Compassion Fatigue Among Nurses: Understanding The Concept And Professional Development Needs

Impact of Compassion Fatigue on Patient Care and Nurse Wellbeing

Eexplore how a nursing theory is applied within a nursing specialty. Describe family involvement in a specific area of nursing practice.

Nurses are known to witness tragedies primarily suffered by patients and respective families. Compassion fatigue is the term given to the concept of explicit personal exposure to trauma on a regular basis. Clarity of the concept is important for better nursing practice and consecutive patient outcomes. However, the reactions of nurses to such profound distress and loss ave been explored to a limited extent. There lies a gap in literature to understand the nature of compassion fatigue and the interventions that can be implemented for minimising the impact of such exposure to adverse events in the care settings (Hunsaker et al. 2015). I have grown an interest in understanding the concept of compassion fatigue among nurses sicne this topic has drawn my attention as a result of my experiences in clinical placement. During my clinical placement I have seen nurses suffer such fatigue due to which they have deviated themselves from the path of delivering optimal care. Since I believe increased knowledge of compassion fatigue would have an impact on my role as a nursing professional after completion of the BN degree, I would like to explore the topic more deeply in relation to nursing practice. The present paper aims at discussing the valuable research topic of compassion fatigue among nurses and highlighting professional development and research needs.

Compassion fatigue has a negative impact on the quality of patient care and nurse wellbeing. Such stress is linked with poor coping among nurses (Berger et al. 2015). Compassion fatigue is a work-related stress faced by nurses that are to be perceived as a ‘cost of caring’ and a chief reason behind the loss of compassion in care delivery. Valuable studies have measured compassion fatigue with the help of Professional Quality of Life Scale. However, the drawback lies in the fact that this scale does not undertake an assessment of the elements of compassion. Though research has highlighted that the major risk factors for compassion fatigue are job-related factors,  and low level of qualification, not much focus has been given in research to demonstrate that exemplary, compassionate carers are more prone to ‘compassion fatigue’ (Sinclair et al. 2017).

As opined by Nolte et al. (2017) there is an urgent need of research that gives insight into clinical milieu required for prevention of compassion fatigue. Theoretical models are to be presented through such research that can set the stage for future clinical practice policies. There is no denial of the fact that reformed policies are required for mitigating the increasing rate of compassion fatigue among nursing professionals. In later times, compassion fatigue has been used to describe secondary traumatic stress disorder caused by experiences of trauma in relation to patient caring. The differences and similarities between burnout and fatigue have been outlined by the researchers. Both of these two situations lead to powerlessness, frustration and reduced morale ensue, and impose additional adaptational demands on the professionals. However, they both are distinct in terms of three variables: outcomes, chronology and etiologies. Sabery et al. (2017) stated that there is a dearth of research highlighting precise and comprehensive tool for measurement of compassion fatigue among nurses. The researchers developed a Nurses' Compassion Fatigue Inventory (NCFI) and evaluated it. The results concluded that NCFI has great validity and reliability. It can be applied in future by nursing researchers and care setting managers within the care context.

Evaluation of Interventions and the Need for Professional Development

Jakimowics, Perry and Lewis (2017) studied compassion fatigue and satisfaction among Australian intensive care nurses. The background to the study was the fact that compassion fatigue has a major impact on the intention of nurses to leave. The term compassion fatigue had been first articulated in the context of nurse burnout almost two decades ago. The term was then used for explaining the loss of the ability to nurture. The study examined the factors contributing to compassion fatigue. It was found that poor level of education on management of stress was the main factor. Multiple environmental stressors, like long hours and expanding workload, together with the need to respond to complex patient needs, including pain, emotional distress and traumatic injury resulted in nurses feeling angry, tired, depressed, ineffective, apathetic, and detached. The researchers stated that further research is required to understand interventions for compassion fatigue.

Kelly and Lefton (2017) in their research paper stated that critical care nurses are at risk of compassion fatigue. Hospitals were meaningful recognition programs are present, nurses suffer a similar level of compassion fatigue when compared to hospitals where such programs are not present. Meaningful recognition had been found to be a major predictor of increased compassion satisfaction. Job enjoyment and satisfaction are predictive of decreased stress, fatigue and increased compassion satisfaction. Apart from giving importance to contributions of nurses to care delivery, meaningful recognition can be useful to reduce compassion fatigue. In this regard, Coetzee and Laschinger (2017) conducted a literature review to understand a comprehensive model of compassion fatigue. The compassion fatigue model studied highlighted that empathy is not the only driving factor for the development of compassion fatigue. Rather, inadequate positive feedback, lack of suitable resources and response to personal distress, all are responsible for compassion fatigue. If these three aspects are considered, the risk of compassion fatigue can be addressed effectively. Further research is entailed that can analyse how care settings can work to reduce the prevalence of these three factors.

