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Christina Dodd

Compassion fatigue and burnout are significant issues for nurses that can lead to negative consequences if left unaddressed. Both result from the stress of caring for patients, though burnout has a gradual onset due to work environment stressors, while compassion fatigue occurs acutely from caring for suffering clients. Clinical manifestations are similar and include desensitization, increased medical errors, and lack of attention to detail. Hospitals can decrease these issues by improving communication, providing education on coping mechanisms, encouraging work-life balance, instituting debriefing sessions, and promoting an accepting work environment as per Jean Watson's Humanbecoming Theory.

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RESEARCH POSTER PRESENTATION DESIGN © 2015 www.PosterPresentations.com • Seen as the biggest threat to nursing because it is the number one reason nurses are leaving the profession • Seen as an “occupational illness” • Leads to decreased patient satisfaction and increased turnover rates • Every nurse is at risk for developing compassion fatigue and burnout Importance Compassion Fatigue • The American Nurses Association (ANA) says that “compassion fatigue evolves when caretaking strategies are unsuccessful, leading to caregiver feelings of distress and guilt. They are both exhibited by frustration, powerlessness, and diminished morale.” (Boyle, 2011) • It is a consequence of caring for suffering clients • Acute onset Burnout • The ANA defines burnout as “emotional exhaustion” (Boyle, 2011) • Gradual onset • Work or environmental stressors (staffing, workload, managerial decision making, inadequate supplies or resources) • The largest cause of burnout and compassion fatigue is lack of administrative support. • Forms of communication • Poor communication • Scheduling conflicts • Unrealistic expectations • Lack of nurse ratios • Long hours • Unfavorable work environment • High amounts of moral and ethical dilemmas Causative Factors • While burnout nurses overall level of care gradually declines, with compassion fatigue the nurse will try harder to give more • Emotional: anger, breakdown, cynicism, desensitization, lessened enthusiasm, sarcasm, • Intellectual: weakened attention to detail, boredom • Physical: increased somatic complaints, accident prone, callousness, lack of energy and endurance • Spiritual: lack of spiritual awareness • Social: callousness, feelings of alienation, estrangement • Work: absenteeism, desire to quit, diminished performance ability (med errors, decreased documentation accuracy/record keeping) Manifestations References Boyle, D., (Jan 31, 2011) "Countering Compassion Fatigue: A Requisite Nursing Agenda" OJIN: The Online Journal of Issues in Nursing Vol. 16, No. 1, Manuscript 2 Cañadas-De la Fuente, G. A., Vargas, C., San Luis, C., García, I., Cañadas, G. R., & De la Fuente, E. I. (2015). Risk factors and prevalence of burnout syndrome in the nursing profession.International Journal Of Nursing Studies, 52(1), 240-249. doi:10.1016/j.ijnurstu.2014.07.001 Coetzee, S.K., & Klopper, H.C. (2009). Compassion fatigue within nursing practice: A concept analysis. Nursing and Health Sciences, 12, 235-243. Cordes, C. L. & Dougherty, T. W. (1993). A review and an integration of research on job burnout. Academy of Management Review, 18(4), 621-656. Erickson, R., Grove, W., (October 29, 2007). "Why Emotions Matter: Age, Agitation, and Burnout Among Registered Nurses" Online Journal of Issues in Nursing. Vol. 13, No. 1. Ebright, P.R. (2010). The complex work of RNs: Implications for health work environments.Online Journal of Issues in Nursing, 15(1). DOI: 10.3912/OJIN.Vol15No01Man04 Hooper, C., Craig, J., Janvrin, D.R., Wetzel, M.A., & Reimels, E. (2010). Compassion satisfaction, burnout and compassion fatigue among emergency nurses compared with nurses in other selected inpatient specialties. Journal of Emergency Nursing, 36(5), 420-427. Hunsaker, S., Chen, H., Maughan, D., & Heaston, S. (2015). Factors That Influence the Development of Compassion Fatigue, Burnout, and Compassion Satisfaction in Emergency Department Nurses. Journal Of Nursing Scholarship, 47(2), 186-194. doi:10.1111/jnu.12122 Jenkins, B., & Warren, N. A. (2012). Concept analysis: compassion fatigue and effects upon critical care nurses. Critical Care Nursing Quarterly, 35(4), 388-395. doi:10.1097/CNQ.0b013e318268fe09 Koppel, J., Virkstis, K., Strumwasser, S., Katz, M., & Boston-Fleischhauer, C. (2015). Regulating the Flow of Change to Reduce Fontline Nurse Stress and Burnout. The Journal Of Nursing Administration, 45(11), 534-536. Lee, V. L., & King, A. H. (2014). Exploring Death Anxiety and Burnout Among Staff Members Who Work In Outpatient Hemodialysis Units. Nephrology Nursing Journal, 41(5), 479-486. Mason, V. M., Leslie, G., Clark, K., Lyons, P., Walke, E., Butler, C., & Griffin, M. (2014). Compassion Fatigue, Moral Distress, and Work Engagement in Surgical Intensive Care Unit Trauma Nurses. Dimensions Of Critical Care Nursing, 33(4), 215-225. doi:10.1097/DCC.0000000000000056 Pilkington, F. B., Jonas- Simpson, C., . (2009). The humanbecoming school of thought: A guide for teaching-learning. 