Running head: COMBATING COMPASSION FATIGUE

Module 4: Combating Compassion Fatigue
Pamela Hartwell-Cooper
Grand Canyon University: HLT 310V Spirituality in Health Care
May 13, 2012

Combating Compassion Fatigue The purpose of this paper is to discuss the significance of Compassion Fatigue (CF) and its effects in the lives of caregivers. A caregiver is defined by dictionary.com as an individual, such as a physician, nurse, or social worker, who assists in the identification, prevention, or treatment of an illness or disability (dictionary.com). Caregivers may also include family members, friends or neighbors who voluntarily have accepted responsibility for looking after a vulnerable neighbor or relative. For the purpose of this paper, the primary caregivers discussed will be nurses. Most nurses chose nursing as a career because they have the desire to both help people and provide care for patients with physical, mental, emotional, and spiritual needs. Having this desire puts nurses at risk for suffering from CF. CF can affect nurses in many areas such as physically, emotionally, in job performance, as well as their attitude toward the work environment, coworkers, and their patients. Nurses suffering from CF may experience emotional symptoms that include, but not limited to; poor concentration, decreased focus, poor judgment, mood swings, irritability, anger and resentment (Eyre & Lombardo, 2011). Work related symptoms that may be experienced are; avoidance or dread of working with certain patients, reduced ability to feel empathy towards patients or families, and frequent use of sick days (Eyre & Lombardo, 2011). Physical symptoms often experienced are; headaches, digestive problems: diarrhea, constipation, and upset stomach, sleep disturbances: inability to sleep, insomnia, or too much sleep, and cardiac symptoms: chest pain/pressure, palpitations, and tachycardia (Eyre & Lombardo, 2011). If compassion fatigue continues and no interventions are implemented to combat it, full Burn Out will result. Burn out (BO) is defined as exhaustion of physical or emotional strength or motivation usually as a result of prolonged stress or frustration, which gradually builds to a breaking point (www.merriam-webster.com). Nurses suffering from CF or burn out are unable to provide their patients optimal care. In order to build a healthy relationship with patients, a nurse must have a lot of compassion. CF prevents caregivers from showing compassion as well as preventing them from providing effective care because they are tired, unmotivated, and not giving prompt attention to their patients. This is problematic because patients want and deserve not only good clinical care but also the feeling and warmth and compassion from their nurse. When a nurse is experiencing CF or BO he or she may be plagued by negative emotions which include frustration, anger, depression, feeling stuck, feeling paralyzed, irritability toward coworkers and clients, cynicism, bitterness, and being negative about self, others, and the world in general (Espeland, 2006). What patient wants or deserves a nurse who has thought tendencies such as these? It may also cause a hostile work environment for their coworkers as well. Their family life is also affected. The main cause of compassion fatigue is the increasing workload of healthcare. Nurses frequently feel overworked and overwhelmed by competing demands on their time. Nurses and other caregivers are required to put in much more time dealing with inflexible aspects of healthcare such as completing paperwork and computer documentation (Windsor, 2007). They are also encouraged to see more patients in less time, leaving much less time for the nurse/patient relationship (Windsor, 2007). Many times nurse have to work short staffed, but are still expected to complete all components of the job. Increased patient load and the desire to complete all task without the possibility of overtime causes nurses to use their lunch hour or stay late to complete task and complete charting. Thus, in trying to save time, they eliminate the very things that replenish their physical, emotional, and spiritual stores such as exercise, family meals, friends outside of work, or meditation (Windsor, 2007). Many nurses such as this writer are trying to balance work, family and school as well as other life events, putting themselves at high risk for CF or BO. Other difficulties include staff communication problems including not being heard and feeling unsupported, as well as no time to build relationships with patients and families and no time to follow up on important issues. It’s imperative to know the causes and the signs of the condition in order to prevent it or get help. Nurses need to provide for their own wellbeing by meeting their physical, emotional, and spiritual needs. Physically, the nurse must participate in exercising, relaxation, maintaining adequate sleep and nutrition. It’s important for them to keep themselves healthy so they can help their patients. Not eating right, drinking plenty of water or getting enough rest puts them and those they care for at risk. Ways they can help themselves physically is by purposely taking some time to take a walk, even if it’s just for 15 minutes. This writer knows personally the benefits of a 15 minute walk. It helps relieves stress, it lowers your blood sugar, and relieves those aching muscles. Eating right is also very important. Many times nurses eat on the run, grabbing whatever they can eat and still move. This is unhealthy. Learning to eat frequent small healthy meals can make you feel like a new