Combating Compassion Fatigue Essay

The nursing profession is a complex field that can challenge you mentally, physically, emotionally, and spiritually. People who go into the field of nursing have daily interacts with patients’ and families in need of medical help and guidance. Nurses face numerous challenges on a daily basis and must be able to handle not only their patients’ issues, but remain strong and healthy to avoid compassion fatigue and burnout. Compassion fatigue is defined as emotional, spiritual, and physical exhaustion resulting from “witnessing and absorbing the problems and suffering of others” (Wisniewski, 2013). Compassion fatigue can lead to burnout with one’s professional career and affect home life. Caregivers can also be affected by compassion fatigue and burnout from the roles that they play with their loved ones. It is vital to be able to identify the warning signs of compassion fatigue and burnout. This is a battle that can be “fought with a commitment to personal health and well-being” (Chapman, 2007).

Health care professionals and caregivers need to be able to find a balance and maintain health in their own spiritual, physical, mental, and emotional lives to assist patient’s to optimal care. Strategies on stress management, healthy lifestyle choices, and resources available will be discussed to help prevent and manage these issues. “Nurses are the backbone of the medical system and act as the first line of patient medical care” (Chen et al., 2009). Dealing and coping with stress is vital for nurses to maintain to provide adequate care. Compassion fatigue is a feeling of hopelessness and a loss in the sense of meaning in one’s life. Symptoms can be “strong feelings of anxiety, difficulty concentrating, being jumpy or easily startled, irritability, difficulty sleeping, excessive emotional numbing, and intrusive images of another’s traumatic material” (Portnoy, 2011). These symptoms need to be recognized to receive help or they can progress to long-term effects and complications. There are five concepts of compassion fatigue that need to be addressed to help with prevention and burnout.

The first concept is cognitive; symptoms can be apathy, disorientation, trouble concentration, and harshness. The second concept is emotional; signs can be anxiety, fear, helplessness, feelings of powerlessness, depression, having bad dreams, and shock. The third concept is behavioral which can be lack of sleep, moody, change in appetite, withdrawn, and repeatedly having bad dreams. The fourth concept is spiritual. This area can lead the individual to question their role in life and their profession, feelings of being lost, and questioning faith and personal beliefs. The last concept is somatic, meaning affecting one’s voluntary nervous system. This can cause rapid heartbeats, trouble breathing, headaches, aches and pains, trouble staying or falling asleep, and sweating (Portnoy, 2011). There are numerous factors that can lead up to and cause compassion fatigue. Triggers can be issues with management such as nursing acuity, patient to nurse ratios, overworked nurses, personal issues, lack of support from coworkers or bosses, and loss of the feeling that the nurse is making a difference.

To combat these factors in nurses and other employees in health care, managers and organizations need to be aware of this dynamic issue and offer help (Portnoy, 2011). Creating an open environment along with education and training on how to deal with these complex issues is the first step to addressing compassion fatigue within the workplace. Group meetings within the workplace will offer the nurses a chance to share their thoughts and feelings, realizing that they are not alone. Building bonds with coworkers and sharing patient experiences will help to encourage positive healthy habits. Self-care is vital for nurses to maintain to keep life in balance and to adequately take proper care of our patients. Everybody has stress, learning how to deal with it is the key to happiness and a healthy well-being. Nurses are constantly educating our patient’s on lifestyle changes needed to maintain health such as a proper diet, exercise, and a strong support system.

We in turn need to practice what we preach and maintain our health to be at our best to help our patients achieve their best. Burnout and compassion fatigue are sometimes talked about as one, but there are differences. Burnout is “state of emotional, mental, and physical exhaustion caused by excessive and prolonged stress” (Preventing Burnout, n.d.). Signs of burnout can be depression or detachment, emotions are rigid, loss of hope and motivation, and a feeling of not worthy of living. Burnout can be caused by lifestyles or work-related issues. Working in an environment that you feel like you have no control or lack of resources can lead to burnout.

