Compassion Fatigue Related to Oncology Nursing - Research Paper Example

Concept Analysis: Compassion Fatigue Related to Oncology Nursing Introduction There is a new term in the nursing profession that i.e. compassion fatigue. The term has been used to describe emotional changes experienced by the nurses during the discharge of their duties. During the provision of care to the patients, nurses observe their patient die, suffering of pain, and their state of helplessness which culminates to serious sense of trauma. The state of the patients affects the nurses directly by making them have mood swings. This happens due to the fact that the nurses tend to empathize humanly with the patients and lose focus on mainstreaming and creating a barrier not to affect their emotions. This condition that arises due to care given to the patients is referred to as compassion fatigue. There are other conditions that arises due to provision of care like burnout, these can be successfully be distinguished from compassion fatigue. The entire nursing profession is faced with rapid exponential increase in case of compassion fatigue due to increased number of population that demands health care and the limited number of the nurses to provide the care. This paper analyzes compassion fatigue and other related concepts. Oncology is the study of the causes, development and the occurrence of cancers coupled with treatments and mitigation of the cancerous cells. Cancer is one of the most devastating medical conditions in the contemporary world and the prevalence and incidence of cancer has been on the rife for the last couple of years (Bissett 56). There are different types of cancer that can be developed and in respect; there are different specialists who specialize on the different types of cancer. Besides the specialists who are involved in the diagnosis and prescription of cancer treatment, there are the nurses who are involved in ensuring that the intended care and comfort is given to the patient (Henke, Barrie, and Thomas, 98). It is important to note that the development of cancer comes with a great trauma to the patient and in most cases extends to the whole family and even close friends. The nurses in this case are not exempted from this cycle of empathy and may end up devastated emotionally. Oncology cases can lead to the development of two types of cancers, the benign and the malignant. Benign cancers are those which are restricted to one part of the body and do not spread to other types of the body. These types of cancers are easy to treat and can be mitigated easily. On the other hand, the malignant cancers are the most lethal and have the tendency of spreading to other parts of the body. This is the lethal types of cancer which poses the greatest danger to the human life (Henke, Barrie, and Thomas 111). The aim of this paper then is to relate the fate of the nurses who are care providers of these patients and are at the risk of developing emotional breakdown which may impact negatively on their lives, otherwise known as compassion fatigue. The sense of compassion fatigue is then dissected in relation to the position of the nurses in light of their duties. Definition of compassionate fatigue The term compassionate fatigue first came into the public limelight in 1992 when Joinson in a nursing article that he published. In the article Joinson described compassion fatigue as the condition in which nurses experience a change in their feeling and instead developed a sense of helplessness and emotional changes as a result of witnessing their patient going through a series of devastating conditions of illness and trauma (Bissett 194). In 1995, another person Figley proposed another definition of what compassion fatigue implies, he advanced that the definition of compassion fatigue is ‘the cost of caring’ (FIgley 154). It is therefore imperative that the concept of compassionate fatigue be conceived well in its context by the nurses so that they may not lose focus on their roles as professional nurses at a time that patients are in dire need of their services. The understanding of the compassion fatigue will help the nurses not to be carried away with the condition of the patient as it helps them be cushioned from experiencing the trauma and emotional fluctuation. The definition of what compassionate fatigue is has taken several dimensions depending on the focus of the writer and the aspect considered couples with the point to be driven. Najjar in his definition says that it is the conditions that arise to professionals who provide care to the patient and thereby get vulnerable and absorb their traumatic conditions (Henke, Barrie, and Thomas 172). The term compassion fatigue can at times be used interchangeably with other terms in the medical care to give the same sense of meaning. With regard to that, the following terms are used in close relation with compassionate fatigue to further corroborate in providing full understanding on how they are interrelated. Valent in 2002 distinguishes the concept of compassionate fatigue and burn out in the sense that compassionate fatigue arises when one cannot give remedy to a situation