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I was diagnosed with depression caused by stress and compassion fatigue

Nurse Aly Foyle appeared to have it all, but then she started to fear going to work

On the surface nurse Aly Foyle had it all, but depression caused by stress and compassion fatigue made her fear going to work


Picture: Alamy

The year 2017 started on a professional high for me when I was runner up in a national oncology nursing award.

However, by the end of the year I was in my office, sobbing my heart out.

Strong-minded and with a willingness to take on any challenge, I have always had a fearless streak.

Ten years into my career I had thought nothing of moving to Saudi Arabia with just two suitcases and without a single word of Arabic.

An enviable work-life balance

A decade later, I returned to England, married with a six month-old baby and another one on the way, and able to speak Arabic to a good standard. 

Stress, at this point, was something that had always been positive and a driving force.

Fast forward another few years and I had achieved an enviable work-life balance.

My children were in school and I was working part-time as a sister in the haemato-oncology unit outpatient’s department of the Royal Marsden NHS Foundation Trust in London. 

For someone who had spent their career up until then referring to the Royal Marsden Nursing Manual, I had to pinch myself I was working there. I loved my job and my team.

Work was no longer a challenge, but something to fear

Yet, as the years went by, I started to change. It was barely noticeable at first, but I began to worry about little things and deadlines.

My work was no longer a challenge, but something to fear.

I started thinking about patients I had nursed through my career, but who sadly had not survived.

Before, I had always been first to sit and talk to patients who had received bad news; suddenly, I had started to find this difficult.

I was becoming intolerant and sensitive to things that usually would not have affected me.

Tears would come easily. I became fearful, and slowly started to withdraw. None of this involved a conscious decision; looking back, it was self-preservation.

Depression caused by stress and compassion fatigue

The turning point came in November 2017, when I collapsed onto my manager in uncontrollable tears. I felt broken.

My boss was brilliant. After telling me to take a week off, she referred me to the Royal Marsden’s occupational health team and I made an appointment to see our staff support team.

I was diagnosed with depression caused by stress and compassion fatigue, something I had never heard of until that point.

At my lowest point, I felt isolated, weak and pathetic – a rubbish manager and a bad mother.

At times, it felt as if everything I had worked for was crumbling around me and I was powerless to do anything about it.

Yet the support I received from my family, GP and the Royal Marsden team was my lifeline. I was given four months off work.

Turning a negative experience into a positive one

Now, I am not only back to my old self, I am stronger than ever. I have been promoted to matron and now ensure that my team and I attend the trust’s regular Schwartz Rounds for staff to talk about the emotional and social challenges of caring for patients.

When I returned to work I was honest with my team about what had happened. I now have some insight into what can be the impact of the job we do.

After all, if one of my patients had a side effect from chemotherapy, I would help to treat it. And that is how I see stress and compassion fatigue – possible side effects of the job we do.

I was determined to turn what had been a negative experience into a positive one, and I now use every opportunity to talk to colleagues about my experiences because I believe they can happen to anyone and it's important to be open about it.

If I can try to help one person now, it makes my experience more worthwhile.

Help and support are always available

My advice is to be kind. Listen and hear what colleagues are telling you. If you are the one who is struggling, speak up. Help and support are available.

It takes strength, and is no way a weakness, to admit you need help. 


Author details

Royal Marsden NHS Foundation Trust matron Aly Foyle

Aly Foyle is a matron at the Royal Marsden NHS Foundation Trust

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