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Question: Effect of compassion fatigue on nursing skills: Possible strategies for resilience
Solution
Introduction
The term, ‘compassion fatigue (CF)’ refers to the experiences of nurses towards forgetfulness, reduction of attentively, fatigue, physical sickness prompting a state of disregard and anger. CF is portrayed by vicarious trauma, secondary traumatic syndrome, anxiety and/or depression (Craig and Sprang, 2010). CF occurs due to a blend events comprising of physical, passionate, and profound consumption connected with patient care in emotional pain and physical distress (Anewalt, 2009). The consequences of weariness are pulverizing, adversely influencing the medical caretaker, the patient, the association and even society (Sabo, 2011). Therefore, the discussion on the topic towards minimization of stress on nurses is required to be addressed. Hence, the present paper describes the repercussion of compassion fatigue and its relevance to patient care followed by resilience to reboot the performance in the healthcare system.
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Search strategy
The topic ‘compassion fatigue’ and ‘resilience’ in healthcare system in general and nurses in particular have been searched utilizing online resources, text books and magazines. The keywords used for the online search include, compassion fatigue and its symptoms, resilience, physical stress on nurses, nursing issues, problems encountered in patient care, mental health of nurses and remedies of nurses. The online resources include Pub med, Springer link, Weily science, Science direct and ingenta. Adequate measures were taken for the filter in order to get relevant articles. The outcome of search was described in below sections as ‘compassion fatigue’ and ‘resilience’
Compassion Fatigue
Watson (2010) proposed a theory behind the relationship between the nurse and the patient in terms of how well the nurses perceiving the feelings of patients and their families; eventually communicating them to the doctors. There exist three types of core relationships for nurses including relationship with patients and families; self, and fellow staff members (Koloroutis, 2007). Among, the nurse association with self is a core idea in overseeing compassion fatigue. The nurses should be emphatic, to express individual needs and values, and to view work-life parity as an achievable result. This association with self is crucial for advancing one's wellbeing, for being empathic with others, and for being a productive individual from a team inside hospital. The symptoms of CF can be seen as an acute onset during the patient care (Anewalt, 2009). The symptoms can be broadly categorized to profession related, physical and emotional (Lombardo and Eyre, 2011). The work related symptoms for instance include avoidance certain patients; decreased association towards patients and their families and lack of adequate involvement in profession. It was evidenced from the reports (Van Mol et al., 2015) that the profession related CF is due to lack of adequate communication skills leading to emotional distress, ethics and patience. The physical symptoms of nurses that contribute for CF include altered physiology, muscle disorders, sleep disturbances and fatigue. Among, the nurses who work for 80 hours or more per week are associated with the development of CF and it was more prevalent in nurses during night shifts (Bellolio et al., 2014). The extent of stress contributes for the emotions (restlessness, anxiety, depression and anger etc) and they in turn influence the CF. Such stress related factors could be the contributing factor for the nurses and other health work force to leave the hospital (Whitebird et al., 2013). It was evident from the preceding section pertaining to the symptoms that contributes for CF. Either single or multiple factors related to the development of CF. It further can lead to increase the financial burden on hospital management towards recruitment of new nurses, mental illness of nurses, high turnover rates for nurses, and reduction of productivity. Therefore, the stress related conditions have to be avoided in health care facility
Relationship between self care and resilience
The status pertaining to the workload and performance of the nurses for the patient care has to be assessed. The experts of mental health, mentors (supervisors and nurse managers), specialists of clinical nursing, and preceptors, can assist in the identification for the presence of CF. The critical step in developing an intervention plan is awareness of the problem. The basic details pertaining to nurse profession have to be collected. The details include (i) evaluation of work load including work set-up and environment, (ii) nurse’s attitude and abilities, (iii) what coping strategies do the nurses implementing for the survival of patients (iv) role of nurses towards self care, psychosocial behavior and other skills and (v) learning skills to increase the productivity. After the assessment, an intervention plan can be provided to promote the resilience. The intervention plan is discussed in below section.
