Compassion Fatigue:
When Caring Starts to Cost You

Ever noticed that after a particularly tough shift, you feel drained in a way that sleep alone can’t fix? Or found yourself growing numb to situations that once would have moved you deeply? Maybe you’ve caught yourself thinking, “I just don’t care anymore,” and then felt guilty for it?

These aren’t signs that you’re bad at your job or not cut out for emergency work. They’re potential symptoms of compassion fatigue—a natural response to repeated exposure to others’ trauma.

At Emergency Fit, we understand that the emotional weight of emergency work is just as real as the physical demands. Your job requires not just your skills and knowledge, but also your heart—and that comes with its own kind of exhaustion that many people outside the industry simply don’t understand.

In this article, we’ll explore what compassion fatigue really is, how it affects your mind and body, and most importantly, practical strategies to protect yourself while still providing the care your community needs.

What Is Compassion Fatigue?

Compassion fatigue is the emotional and physical exhaustion that can develop when you’re repeatedly exposed to other people’s trauma and suffering. It’s sometimes called “the cost of caring”—because it happens specifically to people who do important care work.

While burnout develops gradually from workplace stressors like staff shortages or excessive paperwork, compassion fatigue is different. It tends to hit suddenly after a traumatic event or build up over time from accumulated exposure to others’ suffering.

For first responders, this might look like:

• Responding to multiple serious car accidents in a single week
• Caring for a child who reminds you of your own
• Being the first on the scene to a particularly disturbing incident
• Witnessing community-wide trauma during natural disasters
• Making life-or-death decisions when resources are limited

Experiencing compassion fatigue doesn’t mean you’re weak or unsuited to emergency work. In fact, it often affects the most dedicated professionals—the very people who care deeply about making a difference.

The Science Behind Secondary Trauma

To understand compassion fatigue, it’s important to understand what’s actually happening in your brain and body when you’re exposed to others’ trauma.

Research shows that witnessing trauma can trigger similar stress responses to experiencing it firsthand. This is called “secondary traumatic stress,” and it’s what causes compassion fatigue.1

When you respond to emergencies day after day, your brain’s threat detection system stays on high alert; your body keeps producing stress hormones like cortisol. These are helpful in short bursts but harmful when constantly elevated.2 Over time, this can physically change how your brain processes emotional information.

A study comparing medical and non-medical students found that medical students showed less activity in brain areas associated with empathy.3 This suggests that the brains of people exposed to continual trauma and suffering adapt to try to protect themselves.

The effect? A dampened emotional response—explaining why many in caring professions report feeling numb or disconnected.

Left unchecked, compassion fatigue can take a serious toll on your life. On a personal level, it can lead to depression, worsened sleep, and substance use as a way to cope with difficult emotions.4, 5, 6 At work, it often shows up as increased mistakes, more sick days, and thoughts about quitting the job altogether.7, 8, 9

Recognising the Warning Signs

Compassion fatigue doesn’t usually announce itself with a single, obvious symptom. Instead, it tends to creep in gradually, showing up in different areas of your life. Knowing the early warning signs can help you take action before it seriously impacts your health and work.

Physical Signs

• Constant fatigue that doesn’t improve with rest
• Disrupted sleep patterns
• Getting sick more often than usual
• Unexplained headaches or body tension

Emotional Signs

• Feeling emotionally numb or detached
• Increased irritability or anger
• Decreased satisfaction from helping others
• Persistent sense of dread about work

Behavioural Signs

• Going through particular emergency situations on autopilot
• Using alcohol, food, or other substances to cope
• Withdrawing from colleagues and social activities
• Making more mistakes or forgetting procedures

In Your Personal Life

• Struggling to be emotionally present with loved ones
• Loss of interest in activities you used to enjoy
• Becoming emotionally cold or detached with friends and family
• Taking out work frustrations on family members

If you’re nodding along to several of these signs, you’re not alone. A survey of urban paramedics found that almost half experience frequent symptoms of compassion fatigue.10

But here’s the good news—research shows that the effects of compassion fatigue can be reversed. With the right recovery strategies, you can restore your capacity for empathy and connection while maintaining the resilience needed to do your best work.

Prevention Strategies That Actually Work

Preventing compassion fatigue isn’t about becoming tougher or caring less—it’s about creating sustainable patterns that allow you to care deeply without depleting yourself.

To help, here are four powerful science-backed strategies you can try.11

Skills Acquisition

One of the biggest challenges in emergency work is finding the right balance between compassion and detachment. You need to care enough to provide quality care, but not so much that every case drains you completely.

