Abstract

The purpose of this hermeneutic interpretive phenomenology study was to describe the shared meaning of compassion fatigue (CF) among registered nurses (RNs) who work in skilled nursing facilities (SNFs). The specific aims were to describe: 1) contributors (triggers, situation, or patient characteristics) that cause symptoms of compassion fatigue, 2) associated physical and emotional symptoms, and 3) the short-term outcomes of unresolved compassion fatigue impacting nurses and patient care. CF can negatively impact patient outcomes, is associated with decreased quality of patient care, and can be a reason why nurses leave the profession. Eight participants were interviewed three times each, while concurrent data analysis helped to formulate mutual understanding of the phenomenon and informed subsequent interviews. Self-reflection, journaling, record keeping, and use of direct quotes enhanced trustworthiness. Four shared meanings were abstracted:1) I feel conflicted and that causes my CF; 2) physical and emotional manifestations of CF; 3) CF is infused in every aspect of my life; 4) we are trying to cope with CF. The participants shared their central desire to make a difference in the lives of their patients, which was of paramount importance. When participants felt they were unable to make the desired difference, they began to develop symptoms of CF. Symptoms were compounded when they experienced frequent patient deaths. A resiliency program specifically addressing the needs of SNF nurses, incorporating individuals and their organizations, could positively impact the nurses’ professional quality of life. Future research is needed to better understand CF and interventions specific to SNF nurses.

Highlights

  • Compassion is a contingent and emerging mental quality developed when individuals interact with their environment (Halifax, 2012)

  • Conclusions drawn from literature reviews about compassion fatigue (CF) are that: compassion is not well defined within nursing; CF and burnout are closely related concepts; burnout and CF are at times used synonymously; and burnout and CF are not conceptually distinguished (Ledoux, 2015)

  • There are conflicting beliefs surrounding the construct of CF and there is no theory or clear theoretical underpinning regarding nurse compassion or compassion fatigue (Ledoux, 2015; Sabo, 2011)

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Summary

Introduction

Compassion is a contingent and emerging mental quality developed when individuals interact with their environment (Halifax, 2012). As a result of helping others who are suffering, positive feelings, compassion satisfaction (CS) or negative feelings, compassion fatigue (CF) can develop (Stamm, 2010). Compassion satisfaction and compassion fatigue can both influence the nurse’s professional quality of life (Stamm, 2010). Compassion fatigue consists of two components: burnout and secondary traumatic stress. Burnout involves negative feelings about the work environment; while secondary traumatic stress is a result of exposure to a patient’s trauma or suffering (Stamm, 2010)

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