in which one is suffering or is harmed, he also explains that I compassionate fatigue, the incidences are abrupt and comes as a matter of agency. Unlike burn out that result from failure to provide a help to a situation that requires the help. This he says can be due to frustration. He also asserts that unlike compassionate fatigue, burn out are not sporadic. Counter transference This is another closely related term that is used to mean some of the conditions that oncology nurses may find themselves vulnerable to as they go about their business of caring for the cancerous patients. In this situation, the nurses tend to identify themselves with the patients and in that sense tries to achieve their own peculiar interest in the patient (Figley 166). For instance, this would happen in a situation where a nurse whose father succumbed to leukemia during his/her time in high school happen to be providing care to another patient of the same age and is also suffering from the same condition, the patient would have a reflection and finds himself/herself loosing focus on the professional code of conduct and identifying with the patient on grounds of reminiscence (Figley 176). Burnout It has a very close association with compassion fatigue and at times it is argued to be a precursor for compassionate fatigue. Burnout is commonly developed when one is disillusioned with his/her work in the sense that he/ she perceive it clearly that they cannot make a difference in people’s lives contrary to their wish (Figley 180). This may be due to shortage of personnel, inadequate facilities among others to enhance service provision. The occurrence of burnout is usually gradual and chronic as opposed to compassionate fatigue that is acute and can arise sporadically. Vicarious traumatization This is another emotional response seen to be manifested by the health care providers and has a long time effect. It makes the individuals to completely have a different perception on issues thereby making a completely different opinion about life. For example a nurse in the pediatric oncology having observed all the trauma and anguish the patient go through may decide not to conceive for the rest of her life on fears that she may be by chance be a casualty. The effect of vicarious traumatization lead to overboard changes in behavior (LaRowe 142). Who is at risk of developing compassion fatigue? Most of the reports that are published do not have the much about compassion fatigue that is related to oncology nurses. The incidence and the prevalence of the conditions are not well documented either. In the available research, there is very little to talk about with regard the development of compassion fatigue in gender and employment status (LaRowe 183). Some of the people at risk of developing compassion fatigue include the following; the inexperienced younger nurses who are in the duty of giving care to the oncology patients, nurses who have not in reality been involved in the management traumatic events and have just been having the traumatic history in theory, those nurses who are involved in the discharge of large amount of workloads and probably having to work for long hours, those nurses who are already in the state of experiencing burnout (LaRowe 199). At the same time, those nurses who are ill trained and have no proper communication are also known to be vulnerable in the development of compassionate fatigue; this can as well happen to those who are not well endowed with collegiate and personal support. Compassion fatigue vs burn out As stated above, those who are involved in providing care for the oncology patients faces many challenges that others may not be aware about. These individuals otherwise called nurses are faced with the daily observation of the patients in their adverse state. The problem that comes with nursing of these patients is acquired. This is so because as the nurses spend most of their times with the patients, they tend to develop emotional feelings with regard to their state of health. This is mostly manifested when they observe the patients dying in their death beds, being traumatized, others undergoing chronic illness while other are heart sank with acute illness. They perceived these patients to be socially disadvantaged and empathize with the patients to the extent that they themselves also get emotionally devastated. This results to a condition of compassion fatigue and burn out. Compassion fatigue has been define in very many perspectives and can be summarized in a snapshot as being the cost of caring for a patient. It must be noted that there are salient distinction between compassion fatigue and burnout and that they should not be usually used interchangeably. While the two remain to be emotional and mental interference brought about by caring for patients, it is important to note the differences that come with the two conditions. First it should be known that one of the two is a precursor of the other and in that regard, burnout is the precursor of compassion fatigue. Burnout is a process that is developed after a long period of time till a critical moment is reached that is transcends compassion