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Nursing Burnout

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Nursing Burnout
Bridget Solomon
Grand Canyon University
Spirituality in Health Care, HLT-310V
Charles Self
January 9, 2015

Nursing Burnout Sitting on my couch yesterday I was scrolling through my Facebook page, when I came across one of my girlfriend’s posts. It was an article written by an inner city emergency room (ER) nurse. The name of the article was, Madness: tales of an emergency room nurse and how I became a bitch. The article talked about the everyday work life of an emergency room nurse. I am an emergency room nurse and have never worked in any other department and this article hit close to home for me. The article talked about the emotional and physical abuse that only an ER nurse would understand. After reading the article it made me think about nurses combating compassion fatigue. Some people might ask, “ What is compassion fatigue?” In this paper I will talk about the cause of compassion fatigue, talk about warning signs, physical, emotional, and spiritual needs of a caregiver, and last some coping techniques.
Causes of Compassion Fatigue Compassionate fatigue refers to the physical, emotional, spiritual, and social exhaustion that overcomes individuals and leads to persistent decline in their desire, energy, and ability to care for other people (Bush, 2009). As nurses our role is to be the patient’s number one caregiver. Many studies show that nurses experience a high level of compassion fatigue. Not a day goes by during a nurse’s shift where we aren’t placed in a constant roller coaster of heart tugging, emotional encounters. Nurses get emotionally invested in the care of their patient’s, by being involved in difficult conversations and sometimes the bearer of bad news. After a long day of this type of work nurses have to go home and take care of their own families, and don’t take time for them selves causing emotional fatigue. Compassion fatigue comes from personal connections nurses create with patients and their family. It’s caused by an emotional commitment and interpersonal passion coupled with observing tragedy in their work setting. Burnout generally progresses over time. The term ‘burnt out’ is when a nurse progressively withdraws, and the 'compassionately fatigued' nurse attempts harder to meet the patient’s needs. Together they have the same outcome, it causes the nurses to feel like she is ‘running on empty’ (Najjar et al., 2009; Yoder, 2010).
Warning Signs For Five Concepts of Compassion Fatigue Nurses work in a healing profession that requires us to handle pain and distress, it is personal, behavioral, emotional, and spiritual experience. Nurses work on high levels of stress, and deal with suffering; these are some signs of physical and mental illness. Nurses are more successful and enjoy more professional satisfaction when we practice with empathy and compassion. Five concepts that can occur are physical exhaustion, emotional exhaustion, apathy, depression, and compulsive behaviors (Tunajek, 2006). A nurse developing any of these concepts can be considered warning signs that they are suffering from compassion fatigue. Physical exhaustion is a decrease in energy supply, not getting enough rest, and lack of physical exercises. Some problems that arise from insufficient nutrients, physical exercise, and physical rest are irritability, fatigue, and insomnia. If these problems aren’t dealt with, they can cause physical complications like dizziness, chronic pain, ulcers, headaches, fatigue, and a break down in your immune system (Bush, 2009). Emotional exhaustion happens when you lack an emotional balance. Nurses play many roles in today’s society; they have to balance family, life, and their job. Nursing is a very demanding profession; you are caring for the sick with limited resources causing nurses to create unrealistic expectations (Bush, 2009). Nurses create a tireless arrangement and emotional connections with patients, shouldering a huge supporting role. Supporting this role causes nurses to feel emotional exhaustion and the weight of care for patients can become overwhelming. Signs of emotional exhaustion can cause nurse to become hostile, isolated, start crying for no reason, and getting upset (Bush, 2009). Apathy means lack of concern or interest, as well as lack of emotion or feelings (Bush, 2009). Exhaustion of emotional reserves can cause nurses to become apathetic, uncaring, and preoccupied. It takes a toll psychologically on the mind causing emotional overload before a nurse becomes numb to emotions. Apathy eventually causes you to feel fatigued and a lack of concentration and reduced productivity at work. Long-term apathy can cause absenteeism and tardiness, complaints by co-workers and patients, and result in job termination (Bush, 2009). Depression happens when someone has extreme feeling of hopelessness and sadness. Signs of depression include lack of one’s self worth, happiness, Indicators of depression include lack of self-worth, determination, feelings of failure. Nurses experience depression because of the roles they play in their home life and at work, sometimes causing unrealistic personal expectations (Bush, 2009). Compulsive behaviors serve as the reaction of the other concepts of compassion fatigue. Compulsive behaviors are impulsive decisions or actions that are made without considering a consequence. Nurses often display these compulsive behaviors to deal with their stress. Compulsive behaviors can be overindulging in shopping, eating, drinking (Bush, 2009).
Spiritual, Physical, and Emotional Needs of a Nurse The needs of nurses need to be meet to prevent compassion fatigue. Nurses need to find a spiritual outlet such as attending church; praying meditating or doing something that renews their sprit. Nurses need to maintain a well balanced diet, not caffeine or fast food, and need to drink a lot of water. Nurses need to get regular exercise and adequate sleep. Nurses need to emotionally recharge to avoid emotional fatigue, do things that make them just feel happy. Nurses need to take care of themselves to continue to provide the best care for our patients. We became nurses for a reason because we love to take of people; sometimes I think it’s a calling.
Coping Strategies and Resources for Nursing Practice The number one cure for compassion fatigue is to prevent it from occurring. As nurses, we need experience some self-indulgence and putting our self-first in order to prevent compassion fatigue. Creating a healthy and happy personal life style can help us prevent compassion fatigue. Positive self-care is about making a personal commitment to ensure that you are functioning at your best. You are getting proper sleep, drinking lots of water, eating a healthy diet, exercising, emotional and spiritual support. These are necessary mechanisms for nurses to use as coping strategies and without these a nurse can experience compassion fatigue. Some good examples of cope strategies are: change your daily activities, have a meaningful conversation everyday, and spend quiet time alone.
Conclusion
In conclusion nurses struggle everyday with emotional, physical, and psychological situations (Bush, 2009). Nurses stress levels grow to sometimes-unmanageable levels due to higher acuity of patients, increased patient ratios, lack of staff. Dealing with these environmental job hazards nurses function on a high levels of stress, creating compassion fatigue. With the baby boomers getting older and health care reform I see more compassion fatigue as the demands of a nurse increase. As, nurses we do need to find a work-life balance to combat compassion fatigue.

References
Bush, N.J. (2009). Compassion fatigue: Are you at risk? Oncology Nursing Forum, 36(1), 24-28.
Huber, L. M. (2009). Making Community Health Care Culturally Correct. Retrieved from http://www.americannursetoday.com/article.aspx?id=5654&fid=5636
Tunajek, S. (2006, September). Compassion Fatigue:Dealing with an Occupational Hazard [Supplemental material magazine]. , 24-26. http://dx.doi.org/http://www.aana.com/resources2/health-wellness/Documents/nb_milestone_0906.pdf
Yoder, E.A. (2010). Compassion fatigue in nurses. Applied Nursing Research, 23(4), 191-197.

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