The Heart of a Caregiver

The words “Compassion Fatigue” don’t quite sound the way it feels. It feels much deeper than fatigue and it’s not just compassion they are tired of. They are tired of being angry, frustrated, sad, and exhausted. I mean really?! When does the bullshit end? What has to happen for it all to just be nourishing again.

This is my opinion about why I think it’s so hard for many caregivers to feel nourished. Please know, I am generalizing here. I am taking liberties with some broad sweeping strokes here but it comes with about a year of building trust, creating connection, and cracking through some of the toughest exteriors to formulate.

In my humble experience, The caregiver’s heart reminds me of a pomegranate.

They are these stoic, well held together packages. They have this smooth but sometimes bumpy exterior that makes them so difficult to know just how ‘done’ they are. They have been trained for years to keep the exterior valiant. They are tenacious, they can survive the bumps and grinds, and very rarely can we see the inside damage through an unrelenting exterior. They hold well. They are graceful and let’s be honest, underappreciated.

They have learned to keep it all in. They have learned that not many ‘get it’ or ‘want to get it’ – and that fucking hurts. It’s easier to carry just the one burden than also have to carry the burden of the nonchalant public. Simple pep talk statement sting deeply:

“You knew what you were getting into”

“Why don’t you just quit?”

They shut it down because they don’t want to crack. They are afraid of what might spill out. They wouldn’t want you to really hear what they have witnessed. Privacy and confidentiality are core to every Nurse. They have built a well-controlled environment where they keep everything nicely locked away for safekeeping. Giving up this control, opening this pandora’s box, cracking this well-held skin, well that just is not an option.

Until Now.

There is only so much one person can hold onto and if they are so filled with the heartbreak for their profession, the people they couldn’t save, the exhaustion, the anger, the frustration, I simply want to know where the room for love, worthiness and boundaries exist?

Where does the nourishment live?

This polished exterior is holding onto too much and if you are lucky, you find a few that are willing to slowly and gently crack that ruby red tough exterior and show you a gift that is beyond comprehension. A gift that just continues to give inside all of their folds, in the pithy middles, and sometimes just their under the skin. Jewels. Beautiful jewels of tender love filled with sometimes bitter cores that shine nonetheless.

If you crack too harshly – you will inevitably end up with red juice staining your clothes forever. But if you take your time, sit with these whole beauties and gently coax the skin back, you are able to witness a box of shining jewels all individually held. A century of wisdom, of truth, of humanness…all there, safely held. Only a caregiver’s heart would be able to hold these stories as beautifully and safely as they do.

But the stories they are now holding are frankly, too much. They are not seeding compassion. They are stagnated bitter cores. The compassion that created the jewels that spawn the burst of passion and purpose has been dried and is now replaced with ‘cover your ass’ audits, protocols, disconnection, and isolation. What once fed these fruits: touch, gentleness, connection, and time – have all been spread across too many patients/residents over 6 double shifts in one week.

Supporting them is hard. It’s hard for them to know what they need when they aren’t used to giving to themselves. They don’t want to be a burden, they find their worth is only in the quality of care they can provide for others. But we need them to know we love them, that THEY matter. That their hearts need saving too. That they are worth every second of care we can provide. Sitting silently, sending love notes, simply listening.

They deserve the gentleness of days to remind them of their beautiful jeweled heart and the stories that only feel safe with them. When they are pressed to share these stories, they know the gifts and the burdens they are being asked to give and it often seems impossible. After all, what keeps the pomegranate together if not for the thick skin and pithy cushions?

The heart of a caregiver is worth our time. They are worthy of connection. They are worth carrying hard stories for. But be gentle, soak that rough exterior with gentle whispers and the warmth of your skin. Should you be so lucky as to peel a small corner back, you will be gifted with the most exquisite beauty you will ever be lucky to see.


Sarah Hines
Sarah Hines
I met a man one blurry night in Manhattan, and little did I know, he would be the soil in which my passion for grief work was to be planted. He had been rejected by his family for his life choices and was preparing for death without them. Helping him through his struggle to come to terms with his love for them and in turn his forgiveness while going through treatments, rejection, and coming to terms with his own death and grief was an unimaginable amount of stress and it literally set me in activism mode. It was shortly after his death, I completed training in Palliative Care Home Hospice. I volunteered in men’s homes for 5 years before the medications became reliable and being gay wasn’t always breaking family ties. Some of the most amazing times I have had in my life have been in the homes of dying. Strange, yes.. but so beautifully honest and raw. I then completed the Children’s Palliative Care Training and dove into the heartbrokenness of dying children. It is in these years I really came to understand just how fickle death can be and how much we embrace death and our grief. It seems that in times of what we would consider the most unimaginable, we are able to find glimmers of beauty, cracks of light and the nourishment in tears. Over the last 20 years, I have carried on with my education in a variety of ways including Coach and Leadership Training, Orphan Wisdom School and Grief Groups. My connection into corporate grief has been slow. It’s something that most organizations do not want to think about. I am inspired by those that see value in bringing grief work into the way they lead teams through uncertainty and the trust this work builds.

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  1. Sarah, what an amazing read. Thank you. I’m choked up at how exquisitely you captured the depth of emotion, wisdom, and self-preservation that a dedicated caregiver must navigate just to be able to continue to care-give. The reality of the need to insulate others from the cruel, heart-crushing, and raw reality of what it takes to get going for another day, another patient, another struggle. To gather the strentgh to walk beside another human being in the midst of crisis, as that patient recognizes, possibly for the first time, that they are not in control. I’m in tears as I think about all the obstacles we have placed in the road between care-givers and patients in the name of “cost-control”. All the euphamisms that the industry uses to conceal the purpose of their “opimizations”, their “data collection”, and their audits. Your description of incredibly powerful experiences in the ante-room to death, as an individual leaves this earth, brought back lessons of my life and moments when all the “stuff” we keep ourselves busy with from day to day, drop away in a flash of crystal clarity about what is truly important.

    I believe the hearts of care-givers are those who choose to see and to know, in the depth of their being, the importance of life, though the experience of caring for those who are fighting for their lives. They choose to be reminded every day that this life is a gift. Sadly, our system is not honoring that wisdom. You are so right “fatigue” is not the right word. I’m not sure there is a “right word”, because it is much deeper than we have acknowledged. Nor am I sure that we will fully understand the catastrophic impact of the neglect our society’s disregard will have on the future of caregiving. You capture the layers beautifully. Valuing caregivers and what they bring to the world is critical for all of us. Whether we acknowledge it or not, someday, we all will need to be cared for, we all will come face to face with our own powerlessness. Are we prepared to do that without quality care? There has to be a better way.

    Thank you for this thought-provoking article andthe much-needed spotlight on an important issue for the future of our world.

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