Emotional Overdrive: How to Pump the Brakes on Compassion Fatigue in Bone Marrow Transplant Nurses

Abstract

The unique and long-standing relationships that bone marrow transplant (BMT) nurses develop with their patients and their families make end-of-life (EOL) care increasingly difficult and stressful for the nurse. Through continued exposure to suffering and pain, many BMT nurses experience compassion fatigue (CF) which can manifest as physical, emotional and spiritual distress. If left unaddressed, CF can eventually lead to burnout and BMT nurses leaving the field. In order to combat CF, literature shows that a variety of interventions including formal debriefing sessions, EOL and grief education programs as well as holistic and spiritual interventions have shown to be effective in reducing burnout and alleviating grief-related stress in BMT nurses. Prior to introducing any interventions, a needs-assessment survey was conducted on our 28-bed hematology/oncology & BMT unit. Forty-two staff members were surveyed and asked about their level of emotional fatigue and if they thought they would benefit from grief support programs. Overwhelmingly the response was “yes” (41 out of 42), so an initial roll out of four interventions were initiated: Condolence cards to be sent out and signed by staff members to families of patients who passed away on the unit Formal debriefing session led by a psychiatrist Group guided meditation and individual Reiki sessions led by an integrative health RN Remembrance/prayer box that staff members could write notes/thoughts/prayers in Initial feedback from RNs was positive, many saying they found “closure”, particularly with the sending out of condolence cards. A six-month post-intervention survey to be conducted in October. Compassion fatigue is not exclusive to field of hematology/transplantation. With no formal compassion fatigue program in place at our institution, we believe that this program could be implemented hospital-wide and serve as a template for other units to help their staff with this ongoing problem.