EDITOR NOTE: This is the second in a two-part series highlighting compassion fatigue and how local agencies help their staff and volunteers through it.
Compassion fatigue can come in waves, and may lie under the surface for some working with people in need and crisis.
Vickie Stryker, executive director of the Lycoming County Society for the Protection of Cruelty to Animals cases, says shelter staff work not only the public but with animals who are in need.
About eight years ago, she learned of compassion fatigue while attending a workshop. She attended the workshop so she could help her staff cope with it.
She learned the signs and is able to recognize if an employee is struggling.
"Some are abrasive ... and people can become aggressive toward others," she said. "Sometimes what I see is people will get abrupt with the public or other staff, or they may not be helping, or working effectively. Even avoiding euthanasia."
Calling off sick often is also a sign.
Vanessa Hunter, social and economic empowerment director with the YWCA, has seen this happen.
"They can start to miss work, become physically ill and the symptoms can manifest themselves as stress," she said.
Capt. Chas Engel, corp commanding officer of the Williamsport Salvation Army, said he has seen where some people become angry all the time, and people may not want to deal with the next person that walks through the door.
"What can happen is that you can start owning that person's problems," he said.
He said that is called vicarious trauma. It is defined as the natural behaviors and emotions resulting from the knowledge of (a) trauma. It is the stress resulting from hearing about an event and-or helping, or attempting to help a traumatized person, by Charles Figley and Rolf J. Kleber, "Beyond the 'Victim': Secondary Traumatic Stress."
"The way I was able to get through it ... after a while you had to start pacing your time. You couldn't allow too many (cases) in one day," Engel said.
"What I have found is to focus on the success stories. They may be far and few between, but they are there and that can help as well," Amy McGovern, social service program coordinator at the Williamsport Salvation Army said.
Stryker said she has built a "stress day" into employees' schedule. One day a quarter, when they have reached their boiling point, they can ask for a day off to relieve the stress and regroup.
"We also try to do lunches where everyone brings a dish or I make something and we try to get together and talk," she said.
Stephanie G. King, adult psychiatric and mental health nurse practitioner in behavioral health, at Susquehanna Health, Divine Providence Hospital, said strategies like Styker's help.
"Other strategies for preventing compassion fatigue include taking regular breaks, changing workloads, working part-time and accessing resiliency training. Workplaces where employees experience high levels of care giving should consider offering resiliency and stress management training to their employees. There are several programs that focus on compassion fatigue resiliency that have shown significant results in reducing levels of stress and burnout," King added.
Sometimes people need a good cry and Stryker said she sits down and listens.
"We talk. We talk a lot. We talk about what is going on and how they feel about it. I have an open door policy. Whatever is going on, please come talk to me," Hunter said.
"Support networks that center on self-care and relationship building may prove useful in treating compassion fatigue and burnout. Special attention should be paid to vulnerable subgroups, especially those with limited resources or minority affiliations, due to other stressors that may confound self-care and resiliency," King said.
Hunter talks with all her staff and potential employees and asks them what they do to care for themselves. She said she asks if they have some kind of outlet or activity.
"Like walking or singing and even something to read or dancing," she said. "Whatever it is just to release it from your physic so you don't carry it."
McGovern said she also establishes clear boundaries when working on a case.
"Know where to draw the line," she said.
She stressed that if one feels like they are having problems, bring it to the attention of your supervisors right away, not to ignore it.
McGovern said she knows she always can turn to her captain or spiritual directors for help.
Capt. Engel said being of Protestant faith, the Salvation Army turns to the Bible for guidance.
"Turn to the Bible and see what it says. Be compassionate, kind, on the seventh day rest ... even Jesus had to take a break from time to time. He had to recharge," he said.
"To stay resilient and prevent compassion fatigue, professionals should develop good support networks, talk about their feelings and stressors, practice disconnecting work from home, and develop strong relationships with others to avoid isolation," King said.
Stryker said people need to find a healthy outlet, ways to enjoy themselves that aren't destructive.
"If individuals are unable to manage their feelings or symptoms, they should seek professional help and avoid self-medicating with food, drugs, alcohol or other destructive methods," King said. "Consequences of untreated compassion fatigue can include leaving professions or jobs, self-medicating with alcohol or drugs or suicide."
After attending the conference, she learned that having that healthy outlet is very important.
"It was amazing when I went to this conference and he (the speaker) went around the room and asked people what kind of hobbies they had, and the amount of people that didn't have any," she said. "They had no hobbies and no outlets ... they were the ones crying ... they were the ones burnt out."
Stryker said it's important to learn to break away from work.
"If we don't have a detachment from that, we have to let it go, if we don't, we drive ourselves crazy," she said.
Capt. Engel said some agencies and organizations haven't realized that compassion fatigue exists.
"They know that their workers get burnt out, but the workers do not know that there is a title for the problem," he said.
Those who have dealt with this agree. It has been a private thing or those experiencing fatigue may not realize it or be able to put a name on it.
"I think they (social and medical fields) are finally putting a name to it. For years, we have seen people get frustrated and quit. There is a high turnover rate in shelters because of that," Stryker said. "It is a very stressful, emotionally-charged job and people can't help but be affected by it."
"It's not easy to identify," Hunter said.
"A lot of people don't talk about it. Like doctors, they don't talk about it because you don't want to have to admit to someone you are having a rough time," Capt. Engel said. "I am not saying it should be this thing the whole world should know about, but the person going through it needs to understand it isn't just them."
McGovern said some may think if they ask for help it may make them look like a weak person or they can't do their job.
"When often time it's the strong way to go. To ask for help," McGovern said.
"The staff at Susquehanna Health Behavioral Health are trained to deal with workplace issues, posttraumatic stress and offer resources for stress management. Anyone experiencing compassion fatigue is encouraged to seek help, as it is possible to manage these symptoms," King said.
Hunter added that people may not understand what it may be like when one is dealing with those in crisis on a day-to-day basis.
"We are nice and compassionate. It wears you out, the needs are relentless," Hunter said.
Stryker said she used to be a nurse and realizes today she thinks she suffered from it from time to time.
"I don't think I recognized that my frustrations were compassion fatigue back then. Maybe if I had known that's what they were, and had I known that I needed to step away and regroup, I wouldn't have left nursing," she said.