Compassion Fatigue and Burnout: What Managers Should Know

A Scoping Review of Compassion Fatigue Among Oncology Nurses Caring for Adult Patients

BACKGROUND

Oncology nurses have frequent contact with oncology patients during their cancer journey. This long-term, recurrent contact can impact the health and well-being of the nurse through the development of compassion fatigue (CF).

OBJECTIVES

To identify what contributes to CF and what individual, interpersonal, and organizational factors mitigate CF among oncology nurses caring for adult patients.

METHODS

A scoping review framework by Arksey and O'Malley guided this review. Electronic databases were searched for relevant studies. A blinded screening process was undertaken by the authors using the following inclusion criteria: English language published from January 2011 to December 2021, primary research peer-reviewed studies, and focusing on CF within oncology nurses caring for adult patients in any practice setting.

RESULTS

Nineteen studies (21 articles) were identified. The review found nurses' personal beliefs around nursing care being provided, and personality traits of psychological inflexibility, neuroticism, passive coping, and avoidance contributed to CF. Workplace conflict and lack of a healthy work-life balance also contributed to CF. However, nurses' personal resilience, ability to positively reflect upon their work, a supportive team environment, and continuing education were found to mitigate CF.

CONCLUSIONS

Levels of CF vary among oncology nurses caring for adult patients. Oncology nurses may benefit from personal and organizational resources aimed at improving oncology nurses' professional quality of life while decreasing CF.

IMPLICATIONS FOR PRACTICE

Consideration and future research of effective interventions are needed to sustain a future health workforce and mitigate CF among oncology nurses.

Compassion Satisfaction, Burnout, and Secondary Traumatic Stress among Saudi Nurses at Medical City: A Cross-Sectional Study

Compassion satisfaction, the pleasure gained from assisting others in their recovery from trauma, can help reduce the effects of burnout and secondary traumatic stress. As such, nurses' job satisfaction can be increased by increasing compassion satisfaction and decreasing compassion fatigue. This study examined the incidence of compassion fatigue and other influencing variables, such as compassion satisfaction, burnout, and secondary traumatic stress, among Saudi nurses. This was a cross-sectional study using convenience sampling. Participants comprised 177 registered nurses from various nursing departments. Data collection included the Professional Quality of Life Scale based on lifestyle, demographic details, and occupation-related questions. The averages of scores for the variables, compassion satisfaction, burnout, and secondary traumatic stress, were recorded (37.1 ± 7.4, 25.7 ± 7.5, and 26.7 ± 6.4). Participants aged 36 or older comprised a negative factor for compassion satisfaction, while years of nursing experience and higher job satisfaction were favorable predictors. Together, these three variables accounted for 30.3% of the overall variation. Low job satisfaction and poor sleep negatively affected burnout, accounting for 39.8% of the total variance. The results offer insights into identifying the risks of compassion fatigue in nurses and help design strategies to address burnout and secondary traumatic stress while enhancing their compassion satisfaction levels.

Compassion fatigue, compassion satisfaction, and burnout: A study of nurses in a large Texas health-care system

PURPOSE

The purpose of this study is to examine compassion satisfaction, compassion fatigue, and burnout in nurses at a large nonprofit, Catholic-based health-care system in southern Texas.

DESIGN AND METHODS

This is a cross-sectional, exploratory study using a self-report survey. The survey included a demographic questionnaire and the Professional Quality of Life Scale version 5 (ProQOL 5). It was emailed to 1000 nurses at a large health-care system in Texas, USA. Three hundred and eighteen nurses completed the survey for a response rate of 31.8%.

FINDINGS

The results find low mean levels of compassion fatigue (CF) and burnout and high mean levels of compassion satisfaction (CS) among the nurses. Hours worked and nursing specialty emerged as factors in whether the nurses experienced CF or CS. The nurses with less than 10 years of experience have lower levels of CS and higher levels of burnout than those with over 10 years of experience. Finally, nurses who hold professional certification have statistically significant higher CF scores than those who do not.

CONCLUSIONS

Health-care settings may need to take into consideration the number of hours worked and nursing specialty as significant factors in whether nurses experience CF or CS.

CLINICAL RELEVANCE

Three key elements in CF prevention are education, awareness, and self-care. Often the climate in health-care settings discourages medical professionals from practicing effective self-care. The strategies for combating burnout are linked to changing health-care systems so that nurses are supported. Hospitals may explore alternative work schedules and lower patient loads to prevent CF and burnout.

Trauma, Compassion Fatigue, and Burnout in Nurses: The Nurse Leader's Response

Within health care, trauma-informed care has become an embedded approach in caring for patients; however, nurse leaders are not always prepared to lead nurses with a background of trauma. Nurses' past trauma, coupled with workplace stressors, may result in compassion fatigue, burnout, and secondary traumatic stress. Nurse leader engagement and trauma-informed leadership approaches are imperative to mitigate and mediate the effects of trauma in nurses as the COVID-19 pandemic recedes.

