Introduction
The profession of nursing carries with it a high risk for burnout
and compassion fatigue. While these two terms may seem synonymous, there are
some significant differences. These differences aside, however, the issue of
how nurses can successfully cope with the potentially debilitating emotional
and physical exhaustion that comes with the close and intense contact with the
emotions of patients and their families as we provide nursing care needs to be
addressed. There are a number of tools and technique available, but are we
making the most effective use of them?
This signage, in the current context, begs the question of, “Where
is the safe space for nurses? It’s a question, the answer to which, nurses must
be seeking from the administrators of acute and long term care facilities
alike.
Compassion Fatigue and
Burnout
Compassion fatigue and burnout may seem to be interchangeable
concepts, and have some similarities, but0 they are separate and distinct. In
both cases, we see “added coping and adaptational demands on nurses” (Boyle, 2011). The most
significant distinction lies in their acuity, with burnout occurring over time
and compassion fatigue presenting more acutely (Boyle, 2011).
Additionally, burnout is generally a reaction to stresses experienced in the
workplace, while compassion fatigue is a consequence of the experiences of the
pain and suffering nurses are exposed to in caring for their patients (Boyle, 2011). In terms of
those tending to suffer from compassion fatigue, older nurses (≥ 50 years of
age) seem to suffer less from compassion fatigue than do their younger
co-workers. This may be attributable to their greater clinical and life
experience (Sacco, Ciurzynski,
Harvey, & Ingersol, 2015). Regardless of age and experience, compassion
fatigue can have leave its mark on any nurse or other caregiver. So, what can
we do to make that “safe haven”? That place where we can take the time to
recover our spent energies and our emotional and spiritual equilibrium?
Building a “Safe Haven”
There are three key components to creating the safe havens nurses
and other members of the healthcare team need to foster recovery from the
stresses leading to compassion fatigue. These are prevention, assessment and
mitigation of the consequences that can arise in caring for acutely and
critically ill patients.
Work-life balance is a crucial aspect of this process, as it
provides nurses the time and opportunity to take time to establish and follow a
plan of self-care so that they can effectively care for their patients (Boyle, 2011). But this plan
must be scrupulously and, “relentlessly carried out in an attempt to enhance a
calm state” (Boyle, 2011). This
latter point, to my mind however, seems to be self-defeating. How can one
achieve a measure of calmness, serenity and equanimity through such relentless
pursuit? Mindfulness and diligence are more appropriate for this endeavor.
First, we have to recognize a very fundamental fact. That being
that we simply cannot face the suffering of patients and their families on a
daily basis and remain unscathed by that experience (Boyle, 2011). Such an
expectation is unrealistic at best and self-deception at worst.
On an individual level, it requires mindfulness of our own internal
states, and the knowledge to recognize the signs of our own compassion fatigue…
WORK RELATED
|
EMOTIONAL:
|
Avoidance
or dread of working with certain patients
Reduced
ability to feel
empathy towards
patients or families Frequent use
of sick days
Lack of joyfulness
|
Mood swings Restlessness Irritability Oversensitivity Anxiety
Excessive use of substances: nicotine, alcohol, illicit drugs Depression
Anger and resentment Loss of objectivity Memory issues
Poor concentration, focus,
and judgment,
|
PHYSICAL:
|
|
Headaches
Digestive
problems: diarrhea, constipation, upset stomach Muscle tension
Sleep disturbances: inability to sleep, insomnia, too much sleep Fatigue
Cardiac
symptoms: chest pain/pressure,
palpitations, tachycardia
|
|
| Source: (Lombardo & Eyre, 2011) | ||
Conclusion
Dealing with compassion fatigue requires effort…proactive
effort…on the part of individual nurses and the organizations they work for. On
the individual level, we need to be mindful of our internal state and diligence
in following a process by which we care for ourselves so that we can better
care for our patients. We must, in this process, be gentle with ourselves. We
will make missteps and mistakes in the process, the expectation of perfection
is both unrealistic and counterproductive (Chordron, 1991). We must be
proactive instead of reactive. At the organizational level a proactive stance
is essential to prevent and ameliorate the effects of compassion fatigue for
nurses and other caregivers. If organizational support is limited, or difficult
to obtain, nurses need to step up and insist on having that “safe haven”. Our
health, and that of our patients, depends on it.
References
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