2nd ed.. International Consortium of Parse Scholars: Toronto, Ontario. Shoorideh, F. A., Ashktorab, T., Yaghmaei, F., & Alavi Majd, H. (2015). Relationship between ICU nurses’ moral distress with burnout and anticipated turnover. Nursing Ethics, 22(1), 64-76. doi:10.1177/0969733014534874 The effects of authentic leadership, six areas of worklife, and occupational coping self-efficacy on new graduate nurses' burnout and mental health: A cross-sectional study. (2015).International Journal of Nursing Studies, 52(6), 1080-1089 10p. doi:10.1016/j.ijnurstu.2015.03.002 Wagner, C. (2015). Moral distress as a contributor to nurse burnout. The American Journal Of Nursing, 115(4), 11. doi:10.1097/01.NAJ.0000463005.73775.9e California Baptist University Christina Dodd Burnout and Compassion Fatigue in Nursing Definitions Prevention/Treatment • Better communication skills through emails, personal communication, or more communication • Provide education on coping mechanisms • Provide education on basic communication skills • Encourage work-life balance • Debriefing sessions after traumatic events • Institute continuing education programs • More consistent scheduling • Educate staff on changes prior to implementation • Promote Jean Watson’s promotion and acceptance of positive and negative feelings and assist with the gratification of human needs PICO question P: Registered Nurses O: compassion fatigue and burnout Question: What can hospitals do to decrease the levels of compassion fatigue and burnout among Registered Nurses? Summary • All nurses are at risk for developing compassion fatigue and burnout. • Burnout is seen as a result of stress while compassion fatigue results from caring • Clinical manifestations are similar and include: desensitization, accident prone, increased somatic complaints, lack of attention to detail, decreased spirituality • They are caused by lack of administration support, poor communication, lack of nursing ratios, and high amounts of moral and ethical dilemmas • Treatment: in services on basic communication skills and coping mechanisms, debriefing, encourage continuing education programs • Prevention: activities that promote bonding within units and hospitals, acknowledgement of employees through recognition programs Humanbecoming Theory • Humans are indivisable, unpredictable, and everchanging: “Humans cannot be reduced: they are different from the sum of the bio-physial spiritual parts. Human beings are characterized by patters of relating with themselves, each other, and the universe” ( Pilkington, 2009, p. 7) • We must seek to understand nurses as being human and promote an accepting environment. • Nurses who recognize feelings of burnout or compassion fatigue will be more open to discussion about how to renew.

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  • 1. RESEARCH POSTER PRESENTATION DESIGN © 2015 www.PosterPresentations.com • Seen as the biggest threat to nursing because it is the number one reason nurses are leaving the profession • Seen as an “occupational illness” • Leads to decreased patient satisfaction and increased turnover rates • Every nurse is at risk for developing compassion fatigue and burnout Importance Compassion Fatigue • The American Nurses Association (ANA) says that “compassion fatigue evolves when caretaking strategies are unsuccessful, leading to caregiver feelings of distress and guilt. They are both exhibited by frustration, powerlessness, and diminished morale.” (Boyle, 2011) • It is a consequence of caring for suffering clients • Acute onset Burnout • The ANA defines burnout as “emotional exhaustion” (Boyle, 2011) • Gradual onset • Work or environmental stressors (staffing, workload, managerial decision making, inadequate supplies or resources) • The largest cause of burnout and compassion fatigue is lack of administrative support. • Forms of communication • Poor communication • Scheduling conflicts • Unrealistic expectations • Lack of nurse ratios • Long hours • Unfavorable work environment • High amounts of moral and ethical dilemmas Causative Factors • While burnout nurses overall level of care gradually declines, with compassion fatigue the nurse will try harder to give more • Emotional: anger, breakdown, cynicism, desensitization, lessened enthusiasm, sarcasm, • Intellectual: weakened attention to detail, boredom • Physical: increased somatic complaints, accident prone, callousness, lack of energy and endurance • Spiritual: lack of spiritual awareness • Social: callousness, feelings of alienation, estrangement • Work: absenteeism, desire to quit, diminished performance ability (med errors, decreased documentation accuracy/record keeping) Manifestations References Boyle, D., (Jan 31, 2011) "Countering Compassion Fatigue: A Requisite Nursing Agenda" OJIN: The Online Journal of Issues in Nursing Vol. 16, No. 1, Manuscript 2 Cañadas-De la Fuente, G. A., Vargas, C., San Luis, C., García, I., Cañadas, G. R., & De