How to keep a sense of compassion in extreme work environments

Many jobs, including caregiving and emergency services, expose personnel to suffering and death daily. Yet they are expected to continually show compassion. How can they achieve that without burning out?  

New research by M. Dolores del Río (University of Victoria, Universidad Austral), Pablo D. Fernández and Alberto Willi (IAE Business School), Ignasi Martí, Professor at Esade and Director of the Institute for Social Innovation, and colleagues reveals that the answer lies in how we experience time. Their study was published in the Journal of Management Studies. 

Many organizations struggle to balance caring for their patients or users with protecting their staff’s wellbeing

The authors conducted an ethnographic study focused on a hospice for the terminally ill, and the research showed that reshaping time helps caregivers to continue offering compassion. The findings provide significant insights for leaders in healthcare, social services, and other sectors prone to employee burnout.  

The compassion dilemma

Compassion means noticing suffering, feeling concern and empathy, and taking action to help. But in extreme work environments such as hospices, refugee shelters, or emergency care, repeated exposure to suffering can lead to detachment, desensitization, and burnout — known as ‘compassion fatigue.’ 

Many organizations struggle to balance caring for their patients or users with protecting their staff’s wellbeing. The study examined how one hospice in Buenos Aires sustains compassion among its volunteers and staff, offering insights with value even beyond the healthcare sector. 

A world between life and death

The hospice, founded to care for poor, terminally ill patients — which it refers to as ‘guests’— deliberately reshapes the experience of time. Instead of viewing the end of life as a waiting period for death, the organization treats it as a meaningful and valuable life stage. It’s a time for the guests to live, connect, and reflect. 

Through dialogue, rituals, and the spatial design of the building, the hospice becomes a unique space: part home, part sanctuary. It is anything but cold and clinical. Volunteers, patients, and families share living and dining areas. A garden offers space for peaceful reflection, and personal touches throughout the building create warmth and dignity. When a patient nears death, a candle at the entrance signals the moment, inviting the community to take a moment to appreciate the gravity of those final hours. 

Simple elements — from the layout of the home to how volunteers are trained — reinforce this focus on the present. Certain rooms within the hospice are reserved for emotionally connected time with patients, while other areas are designed for practical tasks that provide caregivers with emotional distance. 

The two sides of compassion

The study identifies two approaches to how carers engage with ‘guests’. ‘Being with the guest’ is the time the carer is emotionally present, an almost sacred connection, where caregivers stop what they’re doing, sit and listen, and share the moment.  

A hospice worker gives a real-world example of this concept in practice, describing seeing a guest, Carlos, in the garden: “I approached him, intending to return to the house, but he kept me there for a long while. I wasn’t in a hurry; I had nothing urgent to do… Carlos needed to talk, or at least wanted to. I stayed there, listening to him, and it seemed like the most important thing to do.” 

The hospice gives caregivers the agency to choose when to engage deeply and when to step back

The other way to show compassion towards guests is ‘being by the guest’ — a more task-focused, practical approach that allows some emotional distance. One hospice volunteer explained: “Sometimes, I don’t feel like entering a room. You need to be aware of how you are, and what state you’re in that day.”  

Importantly, when the caregiving team steps in to ‘be with the guest’ because a worker feels unable to do so, they show compassion not only for the guest but also for their colleague. 

These two temporal experiences, ‘being with the guest’ and ‘being by guest’, correspond to two notions of time that have their roots in ancient Greece: chronos and kairos. Switching between these modes helps prevent burnout, giving caregivers the agency to choose when to engage deeply and when to step back. And performing practical tasks allows for some emotional distance and recovery.  

Constant emotional exposure can lead to exhaustion or detachment. Taking a lesson from air travel, the reason we should fit our own oxygen masks before helping others is that only by protecting ourselves can we then effectively help others. 

The hospice trains volunteers to manage this balance. In addition to practical care, they are taught to recognize when they need to switch modes and are guided not to enter a patient’s room until they feel emotionally prepared. 

The research draws on philosophical ideas from Heidegger, showing that the way space and time are experienced — not just measured — affects how people relate to each other, and how compassion can be sustained. 

Lessons beyond the hospice

Although the research centers on a hospice, its implications are relevant to many sectors where burnout is common: healthcare, social work, crisis response, and even corporate leadership. 

Organizations need to give overburdened caregivers a ‘time out’ to undertake useful but not emotionally demanding tasks

The problem is substantial. The World Health Organization (2024) estimates that burnout among healthcare professionals has reached critical levels, with up to 50% of healthcare workers reporting symptoms globally, particularly in the aftermath of the pandemic. 

An OECD report (2023) found that countries such as Spain, France, and Italy face worsening healthcare staff shortages as a result of burnout. 

The crux of the study showed that when organizations acknowledge the emotional demands on their staff and create ‘time for agency’ — moments to pause, reset, or engage differently — compassion becomes sustainable. “Sustaining compassion isn’t only about individual resilience,” says Martí. “It’s also about how organizations shape time and space.” 

Put simply, organizations need to give overburdened caregivers a ‘time out’ to undertake useful but not emotionally demanding tasks. 

The study shows that compassion can be organized, and that rethinking how time is spent could be the key to healthier, more humane workplaces. At the same time, staffing shortages often mean that caregivers are overloaded and unable to find time to disconnect emotionally. But that makes the design of the spaces in which they work even more important. 

Rethinking compassion at work

Compassion is often seen as a personal trait — but as this research shows, it is also an organizational practice. By reshaping time and allocating it differently, organizations can help people maintain a connection to their work and one another, even in the toughest environments. 

In a world facing crises of healthcare, inequality, and burnout, creating spaces where compassion thrives is not only good for morale, it also makes a tangible difference. It enables caregivers to help and support more people in need, for longer, and with more empathy, by supporting themselves first. 

More research is needed to determine how such temporal work would look in different organizations, and the extreme contexts in which some caregivers operate often limit how much control they have over space and time. However, the significance of the study lies in showing how caregivers can be empowered to sustain compassion.