the boundaries that may need to be established for you to continue doing so.

A counselor can support you in working through your emotions, listening to the stories you’ve witnessed, and helping you process those experiences.

In a judgment-free space, you are invited to share the fullness of your humanity with someone who understands.

We might explore:

• What pain have I been holding that isn’t mine?

• What parts of my care have I neglected to extend to myself?

• What do I need to feel restored again?

However you choose to move forward in your healing, understand that empathy and boundaries can coexist.

We can hold the secrets of our communities—but not at the expense of our well-being.

If you recognize yourself in these words, know that you’re not broken: you’re human.

Your compassion is still your strength, even when it feels heavy. It’s okay to lay it down sometimes.

Ready to Reconnect with Yourself?

If you’re feeling the weight of caring for others and ready to begin your own healing, we’re here to support you.

At Her Time Therapy, we help women move through burnout, rebuild self-trust, and reconnect with the parts of themselves that have been quieted by stress or compassion fatigue.

You deserve to feel whole again—to care deeply without losing yourself in the process.

Let’s begin together.

Call/Text (303) 900-8225 | info@hertimetherapy.com | www.hertimetherapy.com

About the Author

Theresa Fagundes is a Graduate Student in Clinical Mental Health Counseling and an intern therapist with Her Time Therapy, LLC. With a background in nursing and trauma-informed care, she brings a compassionate, holistic approach to therapy—blending mindfulness, expressive arts, and somatic awareness. Theresa is passionate about helping women reconnect with their inner strength, heal from trauma, and cultivate self-trust through creativity and reflection.

Disclaimer: This blog does not provide medical advice; the information contained herein is for informational purposes only. Always seek the advice of a licensed health provider before starting a new treatment regimen.

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