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Compassion fatigue in pediatric nurses
Nursing philosophy on compassion
Compassion fatigue in pediatric nurses
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Nurses should be empathetic and compassionate caregivers. However, what happens when nurses are constantly giving their energy to compassionate care, without seeing the positive outcomes nor being able to regain energy through self-care? This eventually would lead to compassion fatigue, which often results in impairment of concentration and diminished performance ultimately leading to poor quality of care. Preventing compassion fatigue can be achieved through a strong foundation with a comprehensive education consisting of critical thinking skills, evidence-based practice, leadership, management, and delegation, which are only taught in baccalaureate nursing programs. Nurses and nursing students must be reminded or taught that in order to prevent compassion fatigue, they should not only be taking good care of their patients but also themselves.
All caregivers are at risk for compassion fatigue, especially nurses, since our profession is based on taking care of the ill. One experience that illustrates this condition was when I helped on an Intensive Care Unit (ICU). I recall one nurse I met who had many years of experience but had a reputation of being anal-retentive and unfriendly. I would greet her every time I walked onto the unit, but she never responded. One day, this nurse was assigned to the son of a non-English speaking Chinese mother for whom I often acted as a translator. Her son was suffering from neuroleptic malignant syndrome and recovering from abdominal surgery for an ischemic bowel, which was infected. The mother rushed to me that day with a worried look and told me that the nurse was harming her son. She said she saw the nurse give two intravenous (IV) medications through his neck (internal jugular central venous ...
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...es have worked long and hard to advance their careers and should have higher standards for education and provide quality care not only for the patients, but for themselves. Additional focus on nurses’ personal health and higher education will allow the nursing profession to advance in the future with improved integrity and credibility and result in better healthcare for patients.
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The 2010 Institute of Medicine (IOM) Report- The Future of Nursing described the role that nurses have in the current and future US health care environment (IOM, 2011). This report was completed at a time when the Affordable Care Act had been passed and a new emphasis was being put on interdisciplinary healthcare teams, care coordination, value-based payment systems, and preventative care (IOM, 2011). Nursing is the largest profession in health care and with an aging baby boomer populace, the expanded role of nurses will be critical in meeting the growing healthcare burdens (Sisko et al., 2014).
Compassion fatigue is a complex form of secondary traumatic stress often experienced by nurses and other health care professionals due to their stressful work environment. Compassion fatigue is extreme exhaustion that penetrates all aspects of one’s wellbeing, including the physical, emotional, psychological and spiritual aspects of life (Murphy-Ende, 2012). Dealing with children who are both chronically ill or in palliative care is known to be extremely stressful. Not only are nurses faced with dealing with the physical symptoms of their patients, they also must attend to their fragile emotional state and be of assistance to their anxious family members. Oncologic diagnoses can put a child and their family into turmoil. Since the nurse is the first, and most constant point of contact, they are often the ones who become responsible for ensuring well-being of the entire family throughout the ...
...nate in their work and genuinely care for their patients, but to do this they must set professional and personal boundaries and be aware of the effect pain; trauma and death may have on their lives. According to Bush (2009), nurses must learn forgiveness and love themselves to prevent and overcome compassion fatigue. “Nurses should treat themselves with the empathy and compassion that they give others” (Bush, 2009, p. 27). Nurses should take time to nurture themselves by maintaining a healthy lifestyle and diet. They should also continue to participate in activities that they enjoy, get plenty of rest, and have a sense of self-awareness throughout their career. Additional resources are available to any caregiver to educate themselves on compassion fatigue at The Compassion Fatigue Awareness Project’s web site at http://www.compassionfatigue.org/index.html.
Current literature continues to reiterate the indicators of a major shortage of registered nurses (RNs) in the United States. The total RN population has been increasing since 1980, which means that we have more RNs in this country than ever before (Nursing Shortage). Even though the RN population is increasing, it is growing at a much slower rate then when compared to the rate of growth of the U.S. population (Nursing Shortage). We are seeing less skilled nurses “at a time of an increasingly aging population with complex care needs and an increasingly complex technological care environment” (Mion). According to recent data from the Bureau of Labor Statistics and the Department of Health and Human Services, it is estimated that “more than a million new and replacement nurses will be needed over the next decade” (Diagnosis: Critical).