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Self-care is needed to maintain positive outlets to express one’s stress to avoid burnout in one’s personal life. There are physical, emotional, and behavioral signs of burnout. Physical signs are feelings of being tired all the time, being sick a lot, change in sleeping habits, body aches, and frequent headaches. Emotional signs can be loss of motivation, feelings of helplessness, feelings of detachment, sense of doubt, and an increased negative outlook in life. Behavioral signs can be isolation from others, avoidance of responsibilities, drug or alcohol abuse, missing work, and anger directed at others (Preventing Burnout, n.d.).

There are several ways to help prevent burnout. Learning how to manage stress and adopting a positive healthy eating, sleeping, and exercising habits are good examples to start with. It is important to know when you need help and that it is available. Burnout can lead to compassion fatigue within your professional career. Nurses who are tired, overworked, and stress out over time without help can suffer from burnout and in turn fall into compassion fatigue. Nurses need compassion to help guide patients in their medical situations, if the nurse is stressed out and needing help herself then how can she guide the patient? Burnout can be healed, addressing the issues and finding “your balance by reassessing priorities, making time for yourself, and seeking support” (Preventing Burnout, n.d.). There is a three “R” approach when dealing with burnout; recognize, reverse, and resilience.

Recognition of burnout, reversal of the damage caused from stress, and building resilience to deal with the stress by taking care of one’s emotional, mental, physical, and spiritual health. Identification is one step into addressing compassion fatigue and burnout. One can recover from burnout. There are three strategies that one should remain mindful of, slow down, get support, and reevaluate your goals and priorities (Preventing Burnout, n.d.). When dealing with job burnout there are a few options that you can do to improve the circumstances. Taking time off, asking for a new assignment, speaking with management about issues, and clarifying your job duties are a few suggestions to start with. Caregiver burnout can happen to anyone at any given time. The roles of caregivers are equally important like that of nursing.

Caregivers are responsible for the direct care of a loved one and can experience compassion fatigue as well as burnout. Being involved with a loved one’s care can cause physical, mental, emotional, and spiritual distress. The health of the caregivers is important for the success of the one who is receiving the care. Promoting policies and interventions that will help the caregivers to avoid emotional exhaustion is the goal. Caregivers need to remain aware of their needs and beliefs and know when to ask for help should they need it. Education is the start to helping patients, families, and caregivers; talking about compassion fatigue and burnout allows people to see that they are not alone and that help is available. There are numerous resources available to assist those seeking help such as The Gift from Within organization that specializes in helping people deal with trauma and stress.

There is also a Compassion Fatigue organization that aims at educating people on how important self-care is and how vital it is to know the signs and symptoms (Portnoy, 2011). In conclusion, compassion fatigue is the loss of self and burnout is the emotional exhaustion that one can feel. Nurses and health care professionals are at higher risks of having these issues come up; however caregivers can suffer from these issues just as easily. The goal to combating these topics is to bring awareness to them and to continue educating people on the ways to handle them.

Sometimes asking for help is hard, but it is the first step in the right direction to becoming a healthy well-being who can handle stress. Seeking guidance from professionals will benefit the person in distress as well as their families. To be emotionally, physically, mentally, and spiritually sound one must take care of themselves in all aspects of life. One must have compassionate caring, empathic boundaries, self-awareness, spirituality and hope, and self-forgiveness to succeed in life (Bush, 2009).

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References

Bush, N. (2009). Compassion fatigue: are you at risk? Oncology Nursing Forum, 36(1), 24-28. doi:10.1188/09.ONF.24-28 Chapman, E. (2007). Radical loving care: Building the healing hospital in America. Nashville, TN: Vaughn Printing Chen, C., Lin, C., Wang, S., & Hou, T. (2009). A study of job

stress, stress coping strategies, and job satisfaction for nurses working in middle-level hospital operating rooms. Journal Of Nursing Research (Taiwan Nurses Association), 17(3), 199-211. doi:10.1097/JNR.0b013e3181b2557b Portnoy, D. (2011). Burnout and Compassion Fatigue Watch for the Signs. Journal of the Catholic Health Association of the United States, 47-51. Retrieved January 20, 2015, from http://www.compassionfatigue.org/pages/healthprogress.pdf Preventing Burnout. (n.d.). Retrieved January 20, 2015, from http://www.helpguide.org/articles/stress/preventing-burnout.htm Wisniewski, L. (2013, February 5). What is Nursing Stress, Burnout, or Compassion Fatigue? Retrieved January 20, 2015, from http://www.nursetogether.com/what-is-nursing-stress-burnout-or-compassion-fatigue

