Compassion Fatigue - Staying Positive

Compassion fatigue (CF) is the accumulation of months and years of exposure to patients with emotional pain. Let’s talk about what you can do right now to help yourself feel more positive. Being proactive about your mental health is just as important as your other everyday needs.

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Compassion Fatigue - Staying Positive

Simone Biles withdrew from some of her Olympic events because she felt like her mind and body were not in sync. Bedside nurses quite often feel the same way ... mind and body out of sync.

Have you ever been at work and felt like you were being pulled in multiple directions? You are trying to start your shift with your first patient in an organized way. This is not possible!! One patient is calling for pain medications, another unstable patient is climbing out of bed with the bed alarm blaring, and we do not have enough staff today to answer all the call lights and alarms going off! Welcome to a typical day in the life of a bedside nurse

It's like being the short-order cook at a crowded diner. You are trying to keep up but you also have to be the hostess, the waitress, the busboy/busgirl and sometimes the manager at the same time! Before having one sip of your coffee, you are being hunted down by nurses from the previous shift who want to unload report on you and go home. Your morning flies by. Halfway through your shift you still have not got a chance to go to the bathroom and you are feeling it from the super-sized coffee you drank this morning to wake yourself up.

The Price of Caring

In reality, for many nurses, the situations we encounter at work can leave us feeling hopeless and powerless. Physical and mental fatigue can seriously impact the quality of your life. Compassion fatigue (CF) is the accumulation of months and years of exposure to patients with emotional pain. We, as nurses, want our patients to know that we feel their pain, their physical and emotional pain. CF is the price of caring. You probably know that constant exposure to traumatic situations can lead to depression and anxiety. You have likely wondered why you feel this way. Let's talk about what you can do right now to help yourself feel more positive. Being proactive about your mental health is just as important as your other everyday needs.

What is Compassion Fatigue (CF)?

The concept "compassion fatigue" was coined by nurse Carla Joinson in 1992. As she described it, she noticed that nurses dealing with frequent heartache had lost their nurturing ability. This phenomenon is a combination of secondary traumatic stress (STS) and cumulative burnout (BO). STS is a state of stress which is extreme tension and preoccupation with emotional pain. BO is a state of mental and physical exhaustion caused by having to deal with a constantly stressful environment.

CF is characterized by feeling burdened by another person's suffering, reduced ability to feel sympathy and empathy, blaming others for their suffering, loss of job satisfaction, insomnia, and alcohol and drug abuse. Decision-making can be negatively affected along with a caregiver's ability to adequately care for their patients. CF can be the cause of some nurses leaving their jobs and/or their nursing careers.

How to Deal with Compassion Fatigue: 3 Interventions

Mindfulness

Are you aware how you act on your days off? Ask your family or your main sources of support. Do they feel like you enjoy your career? Are you constantly complaining to them about your job? Are you able to separate work from home?

Work environment tips

Educate yourself about what resources might be available at work. Employee Assistance programs may offer assistance and counseling. These programs can help with stress reduction at work, work-life balance and effective communication strategies. Vocalize your needs to your coworkers instead of trying to do everything yourself. Don't be afraid to delegate tasks. Support groups can also help to allow you to debrief a situation and focus on what you accomplished rather than missed opportunities. Alternative approaches such as massage, journaling, prayer or meditation are valuable ways to reduce work-related stress.

Self-care

CF can threaten the quality of our abilities as a professional nurse and our quality of life. Most of us only allow a small amount of time to being selfish of our well-being. A mixed methods study done by Katherine Valentine Upton in an acute care setting showed the prevalence of CF in acute medical care nurses and its damaging effects from stress. The results of the study also showed the moderating effect of self-compassion. A self-care plan should include exercise, proper nutrition, spiritual health, and social activities. You must give as much importance to self-care as you do eating and sleeping. You need to take care of YOU!

References

Simone Biles: what if nurses followed her lead?

Compassion fatigue. The cost of caring

Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review

Nursing on empty: compassion fatigue signs, symptoms, and system interventions

An investigation into compassion fatigue and self-compassion in acute medical care hospital nurses: a mixed methods study

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JeanstarMSN

About JeanstarMSN

JeanstarMSN has 21 years experience in Med/Surg nursing. I teach nursing part-time.

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Specializes in CMSRN, hospice.

I think mindfulness is very important. It's often not until work collides into my personal life that I realize something is wrong. I am currently trying to regain control of everything, as I have noticed myself being more of a couch potato, having no interest in doing anything but sitting in silence, which does nothing to nurture my relationships outside of work. Hopefully I can figure out hope to address this *before* it gets to this point again.

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Specializes in ER.

Or, get out of nursing, before it totally grinds you into the ground...?

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I stay positive by only working travel contracts, the money makes it worth the fake I love my career choice attitude. Beyond the pay, there really isn't anything positive about nursing anymore. 

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I think trying to live one's best life is an idea that is separate from interventions undertaken to combat nursing stress.

The reason they are two separate things to me is because of the underlying intent of each of them. Specifically, just trying to do those things which would represent living your own life in the best most fulfilled, peaceful way you can, is something that is not meant primarily to benefit anyone else. Being selfish isn't the goal; rather this is a different mindset wherein you are allowed to pursue something for your own peace and happiness (not in relation or response to anything else) as a goal.

Nursing is very wrapped up in doing x, y and z so that we can...keep up serving people without too much damage to ourselves.