It can be related to feelings of hopelessness and lack of meaning, anxiety, decreased ability to concentrate, irritability, insomnia, emotional numbing, lack of empathy, and escapist activities (such a self-medicating with drugs and alcohol). This is in direct opposition to the idea that nurses would be responsive to an insightful of their clients needs. Dennis Portnoy wrote “Compassion fatigue was often triggered by patient care situations in which nurses believed that their actions would “not make a difference” or “never seemed to be enough”. He further elaborated in the article Burnout and compassion Fatigue that nurses who experienced this syndrome also did so because of systemic issues such as; overtime worked, high patient acuity, high patient census, heavy patient assignments, high acuity, overtime and extra workdays, personal issues, lack of energy and lack of experience (Portnoy, 2011). These issues, interfere with the nurses' ability to identify with the patient and to tune in to important issues and obscure symptoms. Once consideration is that nurses can use Orlando’s theory to identify and address their own needs and respond with the same level of consideration to their own needs in order to prevent a burn out
...e with compassion fatigue will be of no use to help with the patient’s emotional and spiritual needs. The emotions of both the nurse and the patient needs to be met in order to establish good communication and compassionate care between the two.
Zerwekh, J., Claborn, J. (2006). Nursing today: Transitions and trends (pp. 343-346). St. Louis, Missouri:
The pediatric oncology unit has become a heavily studied area for those interested in prevention of compassion fatigue, burnout, and identification of those character traits that offer increased resilience. Nurses are expected to maintain professionalism and appropriate work-life balance but this may become a difficult task on a unit where children have a chronic, intensive, and potentially life-ending condition. Nurses become close to the patient and their family and when death occurs they too may feel a great sense of intense grief and loss. The acknowledgment of this grief and the promotion of adequate self-care habits, work-life divisions, and the ability to recognize when help may be needed are amongst the most important means in prevention of burnout and compassion fatigue. In addition to utilization of positive coping skills by the nurse a responsibility by the organization is also necessary to prevent staff burnout and turnover. The organization is responsible for acknowledgement of a loss on the unit. Presentation of prompt and anonymous counseling services to everyone on the unit following a death and regularly on high-risk units is just one of the many ways an organization can continue to decrease the loss of good nurses to compassion fatigue and
Some foresee their death and lack to feel the need of adhering to medication or advice from the practitioners. As a nurse who has learned the art of patient care, I try to revive the hope of the patients through cases of other patients who have been in the same situation but are still alive and healthy. Providing assurance to my patients has been a product of learning and understanding the essence of patient care. Vaughn and Spetz (2013) assert that there is a significant relationship between nursing education and the delivery of quality care for nurses. From the research, registered nurses with high education levels decreased the mortality rate for patients considerably. A different study by Weinberg, Cooney-Miner, and Perloff (2012) articulate that the hospital-based research conducted indicates that registered nurses having a baccalaureate of science in nursing were linked to low mortality rates among patients. As such, it is evident that education plays a critical role in the nursing career. As an individual, nursing education has increased my level of empathy when addressing various issues within the society. I am more
The Institute of Medicine has released a report that discusses the future in nursing. The IOM has developed four key messages that outline the barriers that need to be overcome, so that nurses can work effectively and to their fullest ability.
Nurses not only provide care but they play many other roles. For example, nurses are considered a communicator, teacher/educator, counselor, leader, advocate and collaborator (Taylor, Lillis, Lynn and LeMone. 2015). As a caregiver, nurses provide physical, emotional, intellectual, and spiritual needs. In addition, as a caregiver, nurse integrates the roles of communicator, teacher, counselor, leader, researcher, advocate, and collaborator to promote wellness through activities that prevent illness (Taylor et al. 2015). The primary role of a nurse is providing care to patients. One positive behavior a nurse should have is keeping boundaries between work and personal life. If a nurse is having a really bad morning at home, she shouldn’t express her emotions while she is working with patient. The patient and the coworkers don’t need to suffer because a nurse is having a bad day. Another positive quality every nurse should have is good working habits. They should come to work at least half an hour early so they can get organized and prioritize their work before starting the shift. In a health care setting, everyone works as a team. It’s very important to help each other out and also ask for help when
In my medical career, I have been privileged to work alongside some of the most professional, dedicated, knowledgeable and compassionate nurses. I have seen first-hand the difference that they can make in a patient’s life and their family, during those unfortunate times when sickness and injury can be so overwhelming. The appreciation and respect that I have for nurses, as well as their indispensable contribution to the health care system, is what encourage me to pursue nursing as a profession.
The Future of Nursing Being a registered nurse affords one the option of working in many diverse healthcare settings. In any practice setting, the climate of health care change is evident. There are diverse entities involved in the implementation and recommendation of these practice changes. These are led by the Robert Wood Johnson Foundation (RWJF), the Institute of Medicine (IOM), nursing campaign for action initiatives, as well as individual state-based action coalitions. Nurses need to be prepared and cognizant of the transformations occurring in health care settings, as well as the plans that put them at the forefront of the future.