fatigue. In that respect it comes clearly that burnout is a chronic condition that definitely needs time to strongly be manifested unlike compassion fatigue that sporadically sprout. Having known the nature of the development of the two conditions, it is necessary then that the cause of the conditions be known. While compassion fatigue is due to the fact that the nurses observe the traumatic events happening and that even which much support to reverse the conditions, the patients are destined to either die or their conditions keep on aggravating and they can do nothing to change the circumstances. In the event of burnout, the nurses are not in a state of providing the necessary care due to factors like inadequacy of equipments brought about by understaffing, inadequate manpower in the sense that the number of casualty cases surpasses that of the staff to undertake to them and most of them end up in severe state because they are not attended to adequately. All the factors that retards the work of the nurses in improving the state of the patients leads to the development of a chronic condition referred to as burnout. In further efforts to distinguish compassion fatigue and burnout, the following can be added; Compassion fatigue is developed due to interaction with the patient while burnout is developed due to the nature of the work environment. Again in compassion fatigue, the development is quite rapid and it can also be given remedy in the shortest time possible (LaRowe 244). This is not the case with burnouts which progressively develop and can culminate into a condition that is difficult to reverse. Compassion fatigue is characterized with mental symptoms, cognitive coupled with spiritual and physical emotional while in the burnout, the characteristics involves mental, emotional and physical tiredness or what is commonly referred to as exhaustion. Some of the symptoms of compassion fatigue are isolation, poor concentration, substance abuse, poor state of self care compulsive behavior as well as legal suits and indebtedness among many others (LaRowe 275). Origination of compassion fatigue The development the nomenclature, compassion fatigue draws mixed reactions as it traces its background from a very long time in history. The study of trauma is known to be traumatology- this is directly linked to the development of trauma due to the factors or circumstances that directly provide the development of trauma to the very person faced with the challenge. When this trauma is transferred to another horizontal person by virtue of being close to the affected persons, then a variety of terms have been used including compassion fatigue, Traumatic Stress, Vicarious traumatization Counter transference, and Secondary trauma (LaRowe 256). To give the origin of the compassion fatigue, it is prudent that first, we identify the year in which the term was used and for what purpose and motive. Then the chronology of the engagement of the world in the various stages will be considered up to the time it has found itself to mean acquisition of trauma by immediate person due to proxy. The origin of the term compassion fatigue traces its origin from 1907 in which it was first used Carl G. when he was discussing coutertransference in his writing ‘The History of Dementia Praecox’. The development of the concept led to the study of the effects of therapy on therapists. According to the Freudian classical consideration of what coutertransference, he considered it as the unconscious reaction that is advanced towards the conditions of the patient. Distinguishing these other terms from compassion fatigue has been a problem and there has been need to find unequivocal reference that is made to mean compassion fatigue. This is in relation to the definition of the countertransference which was perceived to include compassion fatigue. In the 1970s another term got into the limelight that is burnout. The term was introduced by Herbert and he addressed it as ‘Stuff Burnout’ in his writing where he used the concept in relation to the workers mental health in Pines and Malach’s journal “Characteristics of Staff Burnout in Mental Health Settings” (Figley 222). He made his definition of the term as exhaustion of the emotional capacity of an individual coupled with reduced personal effectiveness and depersonalization of people who do get involved in some routine jobs. In relation of the trauma that horizontally affect other people in proximity, Figley did made a reference to the observations he made during the Vietnam’s war, the tribulation of the soldiers who went to fight in the war and how their relatives were affected with their conditions. The engagement of the term was later widely used in the US in 1981 regarding emigration policies; again in the 1990 the media firms in the US developed serious concern about homeless crisis in the US and could not exercise patience to the issue. It is in this situation that the term compassion fatigue got wide public utterance. Joinson in 1992 used the term in the nursing context to denote the cost of giving care to other people during emergency case in the hospitals. He gave the in-depth effect of dealing