Respite for the nurses: The hospital management should ensure in providing a break (respite) from the work with varying increments. This will facilitate the nurses to have adequate time for the lunch, periodic short breaks for refreshment and long respite to spend time with family. Especially the respite is important for the nurses with personal work for instance ‘who got married on recent’ can improve the quality of work towards nursing services (Chao et al., 2016). The respite also relaxes the nurses from stress and worries and enhances the professional skills.
Continuing learning: From education perceptive, the hospital management should provide continuous education. The advancements and information needed to perform the nursing job for the benefit of practice. The nurses also gains individual satisfaction from the process of learning something new, and being able to implement positive changes in the practice. The management should ensure in achieving the education for all the nursing personnel. However, some of the training programs are associated with cost. In such cases, the management has to be discussed with team members and on mutual discussion, an appropriate decision can be taken.
Benefits to nurses: Employee (nurse) benefits will also encourage the nurses to extend the work. Adequate number of leaves to accomplish the nurse personal activities for instance casual leaves and sick leaves; health insurance to employee depends etc can motivate the nurses to work with enthusiasm. Lack of adequate tools in multi disciplinary hospitals can increase the stress on nurses and other health work force can lead to the development of CF (Chesak et al., 2015).
Implementation of advanced tools: The presence of adequate and sophisticated tools for the nurses and management in order to meet the needs can minimize the development of CF. The tool may be equipment or supplies, which are obvious. Often more important and not as obvious is the allotment of time needed to do the task, or the authority with which the person. The hospital management and/or supervisors should involve in monitoring the workloads on each nursing professional. The conduct of ‘soft skill improvement’ program can promote team-building activities and offer a concrete association between nurses.
Transparent policies and promotion of communication skills among/between nurses: The transparent system in the hospital for the policies, rules and regulations towards management and staff members can eases the understandings in nurses. The policies in terms of duties, data transfer across the departments, case sheet entries and information policy. Accordingly, the nurses can mold their mind set-up and develop the thoughts to meet the expectation of hospital management. The management should keep any hidden policies to avoid the discrepancies. In case of any dispute among the nurses, the management should involve and sole the issues without hurting the staff members. Periodic evaluation of soft skills is needed to address and improve the skills. This will facilitate the nurses to increase association among and between the nurses.
Self-care training and education for medical learners: The drawbacks pertaining to substantial practical skills and advanced methods to handle complex situations and multiple patients in the stipulated period, it is desired to provide self-care training and education. This will reduce the negative consequences of CF and psychological distress. As a part of training session, the self-care comprises of spectrum of knowledge, skills, and attitudes including self-reflection and self-awareness, identification and prevention of CF, appropriate professional boundaries. According to the evidence, it appears that the nurses, medical students, staff members and paramedical fellow are lacking the adequate self-care training (Sanchez-Reilly et al., 2014). Therefore, the individuals should be identified and encouraged for training.
Conclusions
The aspects of compassion fatigue pertaining to the probable causes and repercussions are discussed. It appears, the over workload and substantial skills are the leading causes of CF. To avoid the consequences and reduce the mental health of nurses; diverse strategies are available for resilience. It is the responsibility of the nurses and hospital management for resilience.
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Anewalt, P. (2009). Fired up or burned out? Understanding the importance of professional boundaries in home health care hospice. Home Healthcare Nurse, 27(10), pp. 591-597.
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Anewalt, P. (2009). Fired up or burned out? Understanding the importance of professional boundaries in home health care hospice. Home Healthcare Nurse, 27(10), pp. 591-597.
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Bellolio, M. F., Cabrera, D., Sadosty, A. T., Hess, E. P., Campbell, R. L., Lohse, C. M. and Sunga, K. L. (2014). Compassion fatigue is similar in emergency medicine residents compared to other medical and surgical specialties. Western Journal of Emergency Medicine, 15(6), pp. 629–635. http://doi.org/10.5811/westjem.2014.5.21624
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Van Mol, M. M. C., Kompanje, E. J. O., Benoit, D. D., Bakker, J. and Nijkamp, M. D. (2015). The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: A systematic review. PLoS ONE, 10(8), e0136955. http://doi.org/10.1371/journal.pone.0136955
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