Compassion Fatigue, Compassion Satisfaction & Burnout among Pediatric Nurses

Abstract

Problem/Background Nurses caring for very ill or dying children are frequently exposed to highly stressful and emotional situations. Over time and with repeated exposures, nurses can develop compassion fatigue and burnout. In addition to placing nurses at increased risk for significant emotional and physical health issues, compassion fatigue also contributes to nurse burnout, medical errors and low patient satisfaction. Research Question or Hypothesis The study aimed to answer two research questions: ●"What is the prevalence of compassion fatigue, burnout, and compassion satisfaction among registered nurses at a large academic pediatric health care facility located in the Midwest?" ●"Is there an association between compassion fatigue, burnout, and compassion satisfaction and age, years of nursing experience, and nursing specialty?" Theoretical Framework: Stamm's Theory of Compassion Satisfaction and Compassion Fatigue serves as the theoretical framework for the study. Whereas burnout is associated with feelings of hopelessness and apathy, compassion fatigue describes the feelings of physical, emotional, and spiritual exhaustion from absorbing the problems and suffering of others. Compassion satisfaction describes nurses' satisfaction when caring for patients and feeling competent and supported by colleagues. Method and Study Design The study was a cross-sectional descriptive design that used convenience sampling. Data were collected via computer using the Professional Quality of Life Scale (ProQOL), a 30-item instrument designed to assess professional quality of life for those in helping professions. The ProQOL is comprised of three subscales, each comprised of 10 items and measured using a 5-point Likert type scale. Reliability for each subscale is as follows: compassion fatigue α = 0.81, burnout α = 0.65, and compassion satisfaction α = 0.88. Descriptive and frequency summaries were computed for all study variables. The effect of demographic factors on the study outcomes was studied using univariate analysis and multivariate analysis. Results A total of 503 RNs participated. The results revealed overall low to average levels of compassion fatigue and burnout and generally average to high levels of compassion satisfaction. In multivariate analysis, younger nurses had statistically significant higher burnout (p = 0.04) and compassion fatigue scores (p = 0.01) and lower compassion satisfaction scores (p = 0.001) compared to nurses aged 40 years or older. In addition, nurses in the Critical Care and Emergency work clusters had statistically significantly higher burnout scores than those in Ambulatory, Perioperative and Medical/Surgical areas. Results also demonstrated nurses in the Emergency work cluster had significantly higher compassion fatigue scores than those in Ambulatory, Perioperative and Medical/Surgical areas. Conclusions/Relevance to Practice Findings suggest younger nurses and those working in critical care areas have higher levels of compassion fatigue and burnout. Improving recognition and awareness of compassion satisfaction, compassion fatigue, and burnout may help to increase retention and identify interventions aimed at decreasing burnout and compassion fatigue. Different generation-specific strategies may be necessary to address the issues of compassion satisfaction, burnout, and secondary traumatic stress. These strategies should strive to ensure a positive work environment that promotes work satisfaction, retention and professional growth for nurses of all ages. Nurses caring for very ill or dying children are frequently exposed to highly stressful and emotional situations. Over time and with repeated exposures, nurses can develop compassion fatigue and burnout. In addition to placing nurses at increased risk for significant emotional and physical health issues, compassion fatigue also contributes to nurse burnout, medical errors and low patient satisfaction. The study aimed to answer two research questions: ●"What is the prevalence of compassion fatigue, burnout, and compassion satisfaction among registered nurses at a large academic pediatric health care facility located in the Midwest?" ●"Is there an association between compassion fatigue, burnout, and compassion satisfaction and age, years of nursing experience, and nursing specialty?" Theoretical Framework: Stamm's Theory of Compassion Satisfaction and Compassion Fatigue serves as the theoretical framework for the study. Whereas burnout is associated with feelings of hopelessness and apathy, compassion fatigue describes the feelings of physical, emotional, and spiritual exhaustion from absorbing the problems and suffering of others. Compassion satisfaction describes nurses' satisfaction when caring for patients and feeling competent and supported by colleagues. The study was a cross-sectional descriptive design that used convenience sampling. Data were collected via computer using the Professional Quality of Life Scale (ProQOL), a 30-item instrument designed to assess professional quality of life for those in helping professions. The ProQOL is comprised of three subscales, each comprised of 10 items and measured using a 5-point Likert type scale. Reliability for each subscale is as follows: compassion fatigue α = 0.81, burnout α = 0.65, and compassion satisfaction α = 0.88. Descriptive and frequency summaries were computed for all study variables. The effect of demographic factors on the study outcomes was studied using univariate analysis and multivariate analysis. A total of 503 RNs participated. The results revealed overall low to average levels of compassion fatigue and burnout and generally average to high levels of compassion satisfaction. In multivariate analysis, younger nurses had statistically significant higher burnout (p = 0.04) and compassion fatigue scores (p = 0.01) and lower compassion satisfaction scores (p = 0.001) compared to nurses aged 40 years or older. In addition, nurses in the Critical Care and Emergency work clusters had statistically significantly higher burnout scores than those in Ambulatory, Perioperative and Medical/Surgical areas. Results also demonstrated nurses in the Emergency work cluster had significantly higher compassion fatigue scores than those in Ambulatory, Perioperative and Medical/Surgical areas. Findings suggest younger nurses and those working in critical care areas have higher levels of compassion fatigue and burnout. Improving recognition and awareness of compassion satisfaction, compassion fatigue, and burnout may help to increase retention and identify interventions aimed at decreasing burnout and compassion fatigue. Different generation-specific strategies may be necessary to address the issues of compassion satisfaction, burnout, and secondary traumatic stress. These strategies should strive to ensure a positive work environment that promotes work satisfaction, retention and professional growth for nurses of all ages.