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Combating Compassion Fatigue Essay

Introduction

According to Van der Cingal, 2009, compassion signifies “an acknowledgement of another’s suffering and is accompanied by the expression of a desire to ease or end that suffering”. Persons in the health care industry are known for their compassion and which is what usually draws them to this profession. Nurses work in a stressful environment that is continually demanding, both physically and mentally. With many highs and lows throughout just one shift, health care workers can be left with challenging emotions.

Throughout their career, these difficult feelings and stressful demands can lead to compassion fatigue. Compassion Fatigue represents the collective emotional, psychological, and physical result of exposure to traumatic events when assisting others, while combined with everyday life stressors (ABA, 2011). This paper will discuss five concepts with warning signs of compassion fatigue. Exploration of the emotional, physical, and spiritual needs of caregivers will be addressed, along with coping strategies and resources useful for the health care worker. Five Concepts of Compassion Fatigue

Though there are many concepts of compassion fatigue, this paper will discuss five major concepts that will include:

Physical Exhaustion

Emotional Exhaustion

Apathy

Depression

Compulsive Behavior

Physical Exhaustion

Health care workers are notorious for not taking care of their physical and nutritional needs. To maintain health, plenty of rest, proper nutrition, and daily exercise are basic needs for a healthful balance. When any of these needs are compromised over a period of time, the personnel will not only physically, but mentally suffer also. The body requires at least 8-10 hours of sleep per night and eventually physical exhaustion will set in. The most common symptoms include insomnia (not being able to fall asleep or stay asleep), irritability and short tempered, heart palpitations and chest pain. If not treated, physical exhaustion can lead to more physical impairments including visual disturbances, headaches and/or migraines, chronic pain, dizziness, decreased immune system, and digestive dysfunction (Espeland, 2006).

Emotional Exhaustion

Emotional exhaustion is the depletion of a person’s emotional reserve and inability to reestablish their emotional stability (Moore, 2009). Daily life is hectic and holds increased stress beyond work with the needs of family, sometimes additional school or continuing education. In addition to family or personal demands, the additional demands in nursing with caring for overwhelmingly sick individuals, along with other job stressors including productivity, staffing issues, and meeting goals becomes burdensome as well.

Nursing is a very emotionally demanding career with the need to bond with the family and patient on a certain level, and still be able to maintain neutral lines with professionalism. Given all the above scenarios, emotional exhaustion is rampant among nurses. Emotional exhaustion is manifested in different ways from person to person. Some symptoms most noted are labile emotions such as crying, sudden outbursts whether crying or anger/hostility, or even showing no emotions at all. Paranoia can also develop with the caregiver having difficulties working within a team-approach (Compassion Fatigue Awareness Project, 2012).

Apathy

Apathy is the lack of concern or interest in something that once was uplifting, or the lack of feelings or emotions (Apathy, 2012). This usually comes after emotional exhaustion. When the emotional reserves are void, he caregiver who once was a doting and passionate team member can change to reflect apathy, uncaring, or indifferent. Psychologically, a caregiver can become emotionally drained (exhausted) and become robotic in their actions, similar to being void of all feelings or numb to emotions. Their work is identified as being burdensome and they loathe taking part in it, finding no pleasure in the career they once enjoyed. Productivity can be decreased; performance will suffer including tardiness, concentration on tasks at hand, absenteeism (Espeland, 2006).

Depression

Caregivers fall victim too many concepts of Compassion Fatigue, and depression remains one of the most noted. Depression is the overwhelming feeling of sadness, hopelessness, feeling inadequate, and feelings of low self-worth (PDR, 2011). These are all common signs of depression and caregivers tend to be inflicted with depression at one time or another. As with apathy, depression can rise due to stress from family needs, job demands, and inability to perform to self-perceived expectations. Depression, like the other concepts, can manifest mentally and physically if left untreated. Signs noted can be a differential attitude such as negativity, sullen, angriness, denial of a problem, self-esteem, or lack of confidence. Depression too can have physical traits such as GI discomfort, weakness (not wanting to get out of bed), and if left untreated can manifest into severe depression and possible suicidal ideation.

