Do you wonder how hospice nurses sustain compassionate practice as they work every day with suffering patients who always die? Expert hospice nurses embrace the suffering of the client and family and become susceptible to compassion fatigue. Compassion fatigue is often viewed as secondary stress. It is the stress felt by the caregiver from exposure to a traumatization. Nurses often describe this as overload. Although signs of compassion fatigue are individualized, they often include exhaustion and a reduced ability to express empathy for the client. This may result in withdrawal by the nurse emotionally from the client and family, as well as the role of nurse.
Staying psychologically as well as physically healthy as a hospice nurse requires a high level of self-awareness. Nurses must be aware of the signs and symptoms that they may have a tendency to exhibit. Symptoms are individualized based on how a particular nurse adapted to stress in the past and are often subject to developmental, spiritual, cultural, and environmental influences. Recognition of the symptoms allows the hospice nurse to institute stress-relieving activities early in the process. According to the Compassion Fatigue Awareness Project (2017), some symptoms that a nurse may experience include the following:
Isolating oneself; poor self-care (appearance, hygiene)
Repressed emotions; apathy; mentally/physically exhausted
Always finding blame with others; many complaints about job/administration
Substance abuse; compulsive behaviors (e.g., eating, spending, gambling)
In debt; legal problems; recurrent flashbacks/nightmares; chronic health problems
Problems concentrating; feeling preoccupied; denies problems
Compassion fatigue can affect an agency, if enough nurses suffer from the problem and nothing is done to assist them. It can cause problems between nurses and administrators, lead to high turnover and absenteeism, and lead to self-perpetuation. Organizations may exhibit these symptoms:
Poor teamwork; high absentee rates; continually changing coworker relationships
Challenging/breaking agency rules; aggression among staff members
Poor task/assignment completion; unable to meet deadlines; lack of flexibility
Negative feelings toward management; reluctance toward change
Poor vision of future; not able to believe that improvements can be made
Compassion fatigue is not isolated to hospice nurses. All nurses are susceptible to the effects. This may lead to higher rates of turnover and an increase in the nursing shortage as nurses leave the profession.
Often, caregivers experiencing compassion fatigue are unable to identify it in themselves.
Answer EACH question below:
1. What ways can you identify compassion fatigue in others?
2. What recommendations can you make to reduce compassion fatigue for yourself?
3. How can you transform your organization to reduce compassion fatigue?