Combating Compassion Fatigue - Essay Example

?Introduction Compassion fatigue is a problem in the nursing profession. It encompasses job stress and burnout, which are lessor forms of compassion fatigue. Job stress is stress that is experienced for a short period of time, and burnout is job stress which occurs over an extended period of time. Compassion fatigue is burnout, plus the fact that the caregivers vicariously suffer the trauma of their patients, experiencing the range of emotions that their patients suffer, and absorb these emotions, and this adds to the level of stress. That said, while nurses experience compassion fatigue and burnout, this is not necessarily inevitable, and there are ways to cope. The nurses have physical needs, which means that they need to keep up their health by exercising, eating right and sleeping. They have spiritual needs, which may be addressed with prayer and meditation. And they have emotional needs, which may be addressed with setting boundaries and learning how to say no. That said, there are also concrete ways of dealing with stress, as Gupta & Woodman (2010) suggest. This paper will deal with compassion fatigue and its facets, including what the needs are for nurses, and how to address these needs. Symptoms Burnout is one of the major concepts of compassion fatigue. The signs of burnout, according to Espeland (2006), includes that the nurses are always exhausted, they are cynical and feel detached, and they feel that they are ineffective. They also exhibit signs that include anger, depression, paralysis, feeling stuck, irritability, cynicism, bitterness and negativity towards others, the self, and the world (Espeland, 2006). Job stress is another concept of compassion fatigue, according to Chen et al. (2009). They state that signs of job stress include job absences, conflicts with staff members, depression, staff turnover, and inferior caregiving. The difference between job stress and burnout is that burnout is the result of unrelenting job stress, over a period of time, therefore job stress is a lessor version of burnout. Compassion fatigue itself is an expanded version of burnout. As stated below, compassion fatigue is really burnout plus the fact that the nurses have to deal with very sick and dying patients, much of the time, as with oncology nurses, who exhibit high levels of compassion fatigue. According to Bush (2009), the signs of compassion fatigue are that the nurse identifies and integrates the grief, emotions and fears of their patients, and this means that their own stress and emotional pain are exacerbated. The nurses experience a kind of vicarious trauma in these situations, as they absorb the emotions of their patient, and this affects the nurse’s perceptions of trust, safety, self-esteem, control, and intimacy (Bush, 2009). Nature of the Problems and their Causes The nature of the problem of burnout is that it results in severe mental fatigue and is an energy drain, according to Espeland (2006). Espeland (2006) states that burnout also results in depersonalization and a reduced feeling of accomplishment. Espeland (2006) further states that there are five work situations which might contribute to job burnout. One is that there is ambiguity on the job, as there is a lack of goals and information. No-win situations represent another type of employment issue which contributes to burnout, and this means that the manager is always dissatisfied, no matter how well the nurses perform. Role overload is the third situation, and this means that the nurses have too many responsibilities. Role conflict is the fourth situation, which means that there are conflicting responsibilities and the nurses feel pulled in different directions. The fifth situation is when the nurses are underpaid, despite the fact that they work hard. Compassion fatigue is slightly different from burnout, but described by Bush (2009) as being an expanded form of burnout. In this case, it is distinguished from burnout, according to Bush (2009) by the fact that, in addition to there being stressors in the workplace, like between colleagues, there are additional stressors from the patients physical and emotional needs. As with burnout, compassion fatigue often results in anxiety, depression and apathy. The causes of compassion fatigue include the fact that nurses are always “on,” in that they must nurture at their profession, then go home and nurture some more. Moreover, according to Bush (2009), the inherent traits of the individual play a part in who gets compassion fatigue. Specifically, individuals who do not have support at home, and who are idealistic at the beginning of their career, are most at risk. Emotional, Physical and Spiritual Needs of Nurses According to Bush (2009), nurses need to learn courage and resiliency, such as what they teach their patients. In other words, the nurses teach their patients forgiveness, compassion and understanding of themselves. They must learn to apply