with emergency case in the hospitals that nurses do undergo. The condition has also been used to mean secondary victimization, this was the reference made by Figley. He referred to is as secondary victimization because of the effects it inflicted on other people who are not directly associated with the primary problem. Having the definition of compassionate fatigue fixed, the term got an extended use in the health domain. It was used to refer to the emotional distress, trauma and empathy that an individual develop due to his /her professional job in caring for the patient with chronic and serious illness in which disillusion is involved. The term compassion fatigue since has then become synonymous with health care provision to patient. In this context, the term compassion fatigue has been discussed vis a vis the oncology patients. Oncology nurses in a daily routine are not only involved in the provision of physical care but also the emotional care with both the patient and the family members. It is at this point that oncology nurses do face the challenge of emotional unpreparedness thus leading to the emotional detriment. Signs and symptoms of compassion fatigue For the oncology nurses who are involved in the provision of care to the oncology patients, there is need that they be able to track and observe their emotional response to their work so that they keep the provision of the necessary services to the patients without compromising the quality. In the same breadth, they are able to shape their own live and behave normally despite the traumatic work they are involved in daily. With regard to this, it is important to gauge oneself with the sign and symptoms of compassion fatigue. In this exercise, the oncology nurses can take the scale of 1-10 as a measure of their condition with reference to compassion fatigue. The scale of 1 would in this case denote least affected by compassion fatigue and 10 indicative of serious negative impacts of the condition. Saakvitne and Pearlman in their writing in 1995 proposed that the signs and the symptoms of compassion fatigue can be looked at in three spheres; physical, psychological and behavioral (Mathieu 201). Physical Signs of Compassion Fatigue One of the most manifested physical signs is exhaustion,-the oncology nurses will have the prolonged state of not willing to resume duties even in the event that it was just a weekend and workers are expected to resume duties with zeal. When the nurses exhibit this condition continuously, it should be indicative of the state of compassion fatigue. Headaches, insomnia and increase level of vulnerability to other infection are indicative signs too. In this case the patient frequently falls sick, a condition that saliently indicate development of the condition. Somatization and hypochondria Somatization is a common condition with the development of compassion fatigue. It involves internal and automatic translation of emotional stress to physical conditions. This condition arises when the one is emotionally depressed and this result into adverse physical condition. The examples of the motional conditions that results into physical disorder are as follows; in the event that one experiences frequent stress coupled with headaches migraines and symptoms consistent to gastro intestinal are observed. Nausea is also caused by stress (Rothschild, and Marjorie 275). In this regard, the emotional conditions have different reactions in the different body parts and the individual oncology nurses should be informed on which part of their body is vulnerable to this emotional response. This is helpful in ensuring that they do track their conditions in time to avoid aggravating the conditions and detraction from work. Hypochondriasis on the other hand is an anxiety condition associated with hyper vigilance regarding a looming potential physical disorder. In the event that the condition is severe, there is he tendency to develop disorders associated with anxiety. This condition is resulted from a state of being worried for a long time about contracting or developing a condition (Bissett 211). It is important to notice that these conditions are not able to inflict conditions that can impair health, but the conditions can be used by an individual to identify the extent of vulnerability of the nurses so that the necessary prerequisites can be put into place to avert a possible adverse outcome that may be resulted from the mild form of the emotional response. Behavioral Signs and Symptoms The behavioral signs are those that are induced by the individual nurses in an attempt to diverse the effect of the compassion fatigue. They opt for these activities as away hibernating from the realities of the condition facing them. There is the tendency of these people to increase the use of drugs and alcohols. It has been observed that the nurses who are faced with emotional problems will always be involved in drugs administration to possibly cushion them from the realities facing them about life. This kind of the behavior cans results into chronic absenteeism from work (Bissett 204). Anger and irritability are some of the characteristics that are known