When You Care Enough to Do Your Very Best: Genetic Counselor Experiences of Compassion Fatigue

Domain 1: Distinctions Between Burnout and Compassion Fatigue This domain involves participants’ attempts to conceptually separate compassion fatigue from burnout. There are 2 categories: 1) Burnout is a risk factor for compassion fatigue (n = 2). Too much work (too many patients) and too much stress from administrative tasks lead to burnout which then may render practitioners more vulnerable to and/or less able to manage compassion fatigue: “If you only had to deal with two patients a week and they, you know, were really horrible patients, you would still easily be able to do those as opposed to seeing 15 or 20 patients.”; and “If you are overwhelmed by the administrative [tasks], you might feel less able to deal with some of the more emotional tasks.” 2) Distinction is not clear (n = 2). Participants were not always sure whether they were experiencing compassion fatigue or burnout. They reported experiencing aspects of both and commented that the phenomena are hard to separate. A question was raised about whether compassion fatigue is an aspect of burnout. Domain 2: Goodness of Fit This domain concerns participants’ perceptions of how well the definition of compassion fatigue applies to genetic counselors. There are 3 categories: 1) Acute versus chronic (n = 2). Participants questioned whether compassion fatigue is transient and acute, or whether it is continually present. 2) Definition is too extreme (n = 2). Some participants considered wording such as trauma in the definition of compassion fatigue to be extreme. They maintained that the phenomenon is more subtle. 3) Stigma (n = 1). There may be a stigma associated with compassion fatigue, such that genetic counselors do not want to discuss their experiences. Domain 3: Catalysts of Compassion Fatigue This domain concerns aspects of the genetic counseling profession and genetic counselor characteristics that may make compassion fatigue especially prevalent. There are two categories: 1) Uniqueness of genetic counseling (n = 1). Certain unique aspects of genetic counseling may place practitioners at greater risk for compassion fatigue relative to other health-care professionals (e.g., short, intense relationships; and most people do not want to see a genetic counselor because it may mean that something bad happened). 2) Genetic counselor personality (n = 2). Participants speculated that genetic counselors may possess certain traits that increase compassion fatigue risk (e.g., desire to be liked, wanting to control patient reactions, and perfectionism). They described a desire to control everything despite knowing that this is not possible. They speculated that their desire may stem from a personality trait and/or from a prior negative clinical outcome that occurred because they were not in control of the situation.