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Compulsive Behaviors

Compulsive behaviors are behaviors derived from decisions or actions which were performed without consideration of the consequences (ABA, 2011). When a person is going through the above concepts or a stressful situation in which they feel an overwhelming since of hopelessness from, sometimes a compulsive behavior can be formed. This is a person’s psychological way of coping in order to attempt to maintain balance. Some examples of compulsive behaviors are excessive work hours, overeating, over-exercising, under-eating, indulging excessively on alcohol, stimulants, or illegal substances (including prescription narcotics), excessive spending (Espeland, 2006). Self-mutilation is another example of a compulsive behavior and is performed in order to feel a sense of control, while at the same time releasing an almost euphoria when performed. Basically, anything in excess to deter thoughts of the stressor can be a compulsive behavior.

Caregiver Needs

Caregivers are at a very high risk for compassion fatigue and ensuring their physical and mental needs are met will enable the caregiver to perform at their optimum level. Caregivers do just that, care for others fist before caring for themselves, however they must recognize their own coping mechanism and developing a system for maintaining balance (Bush, 2009). Physically, caregivers need to maintain optimum health by allowing themselves proper nutrition, daily exercise, healthy hydration, and at least 8-10 hours of sleep per night.

Emotionally, caregivers need to know when they need a break, take personal time and seek activities they enjoy such as reading, visiting friends/family, going on vacations. Spiritual health needs should also be addressed if needed with prayer, practicing one’s religion (attending church/outings), and meditation. In order to give the best care, caregivers must first address their personal emotional, physical, and spiritual needs.

Coping Strategies and Resources

With life and work stressors abound, caregivers need to be diligent with self-care in order to avoid compassion fatigue. Prevention through self-care can be achieved by setting both professional and personal boundaries, knowing the signs of unhealthy behaviors, and how to effectively manage healthy behaviors. As previously mentioned, healthy behaviors include proper nutrition, daily exercise, addressing spiritual needs, and obtaining adequate sleep. Allowing a positive support system to be present is also beneficial and can be met through friends, family, or support groups. The Compassion Fatigue Awareness Program (www.compassionfatigue.org) is an excellent source for educational information, support groups, and identifying and addressing compassion fatigue.

Conclusion

Caregivers are challenged daily with the needs and stressors of not only family and personal dilemmas, but difficult and emotional work stressors as well. With work demands rising to include short staffing, increased patient load, production and metric demands, along with patient and family needs to be met, caregivers can easily fall victim to compassion fatigue. With the proper knowledge, caregivers will be able to address the signs of compassion fatigue effectively manage it, if not prevent it all together. Work and life balance is essential and by addressing their needs first, they can be a more effective caregiver themselves.

References

American Bar Association (ABA), (2011). What is compassion fatigue? Retrieved February 9, 2013 from http://www.americanbar.org.

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Apathy. (2012). In Merriam-Webster Dictionary. Retrieved February 8, 2013, from www.merriam-webster.com

Bush, N. (2009). Compassion Fatigue: Are You at Risk?. Oncology Nursing Forum, 36(1), 24-28.

Compassion Fatigue Awareness Project (2012). Recognizing Compassion Fatigue. Retrieved February 7, 2013, from http://www.compassionfatigue.org.

Espeland, K. (2006). Overcoming Burnout: How to Revitalize Your Career. Journal of Continuing Education in Nursing, 37, 178-184.

Moore, D. (2009). Causes of Emotional Exhaustion. Retrieved February 5, 2013, from http://www.helium.com/items/1689857-how-to-understand-and-avoid-the-causes-of-emotional-exhaustion.

PDR Health: Depression symptoms. Retrieved February 8, 2013 from http://www.pdrhealth.com/diseases/depression/symptoms.

Van der Cingal, M. (2009). Compassion and Professional Care: Exploring the Domain. Nursing Philosophy, 102, 124-136.

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