Clinical Pearls

Abstract

Compassion fatigue occurs in response to repeated exposure to emotional and interpersonal stressors. Nurses who experience compassion fatigue have symptoms of depression and anxiety, and they are at higher risk for suicide than other health care workers. Critical incident debriefing is effective at reducing distress; however, the focus has been on clinical feedback and management after a critical situation.Arbios and colleagues examined the effectiveness of cumulative stress debriefings (CSDs)—debriefings offered on a regular basis and not just after a critical event—on reducing compassion fatigue and improving job satisfaction among pediatric intensive care unit (PICU) nurses. They found that those who attended CSDs: The use of CSDs in the PICU was successful in reducing symptoms of compassion fatigue. Most participants stated they would attend a future CSD session.See Article, pp 111-118. Proactive, interprofessional family meetings are held to inform and support patients’ families even when no immediate decisions need to be made. Although such family meetings have been a part of professional organizations’ best practice guidelines since 2007, adherence to them has been low.Seaman et al interviewed members of the intensive care unit team to understand their perceptions of implementing family meetings. They found The authors suggest various types of interventions to shift the thinking from reactive family meetings where a decision needs to be made to proactive meetings where consistent communication and support can be offered.See Article, pp 129-136. Approximately 50% to 70% of intensive care unit (ICU) survivors develop post–intensive care syndrome (PICS), a complication that leads to worsening cognitive, physical, and mental health functioning Self-report tools, such as the Healthy Aging Brain Care Monitor (HABC-M) Self-Report, were developed to detect PICS in the primary care setting, but they may not be appropriate for ICU survivors with significant cognitive deficits.Wang and colleagues used the HABC-M Caregiver version of the tool with informal caregivers of ICU patients to establish its validity for rapid detection of PICS. They found The HABC-M Caregiver tool was validated for use in early detection of PICS symptoms. The tool is user friendly, requires little training, and can be administered in person, on the phone, or through telehealth visits.See Article, pp 137-144. Prepandemic levels of moral distress, burnout, and posttraumatic stress symptoms were higher in intensive care unit (ICU) nurses than in other health care workers (HCWs). Although it is assumed that the additional stress the pandemic placed on front-line HCWs negatively impacted their mental health, no study has described US ICU nurses’ experience.Guttormson and colleagues conducted a national survey with ICU nurses and found 4 major themes: Although some nurses reported positive experiences during the pandemic, most reported a negative impact including high levels of anxiety and depression. The authors recommend continued study of ICU nurses to help build and sustain the nursing workforce.See Article, pp 96-103.