these teachings to their own situations. Moreover, their physical needs are also paramount, and the physical intersects with the emotional. They must learn to relax, eat right, and exercise, as well as get enough sleep (Bush, 2009). According to Espeland (2006), nurses have further needs that they have to look at. One of them is the need to establish boundaries, and to become assertive. If a nurse does not establish boundaries, then his or her own time is infringed upon. The nurse then feels as if he or she is always working, and that working defines him or her. They also have the emotional need to change their thought processes. This means that they can change their negative thoughts into positive ones, and feel in their mind that they can do things. This leads to more positive thinking. Also, along the emotional end, according to Espeland (2006), nurses have a need to avoid negative communication. This would mean that, for their emotional health, they should avoid gossip and backbiting. This is also good because the gossiper might be perceived negatively, because they are spewing negativity. For their spiritual needs, as well as their emotional needs, Espeland (2006) states that meditation is a good way to shore this up. Listening to quiet music is another way. This means that the nurses can reinforce the positive emotions by doing this, as well as by hanging around with positive people. Moreover, Espeland (2006) states that, along the emotional needs line, nurses need to laugh and have humor in their lives. Laughter releases endorphins, which help kill pain and elevate mood. Examples of Coping Strategies and Resources There are a variety of coping strategies, and Gupta & Woodman (2010) have outlined a few. They recommend that nurses take fewer meetings – perhaps, instead of having weekly meetings, they could meet monthly. They also state that nurses may reorganise their caseloads. This would mean that nurses may take over small cases, and only share the large cases. This would give them more autonomy, and would reduce the need to frequently handover cases. Nurses may also remove families from their caseloads, if the families are not giving them input, or if the patient was ready for transition. Another solution is that, if a nurse worked more than 8 hours, he or she was given this time back. Another solution that they proposed is that workers, if they are working in an unusually stressful environment, should take off an afternoon and just have fun, such as go to a bowling alley. The nurses stated that this was a good way of relieving their stress (Gupta & Woodman, 2010). These are some of the hands-on ways that Gupta & Woodman (2010) relieved the stress of their nurses. Ekedahl (2007) provided other ways. They stated that boundary demarcation is one way, and the strategies that they advocated to demark boundaries are “ventilation and caritas oblivion” (p. 46). Caritas oblivion, explained Ekedahl (2007) refers to the permission for the nurse to forget patients who died, and instead focus on the living. They also advocated reconstructive strategies, which means that the event, person and sacred is reconstructed. Additionally, they note that prayer, along with physical and mental strategies, including exercise and proper nutrition, are also good coping strategies. Yoder (2008) expands upon this, stating that nurses may detach, which would be a form of caritas oblivion, and they may also use prayer to cope. Introspection or self-examination, which may come with meditation, are also recommended strategies. Conclusion Compassion fatigue is a serious problem in the nursing profession, especially with nurses who work with dying patients. If they do not take care of their own needs, then they are in danger of becoming bitter, angry and depressed, and this would, in turn, affect their daily work ethic. They must learn to take care of themselves in any way that they can. Whether this means setting boundaries, staying away from negative people, making sure that they are eating right and exercising, or praying, the nurse must find the coping mechanism which is right for them. Sources Used Bush, N. (2009) Compassion fatigue: Are you at risk? Oncology Nursing Forum, 36(1), 24-28. Chen, C., Lin, C., Wang, S. & Hoe, T. (2009) A study of job stress, stress coping strategies, and job satisfaction for nurses working in middle-level hospital operating rooms. Journal of Nursing Research, 19(2), 199-211. Ekedahl, M . & Wengstrom, Y. (2008) Coping processes in a multidisciplinary healthcare team – a comparison or nurses in cancer care and hospital chaplains. Journal of Cancer Care, 17, 42-48. Espeland, K. (2006) Overcoming burnout: How to revitalize your career. The Journal of Continuing Education in Nursing, 37(4), 178-184. Gupta, V. & Woodman, C. (2010) Managing stress in a palliative care team. Paediatric Nursing, 22(10), 14-18. Yoder, E. (2010) Compassion fatigue in nurses. Applied Nursing Research, 23, 191-197. Read More