When it comes battling poverty and sickness, nurse practitioner Donna Torrisi and her team at the Family Practice and Counseling Network in Philadelphia are on the front lines, seeing 23,000 patients a year, many of whom have such low incomes that they qualify for Medicaid.

Compassion fatigue is a real issue for people like Torrisi, her staff, first responders and many others in the helping professions. In our Executive Q&A interview, I asked her how she copes with compassion fatigue — not only for herself, but for her staff.

"I'll answer for myself first," she said. "I think doing things outside of work is really energizing for me.

"I try to, even if I have to stay here late, be done with work when I go home.  It's not always the case. And, the other thing is I have known these patients and their kids, and their grandkids now, I've watched them grow up. I'm in the third generation now.  One of the things I said when I spoke [at a recent event] was what a privilege this has been to be able to do this work, and be able to be a nurse to so many people, and to be their friend.

"Sometimes, they call me their family. That choked me up, because it's like what could be more of a honor than for someone to say I feel like you're part of my family. So, I actually find, even though there's some very sad stories, and I've lost a lot of patients over the years, is I find my patients to be energizing for me — the connections and the relationships."

You said that you pray. Does that help?

I mean I would say more of me believes that prayer is helpful than doesn't believe it, though not 100 percent. I feel it gives me a certain kind of a calm and peace.

Sometimes managers forget what it’s like to actually be a worker. Is it the same for you? Do you still see patients? Is it your choice or do you have to see patients to keep the enterprise afloat? Does it help you be a better leader?

I don't have to. It's my choice, but I only do it a half day a week, well, a little more than that. Absolutely [it helps in leadership]. I mean I am part of the gang when I'm in there. I'm nobody's boss. I'm just right there with everybody else. It's humbling, and it makes me feel part of the team, and I get it. I also get it, because I've worked full-time in primary care for 15 years. So, I get that it's exhausting. It's really hard to do it day-in and day-out every 20 minutes seeing somebody new. Then managing everything else. There are labs that come back. There are phone calls. There are medication renewals. The consultation reports from providers. It's very hard. So, we're really open about giving people – of letting people say look, I'd like to cut down to 80 percent time. We're really open to doing that.

How do you advise the people who work with you about on-the-job stress?

We talk a lot about self-care.  I actually bring a masseuse in to each office once a month to do chair massages for staff. We do some kind of playful, somewhat meditative, somewhat playful kind of activity, team building, for maybe 40 minutes before we start the day. So, for example, on a Friday morning, instead of starting to see patients at 8:40, we'll start at 10:00 and we'll just go a little bit later in the day, because we don't do patients in the afternoon on Fridays in primary care.

So it's mandatory. Everybody has to go to Bill's room. [Bill Simpson is a former radio personality who was famous for doing imitations and now works as a wellness and meditation coach at the Family Practice and Counseling Network.] He's a very fun guy. He's very playful. When you first meet him, he seems so serious. But, then you get in the room with him and he has you doing a limbo rock, and all these playful kinds of things. Then you'll have some quiet time, just some meditative time. It's just so fun. So, we really try and do things with our staff.

Does the staff like it?

It looks like they're having fun to me. He's got a jar in one of the rooms, and you pick something out of it. It's a gratitude jar. It asks you certain questions, things to think about. There are leaflets on the bathroom doors that say, `Do you need to see Bill? It shows a picture of a stressed-out person, and then how they feel after.

What would be your advice to someone leading an organization of first responders, particularly in healthcare?

If you're going to be a leader, it's stressful. You have personnel problems all the time. You have to be very compassionate to yourself, and really take good care of yourself, and that you encourage that in your staff in a very, very big way. When I do a new staff orientation, one of the questions I always ask is `What makes you really feel rejuvenated?  I really encourage people to do those things. It's hard when you have little kids, especially, but it's really important to be able to do that. I mean you just can't go from one stress thing to another. You'll totally burn out.

Have you ever burnt out?

I have felt that way. I'll tell you something that wore me out.  o you remember the security door that killed a three-year-old a couple of years ago?

Her mother was my patient, and what a lovely woman she was. She came to me when she was 46 years old, and I told her she was pregnant, and she just kind of freaked out, because she had grown kids, and here she was 46.

That totally wore me down, because I knew and loved this woman, who had this child, and I knew what this child became to her and her husband. And, I happened to be on call that weekend. I got a call that somebody needs Xanax [an anti-anxiety drug]. Then I find out who it is and what happened. That was probably one of the most horrific things. I've always had staff who've lost children in accidents or suicide. Those are the things that – those are the kinds of things that have sort of worn me down the most, because they're people that I've had really strong connections with.

How can you help them?

One time we had a patient who shot himself in the head. We were very small then. The leadership group decided that if anything else like that happened again, like a crisis, we would all come together immediately.

NEXT: Leadership lesson: How to praise an employee.