Analyzing the Effects of the COVID-19 Pandemic on Compassion Fatigue in an Urban Emergency Department

BACKGROUND: The emergency department is a high-stress environment where healthcare workers are repeatedly exposed to patients’ physical and emotional traumas. This often leads to the development of compassion fatigue (CF), which is the loss of empathy that develops directly from exposure to trauma. It is comprised of three components: burnout, secondary traumatic stress, and compassion satisfaction (Hinderer et al. 2014; Harris 2015). During the COVID-19 pandemic, the constant COVID-19 exposure and high volumes of acute critically ill or injured patients, results in a prolonged stress environment that could potentially increase CF in healthcare workers. METHODS: The ProQol-5 was used to measure CF across the three components (Figley 1995; Stamm 2010) at three time points: January 2020, July 2020, and January 2021. Univariate and bivariate analyses were used to evaluate the three CF components across different demographics. A generalized linear regression was used to assess which predictors influence CF when adjusted with collection date and role. RESULTS: Resident/Fellow/APNs overall experienced an increase in burnout, secondary traumatic stress, as well as compassion satisfaction. Both attending physician and nursing roles experienced an overall increase in burnout and secondary traumatic stress, while simultaneously experiencing a decrease in compassion satisfaction. ERT/MAs and supportive clinical staff had high mean burnout scores from the beginning of this study and maintained the level throughout the three collection dates. In the multivariable analysis, all three components are significantly different from the start of the study to the end of the study, with a p-value of <0.05. DISCUSSION: Overall, there was an increase in CF during this study. Characterized by the increase in burnout and secondary traumatic stress, accompanied with the overall decrease in compassion satisfaction, when adjusting for indicators such as gender, age, years worked with trauma patients and years worked in the role, the increase in CF along the COVID-19 timeline suggests as the pandemic ensued, CF increased among our healthcare workers.