Findings provide evidence of the need to implement strategies which prevent, identify and mitigate compassion fatigue in nurses. Efforts to handle the complex demands of an overburdened healthcare system place extraordinary stress on those charged with providing services. Social media is replete with reports of failure to care for patients during highly vulnerable periods in life.
As the need for healthcare continues to escalate, placing ever greater demands on nurses, such information can serve to inform the development of clinical practices which reduce burnout, ensure quality care and retain nurses in the workforce. The purpose of this research was to conduct a robust review of studies which have explored compassion fatigue and to extract the common, central, core features which might be applied to nursing care.
Such distillation offered the possibility of gaining a richer understanding of compassion fatigue than was available from review of individual qualitative investigation Florczak, This grand interpretive process affords synthesis of the key facets of compassion fatigue which can then be used to guide clinical practice and direct additional study, constructing a larger narrative Beck, Compassion fatigue has been variably interchanged with secondary traumatic stress, secondary traumatic stress disorder, vicarious stress and burnout, creating conceptual confusion.
Specific consequences as a result of compassion fatigue include sleep disturbance, hypervigilance, fear, anxiety, difficulty concentrating, physical sensations such as tight muscles, feeling burdened, fatigued and overwhelmed with hopelessness and isolation resulting, along with disengagement Figley, Burnout as a dimension of compassion fatigue has been proposed Stamm, but is more often situated as the outcome.
Compassion fatigue has been noted to be a term preferred over secondary traumatic stress Figley, or vicarious trauma since it embodies a process occurring over time and typically does not reflect onset as a result of a single traumatic event. Given the multiple challenges and demanding circumstances which face nurses in practice, compassion fatigue is likely to be a far more common phenomenon than might be acknowledged. However, there has never been a systematic study of its prevalence or the extent to which nurse's experience compassion fatigue and how that might vary with individual characteristics and practice setting.
A clear understanding of the experience as reflected in qualitative work done to date can meaningfully inform such research. The aim of this research was to interpret the body of qualitative work that has focused on compassion fatigue and to distil a common understanding that could then be applied to nursing care. A research librarian was consulted to establish the most appropriate research strategy. The time period was from —present; was the starting point as this was when the term first appeared in the literature.
Exclusion criteria included all quantitative studies, reviews, concept analyses, dissertations and theses. Researchers independently appraised reports with scores ranging from 7—9. No study was excluded because of appraisal as our aim was to explore compassion fatigue and its dimensions — extracting the common, core features; studies were not excluded based on quality. It was therefore exempt from ethics committee review. Despite the terms often appearing interchangeable, they were found to be terms which focused exclusively on one or more identifiable traumatic event.
Case Study Proactive RN Nurse 2 was a nurse who exhibited anxiety and job dissatisfaction on a regular basis. She was often overwhelmed with her complex, patient-care assignments and expressed much sadness about her patients' social and emotional problems. She was frequently tearful and verbally acknowledged not wanting to come to work. In addition she was sensitive to feedback and felt a lack of support from some of her peers and supervisors.
She had difficulty sleeping, worried about work on her days off, and talked openly about wanting to leave the hospital. Nurse 2 talked often with several clinical nurse specialists who helped her focus on achieving a healthy work-life balance.
They counseled her on positive self-care strategies and effective communication techniques and guided her in considering long-term career plans. Although attempts were made to help improve the situation on her unit, she continued to experience anxiety and dissatisfaction. Despite her growing unhappiness, she identified a specific area of nursing in which she had always wanted to work. Arrangements were made for her to talk with the supervisor and schedule a shadowing experience in this area.
She decided to transfer to this new area and has since made a positive adjustment. Being proactive in meeting her own needs and addressing work-related needs has resulted in Nurse 2 feeling more energized about her work assignment and more eager to come to work.
Compassion fatigue needs to be studied in its entirety. We need to identify what specific characteristics and experiences precipitate this phenomenon among individuals employed in caring work and to investigate what personal qualities and traits might provide protection. Longitudinal studies are needed to investigate factors that contribute to the development of symptoms.
Studies are needed to identify the effectiveness of interventions, such as those described in this article, for combating compassion fatigue in a variety of work settings. One could begin with a pre- and post-intervention questionnaire asking nurses to describe, for example, the effects of weekly patient care conferences on their stress and compassion levels.
An initial finding from this program is that more support and resources are needed for caregivers who attempt to cope with stressful situations on a daily basis. Conclusion There are 3. A nursing occupational hazard of providing empathic, relationship-based care to patients and families is the development of compassion fatigue.
