Overview and Summary: Compassion Fatigue: Caregivers at Risk

Abstract

Becoming a nurse and caring for others can be very rewarding and fulfilling. However, caring for those in need can also lead to severe stress in all areas of nursing. In 1992 Joinson, a nurse, described the phenomenon of compassion fatigue (CF) as a unique form of burnout that affects people in caregiving professions. Figley (1995) defined it as a secondary traumatic stress reaction resulting from helping or desiring to help a person suffering from traumatic events. Its symptomology is nearly identical to that of post traumatic stress disorder (PTSD), except CF applies to caregivers who were affected by the trauma of others. Caregivers with CF may develop a preoccupation with their patients by re-experiencing their trauma; they can develop signs of persistent arousal and anxiety as a result of this secondary trauma. Examples of this arousal can include difficulty falling or staying asleep, irritability or outbursts of anger, and/or exaggerated startle responses. Most importantly, these caregivers ultimately experience a reduced capacity for, or interest in being empathic toward the suffering of others. Scholars differ in their perspectives of CF especially at it relates to burnout. However, they tend to agree that in general CF has a more sudden and acute onset than burnout, a condition that gradually wears down caregivers who are overwhelmed and unable to effect positive change. Understanding CF can empower nurses to utilize preventive measures that promote self care, improve patient outcomes, and optimize therapeutic relationships. Sabo, in her article, Reflecting on the Concept of reports that nurses working in specialty areas, such as intensive care, are quite vulnerable to work-related stress. She focuses on the theoretical conceptualization of CF, positing that care providers' declining ability to provide empathy in a therapeutic relationship is considered a key factor in compassion fatigue. Sabo explores Figley's (2002a) model of CF noting that the personal characteristics of resilience and hope, as well as the nature of relationships, may add more depth to Figley's model. She emphasizes the need to better understand the roles of empathy and engagement as contributors to CF. In Countering Fatigue: A Requisite Nursing Agenda Boyle, as does Sabo, distinguishes CF from burnout. Whereas CF stems from witnessing another's traumatic events, burnout evolves from dissatisfaction with working conditions. The author admits that both constructs result in outcomes associated with nurses' sense of emotional/physical depletion. Boyle, too, values the need to address resilience in CF research initiatives, especially since nurses are considered first responders who often have little or no formal support to counter the effects of CF. She further indicates that available tools for assessing CF are limited in scope and provide minimal help for nurses who are in dire need of onsite workplace interventions, such as counseling, support groups, and/or de-briefing sessions, to address CF. Lombard and Eyre bring an interesting case-study approach to their discussion of CF in Compassion Fatigue, A Nurse's Primer. They emphasize how CF can negatively affect job satisfaction and care providers' health, resulting in decreased productivity and increased turnover, a significant concern as nurses comprise the largest group of healthcare providers in the country. Lombard and Eyre, too, suggest that imbalanced, empathic, relationshipbased care can contribute to CF. Interventions, including a knowledge of CF symptoms and healthy workplace environments, can help to prevent CF among healthcare providers. Ward-Griffin, St-Amant, and Brown introduce an additional population considered to be at risk for CF in their article, Compassion Fatigue within Double Duty Caregiving: Nurse-Daughters Caring for Elderly Parents. Their qualitative study of nurse-daughters identifies the variable of being an informal family caregiver while at the same time working as an employee in a healthcare setting as another contributor to CF. …