The relationships between self-efficacy, self-care ability, and burnout and compassion satisfaction among hospice staff in Taiwan

OBJECTIVES

Professional quality of life involves the negative and positive effects of proving care to terminal patients on health care professionals, including burnout and compassion satisfaction. Around 18% of hospice staff have experienced burnout, and few studies explore the role of an innate ability to cope with burnout. The aim of this study was to explore the significant predictors of burnout and compassion satisfaction as well as the coping strategies among hospice staff in Taiwan.

METHODS

A cross-sectional study was conducted, and 220 hospice staff were recruited. Standardized questionnaires were used to collect self-rated stress and growth due to hospice care, self-efficacy, self-awareness, and managing emotion.

RESULTS

Hospice staff who perceived higher stress and lower growth due to hospice care and had lower self-efficacy in providing hospice care experienced higher burnout and lower compassion satisfaction. Those who had a lower level of ability related to self-awareness and managing emotion tended to experience higher burnout. The common coping strategies included seeking social support, taking professional courses for clinical skills, and developing hobbies.

CONCLUSION

Hospice staff have to develop professional abilities in regard to hospice care as well as an ability to maintain awareness and manage emotions related to work.

Cumulative Stress Debriefings to Combat Compassion Fatigue in a Pediatric Intensive Care Unit

BACKGROUND

Nurses working in pediatric intensive care units report high levels of compassion fatigue from exposure to critical and traumatic events. Cumulative stress debriefings can reduce compassion fatigue.

OBJECTIVE

To evaluate the use of cumulative stress debriefings to alleviate symptoms of compassion fatigue and promote job satisfaction in nurses.

METHODS

In this quality improvement study, a survey modified from the Self-Reporting Questionnaire-20 was distributed to pediatric intensive care unit nurses at a large, tertiary, freestanding children's hospital on the US West Coast to measure compassion fatigue and job satisfaction. The survey revealed widespread symptoms of compassion fatigue. Subsequently, monthly 1-hour cumulative stress debriefing sessions were initiated in the pediatric intensive care unit. Between 149 and 168 nurses were eligible to participate across time points. Interprofessional team members were trained and paired to facilitate the debriefings. Follow-up surveys were distributed at 6, 9, and 12 months after implementation of the intervention.

RESULTS

Survey response rates ranged from 22.6% to 49.7%, with responses declining over time. Nurses who attended 1 or more cumulative stress debriefings reported fewer symptoms of compassion fatigue and negative personal effects from work and were less likely to consider leaving their current position and the nursing profession. Results indicated a high level of acceptability of the intervention, with nearly 90% of participants at 9 and 12 months indicating that they were likely to attend a future session.

CONCLUSION

Initiation of cumulative stress debriefings may reduce compassion fatigue and improve job satisfaction in nurses.

Compassion fatigue, burnout and compassion satisfaction among emergency nurses: A path analysis

AIMS

To verify a hypothesized model of the relationships between compassion fatigue, burnout and compassion satisfaction, as well as their influencing factors and consequences, among emergency nurses.

DESIGN

A descriptive, cross-sectional design.

METHODS

A hypothesized model was proposed on the basis of the current literature. A convenience sample was conducted of nurses working in the emergency departments of six hospitals in Shanghai, China, from July to September 2020. A total of 445 valid data points were collected using various self-designed and well-validated instruments. Descriptive statistics and correlations were computed, and a path analysis was used to assess model fitness and to investigate direct and indirect effects.

RESULTS

The final model reported a desirable fit with significant paths. Compassion satisfaction and compassion fatigue directly and inversely affected burnout, and compassion satisfaction positively influenced compassion fatigue. Perceived social support directly improved compassion satisfaction and protected against compassion fatigue. Compassion satisfaction and compassion fatigue directly affected mental health, and burnout directly influenced physical health. Compassion fatigue, burnout and compassion satisfaction had complicated effects on turnover intention.

CONCLUSION

Emergency nurses' compassion satisfaction and compassion fatigue may be two coexisting constructs, and both affect burnout. Perceived social support acts as a protector of the three dimensions, and their effects on health status and turnover intention can be significant and complicated.

IMPACT

Emergency nurses may experience high levels of compassion satisfaction and compassion fatigue simultaneously, which can help to explain why compassion fatigue did not directly increase emergency nurses' turnover intention. The direct effects of compassion fatigue and burnout on emergency nurses' health status and working engagement were significantly different. Support from significant others, professional psychological intervention and emergency nursing system reforms are required to tackle emergency nurses' compassion fatigue and burnout and improve their compassion satisfaction.