The impact of compassion fatigue on nurses can be profound. It may cause stress-related symptoms and job dissatisfaction among caregivers and decreased productivity and job turnover within the healthcare system Medical News Today, It is important for nurses to become knowledgeable about compassion fatigue symptoms and intervention strategies and to develop a personal plan of care so as to and achieve a healthy work-life balance.
Equally as important is that healthcare systems invest in creating healthy work environments that prevent compassion fatigue and address the needs of nurses who are experiencing compassion fatigue. This article has described a variety of interventions to enhance wellness opportunities and decrease job stress. Caring for caregivers, whether on a personal or system level, provides the foundation needed for optimal patient and family care.
Recognizing compassion fatigue symptoms and developing a personal plan of care will allow nurses to meet both their own needs and the needs of patients and families through an empathic relationship.
Authors E-mail: barbara. Her areas of expertise include facilitating patient- and family-centered care and providing support to patients, families and staff. She is co-facilitator of a patient family advisory council.
She teaches classes on communication, conflict resolution, and teambuilding to nursing staff. References Anewalt , P. Fired up or burned out? Understanding the importance of professional boundaries in home health care hospice. Home Healthcare Nurse, 27 10 , Dunn , D. The intentionality of compassion energy. Holistic Nursing practice, 23 4 , Figley , C. Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized.
New York: Brunner-Mazel. Gentry , J. Training as treatment: Effectiveness of the certified compassion fatigue specialist training. Health Resources and Services Administration. Harmer , B. Textbook of the principles and practice of nursing 5th ed. Stressing the importance of dealing with stress.
Ohio Nurses Review, 85 5 , Joinson , C. Coping with compassion fatigue. Nursing 22 4 , , , Koloroutis , M. Relationship-based care: A model for transforming practice. Medical News Today.
Compassion fatigue may emerge as nurses continually connect with patients who are suffering and absorbing the patients' trauma or pain or when nurses care for traumatized patients and re-experience traumatic events. However, the relationship of this attribute to CF in the acute medical care hospital nursing setting has not been intensively studied.
Nurses who reported that their unit had a managerial change within the preceding year scored lower on the compassion satisfaction scale and higher on the burnout scale than did nurses who did not experience such change. Conclusion This unique study could lead to care environments encouraging the self-compassion and well-being of their acute medical care nursing staff and become places where threat cultures, weak leadership, an emphasis on task rather than process and a feeling of being undervalued, do not monopolise. For the purposes of our study, a major system or practice change was defined as changes within the unit environment such as the opening or splitting of a unit unit redesign within the preceding year. Exclusion criteria included all quantitative studies, reviews, concept analyses, dissertations and theses.
De Boer et al.
The most striking finding suggests that the age of a nurse has a great impact on ProQOL. In many cases, the first symptoms are emotional. Organizational, or system, factors that affect Pro-QOL in our sample included management change, unit acuity level, and major systems change. These actions have the potential to enhance the work environment and promote work-life balance. Before you were a nursing student and nurse, you probably had hobbies or activities you enjoyed.
De Boer et al. Previous Section Next Section Discussion and Implications The primary aim of this study was to determine the prevalence of compassion satisfaction and compassion fatigue in critical care nurses in an academic medical center. The study also examines whether the level of SC can predict CF in acute medical care nurses. What does this paper contribute to the wider clinical community? Therefore, efforts to retain qualified critical care nurses and nurse managers should be emphasized.
Compassion fatigue leads nurses to withdraw or distance themselves from the patient and family and focus on the technical aspects of the job, avoid the essential development of the nurse-patient relationship and generally become more pessimistic about the ability for positive change.
The relationship between age and ProQOL has been examined by other researchers. Compassion fatigue CF has been variously defined, and the related concepts of BO, STS and vicarious traumatisation VT are often used interchangeably and incorrectly to describe the phenomenon. She is co-facilitator of a patient family advisory council. Disseminating information about Pro-QOL to bedside nurses is particularly important because everyone has a role in improving the work environment. See Research on compassion fatigue. These classes are designed to decrease stress, enhance work-life balance, and provide help for employees experiencing conditions such as compassion fatigue.
Often requests were made for additional sessions. If you realize, for example, that interactions with a specific colleague often feel uncomfortable or unpleasant, reflect on that a bit. Compassion fatigue may emerge as nurses continually connect with patients who are suffering and absorbing the patients' trauma or pain or when nurses care for traumatized patients and re-experience traumatic events.