la Fuente, E. I. (2015). Risk factors and prevalence of burnout syndrome in the nursing profession.International Journal Of Nursing Studies, 52(1), 240-249. doi:10.1016/j.ijnurstu.2014.07.001 Coetzee, S.K., & Klopper, H.C. (2009). Compassion fatigue within nursing practice: A concept analysis. Nursing and Health Sciences, 12, 235-243. Cordes, C. L. & Dougherty, T. W. (1993). A review and an integration of research on job burnout. Academy of Management Review, 18(4), 621-656. Erickson, R., Grove, W., (October 29, 2007). "Why Emotions Matter: Age, Agitation, and Burnout Among Registered Nurses" Online Journal of Issues in Nursing. Vol. 13, No. 1. Ebright, P.R. (2010). The complex work of RNs: Implications for health work environments.Online Journal of Issues in Nursing, 15(1). DOI: 10.3912/OJIN.Vol15No01Man04 Hooper, C., Craig, J., Janvrin, D.R., Wetzel, M.A., & Reimels, E. (2010). Compassion satisfaction, burnout and compassion fatigue among emergency nurses compared with nurses in other selected inpatient specialties. Journal of Emergency Nursing, 36(5), 420-427. Hunsaker, S., Chen, H., Maughan, D., & Heaston, S. (2015). Factors That Influence the Development of Compassion Fatigue, Burnout, and Compassion Satisfaction in Emergency Department Nurses. Journal Of Nursing Scholarship, 47(2), 186-194. doi:10.1111/jnu.12122 Jenkins, B., & Warren, N. A. (2012). Concept analysis: compassion fatigue and effects upon critical care nurses. Critical Care Nursing Quarterly, 35(4), 388-395. doi:10.1097/CNQ.0b013e318268fe09 Koppel, J., Virkstis, K., Strumwasser, S., Katz, M., & Boston-Fleischhauer, C. (2015). Regulating the Flow of Change to Reduce Fontline Nurse Stress and Burnout. The Journal Of Nursing Administration, 45(11), 534-536. Lee, V. L., & King, A. H. (2014). Exploring Death Anxiety and Burnout Among Staff Members Who Work In Outpatient Hemodialysis Units. Nephrology Nursing Journal, 41(5), 479-486. Mason, V. M., Leslie, G., Clark, K., Lyons, P., Walke, E., Butler, C., & Griffin, M. (2014). Compassion Fatigue, Moral Distress, and Work Engagement in Surgical Intensive Care Unit Trauma Nurses. Dimensions Of Critical Care Nursing, 33(4), 215-225. doi:10.1097/DCC.0000000000000056 Pilkington, F. B., Jonas- Simpson, C., . (2009). The humanbecoming school of thought: A guide for teaching-learning. 2nd ed.. International Consortium of Parse Scholars: Toronto, Ontario. Shoorideh, F. A., Ashktorab, T., Yaghmaei, F., & Alavi Majd, H. (2015). Relationship between ICU nurses’ moral distress with burnout and anticipated turnover. Nursing Ethics, 22(1), 64-76. doi:10.1177/0969733014534874 The effects of authentic leadership, six areas of worklife, and occupational coping self-efficacy on new graduate nurses' burnout and mental health: A cross-sectional study. (2015).International Journal of Nursing Studies, 52(6), 1080-1089 10p. doi:10.1016/j.ijnurstu.2015.03.002 Wagner, C. (2015). Moral distress as a contributor to nurse burnout. The American Journal Of Nursing, 115(4), 11. doi:10.1097/01.NAJ.0000463005.73775.9e California Baptist University Christina Dodd Burnout and Compassion Fatigue in Nursing Definitions Prevention/Treatment • Better communication skills through emails, personal communication, or more communication • Provide education on coping mechanisms • Provide education on basic communication skills • Encourage work-life balance • Debriefing sessions after traumatic events • Institute continuing education programs • More consistent scheduling • Educate staff on changes prior to implementation • Promote Jean Watson’s promotion and acceptance of positive and negative feelings and assist with the gratification of human needs PICO question P: Registered Nurses O: compassion fatigue and burnout Question: What can hospitals do to decrease the levels of compassion fatigue and burnout among Registered Nurses? Summary • All nurses are at risk for developing compassion fatigue and burnout. • Burnout is seen as a result of stress while compassion fatigue results from caring • Clinical manifestations are similar and include: desensitization, accident prone, increased somatic complaints, lack of attention to detail, decreased spirituality • They are caused by lack of administration support, poor communication, lack of nursing ratios, and high amounts of moral and ethical dilemmas • Treatment: in services on basic communication skills and coping mechanisms, debriefing, encourage continuing education programs • Prevention: activities that promote bonding within units and hospitals, acknowledgement of employees through recognition programs Humanbecoming Theory • Humans are indivisable, unpredictable, and everchanging: “Humans cannot be reduced: they are different from the sum of the bio-physial spiritual parts. Human beings are characterized by patters of relating with themselves, each other, and the universe” ( Pilkington, 2009, p. 7) • We must seek to understand nurses as being human and promote an accepting environment. • Nurses who recognize feelings of burnout or compassion fatigue will be more open to discussion about how to renew.