The association between compassion fatigue and personality traits had been explored by Chen et al. (2017). A cross-sectional descriptive study found that compassion fatigue can be decreased by providing support for the emotional stability of nurses. Further, the involvement of nurses in outdoor activities can increase social connection and reduce stress. Kelly and Todd (2017)  environmental factors predict burnout to the extreme level. Care settings must focus on implementation on policies for healthy work environment if compassion fatigue is to be reduced. The requirement of building a supportive environment focusing on nurses for reducing compassion fatigue and burnout has also been felt by Kolthoff and Hickman (2017). Mathias and Wentzel (2017) felt the need of investigating compassion fatigue among undergraduate nursing students. The rationale behind this is that if nursing students face fatigue, there would be a negative impact on their training and professional development. 

At the end of the paper, it can be concluded that nurses are challenged to deliver optimal care with complexed needed is burdened care settings. Compassion fatigue, as a state of burnout and fatigue that restricts the ability of nurses to take part in caring relationships, acts as a vital element influencing professional practice. Strategies for reducing stress and burnout are entailed for ensuring high quality care and retention of care professionals in healthcare settings. More in-depth research is required to gather information on the different strategies that can prevent, and mitigate compassion fatigue among nurses. Since compassion fatigue has been highlighted as an iconic euphemism, critical examination of the topic through rigorous research is needed.

References

Berger, J., Polivka, B., Smoot, E.A. and Owens, H., 2015. Compassion fatigue in pediatric nurses. Journal of pediatric nursing, 30(6), pp.e11-e17.

Chen, Y.P., Tsai, J.M., Lu, M.H., LIN, L.M., Lu, C.H. and Wang, K.W.K., 2017. The Influence of Personality Traits and Socio?Demographic Characteristics on Paediatric Nurses’ Compassion Satisfaction and Fatigue. Journal of advanced nursing.

Hunsaker, S., Chen, H.C., Maughan, D. and Heaston, S., 2015. Factors that influence the development of compassion fatigue, burnout, and compassion satisfaction in emergency department nurses. Journal of Nursing Scholarship, 47(2), pp.186-194.

Jakimowicz, S., Perry, L. and Lewis, J., 2017. Compassion satisfaction and fatigue: A cross-sectional survey of Australian intensive care nurses. Australian Critical Care.

Kelly, L. and Todd, M., 2017. Compassion Fatigue and the Healthy Work Environment. AACN advanced critical care, 28(4), pp.351-358.

Kelly, L.A. and Lefton, C., 2017. Effect of Meaningful Recognition on Critical Care Nurses’ Compassion Fatigue. American Journal of Critical Care, 26(6), pp.438-444.

Kelly, L.A. and Lefton, C., 2017. Effect of Meaningful Recognition on Critical Care Nurses’ Compassion Fatigue. American Journal of Critical Care, 26(6), pp.438-444.

Kolthoff, K.L. and Hickman, S.E., 2017. Compassion fatigue among nurses working with older adults. Geriatric Nursing, 38(2), pp.106-109.

Mathias, C.T. and Wentzel, D.L., 2017. Descriptive study of burnout, compassion fatigue and compassion satisfaction in undergraduate nursing students at a tertiary education institution in KwaZulu-Natal. Curationis, 40(1), pp.1-6.

Nolte, A.G., Downing, C., Temane, A. and Hastings?Tolsma, M., 2017. Compassion fatigue in nurses: A metasynthesis. Journal of Clinical Nursing. 26(23), pp. 4364–4378

Sabery, M., Tafreshi, M.Z., Hosseini, M., Mohtashami, J. and Ebadi, A., 2017. Development and Psychometric Evaluation of the Nurses' Compassion Fatigue Inventory. Journal of nursing measurement, 25(3), pp.185E-201E.

Sinclair, S., Raffin-Bouchal, S., Venturato, L., Mijovic-Kondejewski, J. and Smith-MacDonald, L., 2017. Compassion fatigue: A meta-narrative review of the healthcare literature. International journal of nursing studies, 69, pp.9-24