This writer will define and identify the keys components to compassion fatigue. This writer will also expound upon the warning signs of compassion fatigue and some interventions that can be put into place by the care giver to help avoid compassion fatigue. This writer will further give some helpful coping skills that can be used to manage compassion fatigue and the resources a care giver can turn too in the event they experience compassion fatigue.
Compassion fatigue has been defined as a combination of physical, emotional, and spiritual depletion associated with caring for patients in significant emotional pain and physical distress (Anewalt, 2009). It can also include depression, apathy, and impaired judgement. It is considered a unique form of burnout that affects individuals in care giving roles (Lombardo, 2011). While compassion fatigue can sometimes be precipitated by burn out, that is not always the case.
Burn out is defined as “a syndrome of emotional exhaustion, depersonalization, and reduced accomplishments that can occur among individuals who do ‘people work’ of some kind” (Maslach & Jackson, 1986, p. 1). While the symptoms of both are similar, the warning signs differ greatly. Some of the warning signs a care giver may be experiencing compassion fatigue include work-related symptoms, physical symptoms, and emotional symptoms (Lombardo, 2011).
Some of the work related symptoms may include avoidance or dread of working with certain patients, reduced ability to feel empathy towards patients or families, frequent use of sick days, and lack of joyfulness (Lombardo, 2011). Some of the physical warning signs include headaches, digestive problems, inability to sleep, insomnia, too much sleep, and cardiac symptoms such as chest pain/pressure, palpitations, and tachycardia (Lombardo, 2011).
Emotional signs of compassion fatigue can include mood swings, restlessness, irritability, oversensitivity, anxiety, excessive use of substances like nicotine, alcohol, and illicit drugs, depression, anger and resentment, loss of objectivity, memory issues, poor concentration, focus, and judgment (Lombardo, 2011). While a care giver can experience any of the above symptoms at any time during their career, it is important to note that a combination of any of the above symptoms would be used to determine whether or not a person is experiencing compassion fatigue.
Possible factors leading to compassion fatigue can be classified according to personality characteristics, previous exposure to trauma, empathy and emotional energy, response to stressors, and work/organizational characteristics (Sabo, 2011). Research clearly demonstrates that working with patients who are in pain, suffering, or at end of life may take a toll on the psychosocial health and well being of nurses (Sabo, 2011). To determine whether or not a health care giver is experiencing compassion fatigue an assessment tool has been developed.
The following is a basic assessment that can be done by the nurse to help determine the risk of compassion fatigue. Description/evaluation of one’s work setting and working conditions; one’s tendency to become over involved; one’s usual coping strategies and management of life crises; one’s usual activities to replenish self physically, mentally, emotionally, and spiritually; and one’s openness for learning new skills to enhance personal and professional well being (Lombardo 2011).
Some interventions that could be used to help reduce the incidence of compassion fatigue include early recognition of signs and symptoms, staying physically fit, staying well rested, develop healthy and supportive relationships outside of the work environment, and implement diversions like journal writing, counseling, or enjoyable recreational activities to help combat compassion fatigue (Panos, 2007). One could also seek guidance from a mentor or counselor. Koloroutis (2007) identified three core relationships for transforming practice using relationship-based nursing including the nurse’s relationship with patients and families, the nurse’s relationship with self, and the nurse’s relationship with colleagues.
The nurse’s relationship with self is a core concept in managing compassion fatigue. Nurses need to be assertive, to express personal needs and values, and to view work-life balance as an achievable outcome. This relationship with self is essential for optimizing one’s health, for being empathic with others, and for being a productive member of a work group within a healthcare facility (Lombardo, 2011). The coping strategies for dealing with compassion fatigue fall along the same line as those of prevention.
If one were to find that one is experiencing compassion fatigue some coping strategies would include exercise, maintaining a personal life that includes healthy relationships, develop a sense of humor, set limits between work and home activities, and broaden your horizons. The Compassion Fatigue Awareness project has developed as a result of more and more care givers experiencing this trauma. This project gives resources for workshops, training, and counseling for care givers. Conclusion.
In conclusion, compassion fatigue can take its toll on care givers and cause dissatisfaction for the care giver and their patients. It is imperative that care givers learn to recognize their limitations, know themselves on a spiritual level and just how much they are able to give of themselves in a work environment without over extending themselves which could then lead to compassion fatigue and/or burn out. It is also important for the care giver to implement strategies to help avoid burn out and compassion fatigue.
These strategies could include those listed above as well as time for mediation at work, create a relaxing environment at work by transforming the work station, or just finding the time to discuss complex patient situations with supportive co-workers. References Anewalt, P. (2009). Fired up or burned out? Understanding the importance of professional boundaries in home health care hospice. Home Healthcare Nurse, 27(10), 591-597. Koloroutis, M. (2007). Relationship-based care: A model for transforming practice.
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Panos, A (February, 2007). Promoting resiliency in trauma workers. Poster presented at the 9th World Congress on Stress, Trauma, and Coping, Baltimore, MD. Sabo, B. , (Jan 31, 2011) “Reflecting on the Concept of Compassion Fatigue”OJIN: The Online Journal of Issues in Nursing Vol. 16, No. 1, Manuscript 1. Retrieved Sept. 29th, 2012 from: http://www. nursingworld. org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-16-2011/No1-Jan-2011/Concept-of-Compassion-Fatigue.