I've kind of turned it in a way that makes sense to me. Which is to: Get out there. Go love your family, your friends. Try for the job you want. Get more education if that brings you joy or some other benefit. Do your hobbies, whatever they are. Work hard, relax whenever you're able. If you're not able to rest, time to change something. Do your best at work. If you're not able to do reasonable work for your own reason or because of someone else, consider a change. Etc., etc.

This is a fundamentally different mindset than (for example) choosing upbeat music during the commute in the hopes of not being overwhelmed before even getting to work. Or walking a nature trail in hopes of relaxing before you have to go back for another 12 hrs.

 

4 hours ago, JeanstarMSN said:

We, as nurses, want our patients to know that we feel their pain, their physical and emotional pain.

This is not my goal. I do not need to feel what a patient feels in order to care about their well-being from a professional perspective and provide the best professional nursing services to them that I can. I do want my patients to know that I am engaged and empathetic. I neither need nor want to feel every pain being experienced by every patient I come across--which would be, in fact, disabling.

Nurses need to think carefully about this, including how we talk about compassion and empathy and related facets of nursing. It isn't appropriate to pretend as if supernatural abilities are required or are just a natural thing that nurses are born with separate from the rest of humanity. It is that thinking that sets the stage for significant dejection, discouragement and altered ability to cope.

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Specializes in ER.

I sincerely hope that no one wants to harm themselves or others, has had their flu vaccine, has not been exposed to Ebola or covid-19, does not smoke, has not Vaped in the last 30 days, and thank you for shopping at Kmart.

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Specializes in Neurosciences, stepdown, acute rehab, LTC.

This is good advice for managing compassion fatigue but I wish organizations would do more to help. They put nurses in a situation that would obviously lead to burnout and then act like its the nurses fault for getting burnt out.  We are all responsible for our own self care in any profession but in nursing we need more powerful people helping fix the bad situation so we don't get so run down. The people who could truly fix it (far removed from us) get no immediate profit for fixing the system so it won't happen for a while. 

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Specializes in MedSurg.

I totally agree! Run into this situation at work all the time!

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We would get bombarded daily with messages from administration about mindfulness, employee assistance and self-care. As if the stress from inadequate staffing was our fault and we should fix it by meditating and journaling. If only it were that simple.

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Specializes in Progressive care, cardiac surgery, telemetry.
On 9/5/2021 at 4:28 PM, 2BS Nurse said:

We would get bombarded daily with messages from administration about mindfulness, employee assistance and self-care. As if the stress from inadequate staffing was our fault and we should fix it by meditating and journaling. If only it were that simple.

I also experienced this. It was crazy to me. There was a ton of talk about burnout and compassion fatigue, and making sure you're spending time on self care, but no actual efforts to address the underlying issues that were making these problems so much more prevalent. The reality is that if the work situation were not so stressful, the encouragement for self care would not be as necessary. I regularly had to take sleep aids the night prior to work (and I worked day shift!) because if I didn't I would get about 4 hours of sleep due to anxiety of anticipating the following day. The constant encouragement to fix problems by meditating them away was very disrespectful. It was as if we weren't seen as smart enough to recognize the real issues at hand and we were just being "weak."

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Specializes in Geriatrics, Dialysis.
On 9/7/2021 at 7:48 AM, deej394 said:

I also experienced this. It was crazy to me. There was a ton of talk about burnout and compassion fatigue, and making sure you're spending time on self care, but no actual efforts to address the underlying issues that were making these problems so much more prevalent. The reality is that if the work situation were not so stressful, the encouragement for self care would not be as necessary. I regularly had to take sleep aids the night prior to work (and I worked day shift!) because if I didn't I would get about 4 hours of sleep due to anxiety of anticipating the following day. The constant encouragement to fix problems by meditating them away was very disrespectful. It was as if we weren't seen as smart enough to recognize the real issues at hand and we were just being "weak."

Exactly what I was thinking and well put! Maybe instead of spending tons of money on whatever  the employee wellness program of the day is maybe divert some or all of those funds to hiring or at least retaining the nurses you have? 

The newest one I just love, the "financial wellness" hub is now live.  So the answer to our all our financial woes apparently is the company sponsored money management advice?   Though I do have to admit I've not even looked at what is in it yet but...How about just skip the advice and give us more money?? All the company sponsored financial, meditation, diet and exercise programs in the world can't fix what is essentially a broken system. 

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I have constant anxiety these days before going into work.  I’ve even doubled the amount of exercise I do in a week.  Yesterday I found myself crying in my garage to my husband because my shift was just so awful Friday.  I find myself becoming more and more jaded.  

I spent Friday doing an extreme amount of education with my patient.  His hospital admission was due to sepsis and it was a hygiene issue.  I spoke with his family extensively.  Tried to see if we needed more help at home.  Daughter in law that I spoke never told me she was an RN, never let on, so I did lots of basic education and when patient told me later, I kind of felt like she was playing me for a fool. 

We had to code a terminal end stage patient.  My other patient was well, let’s just say, I had little compassion because he was on my unit due to his violent felon behavior outside the hospital.

Then I come home and try to decompress only to see post after post of how healthcare workers are the enemy over “the jab”.  Today, I should be chilling and watching some football, instead I’m getting endless texts about bonus for work the next few days so I’m anxious about how awful tomorrow will be.  

I’m actually interviewing other places right now.  I’m burnt out and my compassion is about zero right now.  I’m hoping getting out of the ICU and getting more time with my family will help.  I’ve had 4 interviews and have 4 shadows set up for this week.  It just terrifies me to start over.  I do like my unit and coworkers, it the patients and public.

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