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Lying Down in the Ever-Falling Snow

Canadian Health Professionals’ Experience of Compassion Fatigue

By Brendan Leier, Denise Larsen, Ph.D., R. Psych, E. Sharon Brintnell, Erika Goble, Leon Kagan, MD, FRCP(C), Linda Kreitzer, and Wendy Austin
Subjects Psychology, Medical
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Paperback : 9781554588886, 230 pages, April 2013
Ebook (EPUB) : 9781554588909, 230 pages, April 2013

Table of contents

Table of Contents for Lying Down in the Ever-Falling Snow: Canadian Health Professionals' Experience of Compassion Fatigue, by Wendy Austin, E. Sharon Brintnell, Erika Goble, Leon Kagan, Linda Kreitzer, Denise J. Larsen, and Brendan Leier
The Question of Compassion Fatigue: An Introduction
What Is Compassion?
Differing Understandings of Compassion Fatigue
A New Way of Understanding Compassion Fatigue
The Cold Heart: The Bodily Experience of Compassion Fatigue
The Endless Winter: The Temporal Experience of Compassion Fatigue
Lost and Alone in a Prairie Blizzard: The Experience of Space in Compassion Fatigue
An Icy Wall (Within and Between): Relations and Compassion Fatigue
Bundling Up: Finding Hope in Cold Climes
Survival in Winter Country


Compassion fatigue from the perspective of insiders in caregiving roles
First used to describe the weariness the public felt toward media portrayals of societal crises, the term compassion fatigue has been taken up by health professionals to name—along with burnout, vicarious traumatization, compassion stress, and secondary traumatic stress—the condition of caregivers who become “too tired to care.” Compassion, long seen as the foundation of ethical caring, is increasingly understood as a threat to the well-being of those who offer it.
Through the lens of hermeneutic phenomenology, the authors present an insider’s perspective on compassion fatigue, its effects on the body, on the experience of time and space, and on personal and professional relationships. Accounts of health professionals, alongside examinations of poetry, images, movies, and literature, are used to explore the notions of compassion, hope, and hopelessness as they inform the meaning of caring work. The authors frame their exposé of compassion fatigue with the very Canadian metaphor of “lying down in the snow.” If suffering is imagined as ever-falling snow, then the need for training and resources for safe journeying in “winter country” becomes apparent. Recognizing the phenomenon of compassion fatigue reveals the role that health services education and the moral habitability of our healthcare environments play in supporting professionals’ ability to act compassionately and to endure.


This book should be required reading in the education of all health and human service professionals. Although technical and therapeutic expertise is a core foundation of competent, ethical, and safe practice, education often neglects compassion fatigue as a central aspect of human relationship. Also neglected is the meaning of human suffering—much to the consistent detriment of service providers and those for whom they care, particularly in the context of increased market-driven healthcare. This book can create the foundation for much-needed open conversations about these pressing issues.

- Elizabeth McGibbon, Ph.D., RN, editor of Oppression: A Social Determinant of Health (2012)