Compassion Resilience

The reality of working in the health care field is that it is both exhilarating and stressful.

For health care providers, caring for clients who are suffering can be incredibly rewarding as well as emotionally draining and physically and intellectually demanding. The stress of working in an evolving practice environment with complex technologies, significant time pressures, and regulatory and organizational demands can take its toll on the wellbeing and resilience of health care providers that are so vital to optimal care of clients and career satisfaction. In our efforts to help clients build their physical and emotional health and resilience, we are charged with the examination of our own capacity personally and professionally to model that which we strive to build. Our capacity to serve our clients and communities are impacted by our personal histories, organizational supports, and the societal context we work in. The toolkit attempts to center trauma and equity informed perspectives that add value in understanding where each individual starts on their path to compassion resilience; this lens also deepens our understanding of what supports can be offered to fuel the energy of a diverse staff that is stretched thin. Simply stated, compassion fatigue and resilience will impact you differently depending on your history, identity, and social position in the school.  The content of this toolkit has been strongly informed by research and best practices related to resilience, equity, positive psychology, compassion fatigue, organizational psychology, trauma, and mindfulness.

*Note that we use the terms ‘client’ and ‘provider’ throughout this toolkit. However, we recognize that you may use different language depending on your work setting and we encourage you to use the language that feels most appropriate for you.

From a Triple to Quadruple Aim

The extent to which our organizational culture and systems support these efforts needs to also be examined. An intentional focus on building providers’ resilience is both an individual and organizational responsibility and opportunity. In fact, there is a strong case for provider well-being, including compassion and resilience, being identified as a core value and pillar of health care organizations.

What is known as the “Triple Aim”— enhancing client care, improving population health outcomes, and lowering costs — is widely accepted as a compass to optimize the performance of health care systems. Yet the health care workforce reports widespread burnout and dissatisfaction. This has been associated with lower client care satisfaction, reduced health outcomes, and potentially increased costs. Therefore, it is imperative that a fourth pillar, provider well-being, be added to the current compass. Without promoting the well-being and resilience of health care providers, it becomes increasingly more difficult to make positive impacts in the other three pillars.¹

What is Compassion Resilience?

Resilience in the health care field is a relatively recent area of investigation which provides a way of understanding what enables health care providers to persist in the face of challenges and offers a complementary perspective to studies of stress, burnout and attrition. Resilience is the ability to recover and continue on in the face of adversity.  Compassion is the combination of the consciousness of others’ distress and a desire to alleviate it, and is a basic quality needed to be able to meet clients’ needs. Compassion resilience, then, is “the ability to maintain our physical, emotional, and mental well-being while responding compassionately to people who are suffering.”² For those in the health care field, this may be understood as:

  1. The ability to maintain our physical, emotional and mental well-being
    (using energy productively) while compassionately caring for those who are suffering,
  2. Identifying and addressing the barriers to caregivers/families and colleagues being able to effectively partner on behalf of clients, and
  3. Identifying, preventing, and minimizing compassion fatigue within ourselves.

Think of this resilience as a reservoir of well-being that we can draw upon on difficult days and in difficult situations. It is a dynamic process or outcome that is the result of interaction over time between a person and their environment. Resilience enables health care providers to have longer, more satisfying careers, and has been shown to increase quality of care while reducing errors, burnout and attrition.3,4 This toolkit will explore the protective factors that build and maintain compassion resilience.

Why Build Resilience in Providers in Health Care Agencies?

A focus on compassion resilience will guide a diverse staff back to the core set of values and the drive for a sense of purpose that drew them to work in health care in the first place. It will do so by supporting the development of a strong set of skills to manage expectations, set professional and personal boundaries, build effective collegial relationships, and practice real-time and ongoing self-care. A focus on relational trust between providers, clients, families, colleagues and administrators will encourage a culture of wellness, personal resilience and exploration of new ideas that promote high quality care. An understanding of systems drivers of fatigue and the differential impact on staff who work without the benefit of unearned privilege allows for a critical examination of power, resources, and who gets support, and who does not. Identification of these gaps encourages prioritization of resources and support for those who need it the most.  Health care providers aren’t the only ones who benefit from a focus on resilience. Administrators, supervisors, client services staff, paraprofessionals, and others who form the health care community contribute to the decisive elements that influence an agency that is thriving. For a deeper introduction on the particular interests of leaders and administrators in promoting and improving compassion and resilience in the work environment, see Toolkit Addendum: An Introduction for Leaders.

The Trauma and Equity Informed Perspective and Staff Resilience 

Trauma informed values include a focus on safety, choice, collaboration, trustworthiness, empowerment, and cultural responsiveness. Staff are invited through individual and team activities to be honored, listened to, and supported in exploring the expression of these values and their impact on well-being at work. Awareness and self-reflection exercises with collegial support invite a collaborative space to examine how staff feel included and engaged at work.  The painful and real context of oppression (racism, sexism, classism, etc.) contributes to fatigue and, without being named openly, exacerbates stress and isolation which can take an extraordinary toll. Conversations where people walk alongside each other without judgment, recognize our unique strengths and challenges, and extend accountability to each other in the form of listening, learning, and transformation are the core methodology. The work of the toolkit is not to fix each other; the work is to simply acknowledge our shared humanity.