person. Fruit, salad and healthy snacks like yogurt and nuts should always be on the list. Taking care of emotional needs is just as important as the physical needs. Nurses can reach out to friends and coworkers when feeling emotionally stressed or drained. Sometimes just having someone to talk to or feel that you can relate to can be so helpful. Today, many facilities have programs to assist employees who are having trouble or feeling stressed. The facility this writer works in provides employees with a psychologist who is available when needed to meet and talk to staff in a private and professional manner. Talking with someone often helps alleviate compassion fatigue by bringing the stress out of yourself and into the open (Windsor, 2007). Colleagues are often a good resource in this area, as they may be having similar day-to-day experiences. Professional counselors are also a good source of help. They have special training and may be able to help create a recovery plan (Windsor, 2007). It’s also a good idea for administration to meet with the staff to find out how they feel about different aspects of the job, and to see if there are any ideas to make their work environment healthier, less stressful and more fulfilling. Spiritual needs may be the most important need of all. Growing spiritually in relationship with God can bring about true healing and resilience. Reading the Bible, praying and meditating are the prescriptions that help us to prevent compassion fatigue, minimize its severity or find healing. God is the one who gave us the desire to be caregivers in the first place, so He is ultimately the one that can help us when we are troubled. Frequently counting your blessings and thanking God for them is so helpful. It takes your mind off of your problems, and keeps you from complaining all the time and thinking negatively. Praying and asking God to show you the source of your struggle and what's bothering you can be the beginning of the healing process. Attending church services routinely can help to revitalize you and prepare you to deal with the many circumstances you may encounter. There are many resources and coping strategies that nurses can use. One thing nurses must do is to remember to take care of them-selves. They need to be mindful that it is not selfish to put them-selves first. If they are healthy physically, emotionally and spiritually, they can be of more assistance to those they care for. Participating in any programs that their place of work offers them to improve performance, encourages physical renewal, and allows for time to de-stress should be encouraged. Joining a gym to get adequate exercise is a good idea. If the nurse has problems with their diet, attending nutrition classes may be helpful. Having a positive self-image is also a coping strategy that is essential for nurses to combat CF. Clearing the mind of negative thoughts immediately is also important. Prayer and meditation is a way to keep the mind clear and on a positive thought path. Learning to provide compassionate care for oneself, allows you to provide that same care to someone else. The most important coping technique of all is balancing their giving to others with giving to themselves (Bush, 2009). Only when nurses take time to heal themselves can they be truly available to aid in the healing of others. The major preventive self-care tasks well understood by the majority of nurse caregivers (Bush, 2009), as previously stated in this paper are: exercising, relaxation, maintaining adequate sleep and nutrition, and reaching out for support from others. In conclusion, suffering from this condition prevents nurses from providing quality care. Not recognizing or refusing to acknowledge and get help for compassion fatigue causes people to leave their profession, turn to drugs or alcohol, or in extreme cases become self-destructive or suicidal (Eyre & Lombardo, 2011). In today’s economy compassion fatigue can be very costly personally and professionally for nurses and financially for institutions (Eyre & Lombardo, 2011). It is important for nurses to become knowledgeable about compassion fatigue symptoms and intervention strategies and to develop a personal plan of care so as to and achieve a healthy work-life balance (Eyre & Lombardo, 2011). Equally as important is that healthcare systems invest in creating healthy work environments that prevent compassion fatigue and address the needs of nurses who are experiencing compassion fatigue (Eyre & Lombardo, 2011). It is important that we all recognize and understand this condition for our own health, but also for our coworkers. If you notice a coworker who you feel may be suffering from CF, reach out to them. Let them know you care and are willing and available to talk if they need you (Eyre & Lombardo, 2011). Remember yourself, and let your coworkers know that this condition is treatable, and you can get the help you need to get your life back on track.

References
Bush, N. (2009). Compassion Fatigue: Are You at Risk? Oncology Nursing Forum 36 (1), 24-28.
Espeland, K. (2006). Overcoming Burnout: How to Revitalize Your Career. The Journal of Continuing Education in Nursing 37(4), 178-184.
Eyre, C., Lombardo, B. (2011) Compassion Fatigue: A Nurse’s Primer. The Online Journal of Issues in Nursing 16 (1) Retrieved May 10, 2012 from http://nursingworld.org http://www.merriam-webster.com/dictionary, retrieved May 10, 2012
Windsor, E. (2007). Compassion Fatigue in the Helping Professions. Retrieved on May 11, 2012 from http://familystressencyclopedia.blogspot.com/2007/08/compassion-fatigue-in- helping.html