to be key compassion fatigue symptoms. In this case the victims are angered with even the slightest issues. For instance, a victim of compassion fatigue will be angered and equally irritated by a simple laughter emanating from a lunch room. These people become critical of almost everything around them and have the problems in associating with the friend, family members, and even the clients. In the extreme cases the victim will end up quarrelling the children for not taking the garbage out for collection (Mathieu 177). Avoidance of the client In the case of compassion fatigue, the nurses will always devise method of hiding for the prospective clients as they perceive them as problems. The nurses will fail to receive calls from the clients or tend to hide for the clients so that they avoid the duties. Psychological signs and symptoms Psychological symptoms are the worst as they make the victim visualize imageries characterized with depression, emotional exhaustation, and distancing. The victims become anti social in several ways of life and in that sense develop poor intimacy. This has brought about several cases of couples problems. This is rounded up with the sense of professional helplessness due to the enormously challenging work environment (Mathieu 247). Ways to prevent compassion fatigue Nurses as in this case of oncology faces several challenges touching on emotions. In this regard, they need to find solutions to their problems. This is what is referred to us the management of the condition. In managing and subsequent prevention of the condition, it is necessary that we the victims submit to follow the prescribed criterion of getting off the condition (Rothschild, and Marjorie 266). In the first stage, one should be able to talk out their conditions in the with their bosses, this should be done in the atmosphere free of the prospective clients and other people who are in need of your services as it will show them that your are doubting your career and will make them be disillusioned in seeking your services. Because the effect of the compassion fatigue is both emotional and psychological, talking your predicament with others will enable you to have quick solution to your problems as they will be able to give you a solution if they had been faced with the same situation in the past and came over it (Florio 234). In some other ways of dealing with the condition, the victims are advised to write a journal about their status as this is seen as a way of self reflection which can advance a remedy to the condition. It does not really matter what you write down and the language you consider, all that is important is that you put in writings the frustrations you undergo (Florio 289). The step two way of managing the condition is taking a retreat for the purpose of a recharge. Healthcare organizations have since included the sense of recreation in their schedule for the nurses involved in the provision of care to the patients. In the recreation centers the nurses are expected to regain and normalize after the emotional reflection they have had for the past working days (Rothschild, and Marjorie 254). The nurses interact with their peers and exchanges experiences with one another so that they can appreciate the predicament s and the tough times their peers have managed to go through as well. One can also consider taking time off the job and if it is impossible, then one should visit a stress free zone in any of the restaurant around. As a career, nurses are trained to have the passion to help the patient and nit to say ‘No’. In real life one has to learn on how and when to say ‘No’ since failure to do this will automatically lead to burnout. The art of developing career needs has also been noted to be helpful, in this case one decides whether to change jobs after a period of time or advance to avoid the compounding of the emotional experiences (LaRowe 167). Finally, one has to balance the career and home life; this is helpful as it prevent skewed concern in the career path only which is detrimental to healthy life. Works Cited Bissett, Jennifer L. The relation between burnout and compassion fatigue in fire fighter- paramedics. New York, NY: Wiley Pub., 2002. Print. Figley, Charles R. Treating compassion fatigue. New York: Brunner-Routledge, 2002. Print. Florio, Christine. Burnout & compassion fatigue: a guide for mental health professionals and care givers. Charleston, SC: CreateSpace], 2010. Print. Henke, Barrie E., and Thomas J. Doyle. Coping with compassion fatigue. St. Louis, Mo.: Concordia, 1994. Print. LaRowe, Karl. Breath of relief: transforming compassion fatigue through flow. Boston, Mass.: Acanthus Pub., 2005. Print. LaRowe, Karl. Transform compassion fatigue: how to use movement & breath to change your life. Eau Claire, WI: PESI, 2010. Print Mathieu, Franc?oise. The compassion fatigue workbook: creative tools for transforming compassion fatigue and vicarious traumatization. New York: Routledge, 2012. Print. Rothschild, Babette, and Marjorie L. Rand. Help for the helper: the psychophysiology of compassion fatigue and vicarious trauma. New York: W.W. Norton, 2006. Print. Top of Form Read More