• Learn grounding techniques to quickly re-center yourself between challenging calls—like the 5-4-3-2-1 sensory exercise (notice 5 things you see, 4 things you feel, 3 things you can hear, etc.).
• Master quick stress-reduction techniques such as controlled breathing or progressive muscle relaxation to calm your body when you feel overwhelmed.
• Develop the ability to recognize your personal “silencing response”—the moment when you start shutting down emotionally because you’ve reached your capacity.

Self-Care Practices

Self-care isn’t just bubble baths and chocolate—it’s about establishing boundaries that protect your emotional resources and replenish your capacity to connect.

• Develop a clear personal mission statement that reminds you why you chose this work and what sustains your commitment.
• Create transition rituals between work and home (like changing clothes or taking a short walk) to signal to your brain that it’s time to shift gears.
• Identify and regularly engage in activities that bring you genuine joy and have nothing to do with caregiving.

Addressing Internal Conflicts

Internal conflicts—like feeling responsible for outcomes beyond your control—can significantly contribute to compassion fatigue.

• Practice “compassionate detachment”—being fully present while acknowledging that you cannot take on others’ pain as your own.
• Develop mental “on-duty” and “off-duty” modes—like switching between different channels in your mind to separate work experiences from home life.
• Learn to identify and challenge unhelpful thinking patterns, like perfectionism or all-or-nothing thinking about your role.

Connection With Others

The social dimension of healing can’t be overstated. Genuine connection with others who understand your experiences is vital for preventing compassion fatigue.

• Participate in regular peer support or debriefing after difficult shifts.
• Build relationships outside of work where you can be known for more than just your role as a helper.
• Consider professional support to process challenging cases without carrying them alone.

Finding Your Sustainable Path Forward

Compassion fatigue isn’t inevitable, and experiencing it doesn’t mean emergency work isn’t for you. Rather, it signals the need for a more sustainable approach to the emotional demands of the job.

Likewise, the goal isn’t to never feel affected by the difficult situations you encounter—that would make you less effective, not more. Instead, the aim is to develop practices that allow you to engage deeply with your work while maintaining your wellbeing over the long term.

Remember that what works for others might not work for you. The most effective strategy is the one you’ll actually use. So don’t be afraid to experiment with different approaches until you find your personal formula for resilience.

References

1. Figley, C. R. (2002). Compassion fatigue: Psychotherapists’ chronic lack of self care. Journal of Clinical Psychology, 58(11), 1433-1441.
2. James, K. A., Stromin, J. I., Steenkamp, N., & Combrinck, M. I. (2023). Understanding the relationships between physiological and psychosocial stress, cortisol and cognition. Frontiers in Endocrinology, 14, 1085950.
3. Kim, S. A., Lee, Y. M., Hamann, S., & Kim, S. H. (2021). Differences in empathy toward patients between medical and nonmedical students: an fMRI study. Advances in Health Sciences Education, 26(4), 1207-1227.
4. Cocker, F., & Joss, N. (2016). Compassion fatigue among healthcare, emergency and community service workers: A systematic review. International Journal of Environmental Research and Public Health, 13(6), 618.
5. Dominguez-Gomez, E., & Rutledge, D. N. (2009). Prevalence of secondary traumatic stress among emergency nurses. Journal of Emergency Nursing, 35(3), 199-204.
6. Jarrad, R., Hammad, S., Shawashi, T., & Mahmoud, N. (2018). Compassion fatigue and substance use among nurses. Annals of General Psychiatry, 17(13).
7. Sabanciogullari, S., Yilmaz, F. T., & Karabey, G. (2021). The effect of the clinical nurses’ compassion levels on tendency to make medical error: A cross-sectional study. Contemporary Nurse, 57(1-2), 65-79.
8. Mathieu, F. (2007). Running on empty: Compassion fatigue in health professionals. http://www.compassionfatigue.org/pages/RunningOnEmpty.pdf
9. Yang, Y. H., & Kim, J. K. (2016). Factors influencing turnover intention in clinical nurses: Compassion fatigue, coping, social support, and job satisfaction. Journal of Korean Academy of Nursing Administration, 22(5), 562-569.
10. Crampton, D. J. (2014). Comparison of PTSD and compassion fatigue between urban and rural paramedics [Doctoral dissertation, University of the Rockies]. ProQuest. https://search.proquest.com/docview/1350627026?pq-origsite=gscholar
11. Gentry, J. E., Baranowsky, A. B., & Dunning, K. (2002). ARP: The Accelerated Recovery Program (ARP) for compassion fatigue. In C. R. Figley (Ed.), Treating compassion fatigue (pp. 123-138). Brunner-Routledge.