ANGIE BRINEGAR, MSN,ANP-BC,AOCNP

Compassion Fatigue

Objectives

Define compassion fatigue

Be able to recognize signs and symptoms of compassion fatigue

Be able to name one intervention to prevent compassion fatigue

quote

Someone once said “One cannot work in cancer care without being affected by it. It’s like trying to go swimming and not get wet”.

Burnout

Defined as “a progressive loss of idealism, energy and purpose experienced by people in the helping professions as a result of the conditions of their work.

Further defined by 3 characteristics: Physical and emotional exhaustion Cynicism Inefficacy

Moral Distress

Defined as the inability to act in a manner consistent with one’s personal and professional values due to institutional and other external constraints.

i.e., given extended end of life care that is futile.

Compassion fatigue

A condition where too much suffering becomes overwhelming. Marked by diminished emotional energy needed to care for patients

Risk factors

Work factors, including work overloadLack of control over one’s environmentHigh levels of work home interferenceBeing femaleBeing early in one’s careerLacking a sense of personal control over an

event

Emotional Toll

Repeated exposure to suffering associated with terminal illness, including physical discomfort, decreased function, loss of personal identity, altered family role and emotional and spiritual distress….

Can lead to feelings of hopelessness, helplessness, frustration, anger, loss of sense of patients as human being, and increased risk of burnout and depression.

How does one do it?

Self Care

Refers to strategies to take better care of oneself.Prioritizing close relationships such as those of familyMaintaining a healthy life style by insuring adequate sleep, regular exercise, time for vacations; fostering recreational activities and hobbies.Practicing mindfulness and meditation; and pursuing spiritual development

Wellness Wheel

Self Awareness

Defined as the clinician’s ability to combine self knowledge and a dual awareness of both his or her own subjective experience and the needs of the patient.

*the most important factor in the ability of the clinician to function well in the face of personal and professional stressors.

Greater self awareness leads to

Greater job engagementGreater compassion satisfactionEnhanced self careImproved patient care and satisfaction

Two methods to improve self awareness

Mindfulness meditation – developing purposeful attention, being in the present moment and cultivating a kind, non judgmental attitudes toward self and others.

Reflective writing – has been shown to promote reflection and empathic engagement.

Professional Self Care

Regular appraisal of all aspects of work lifeDeveloping a network of peers and mentorsSeeking organizational engagement

opportunitiesImproving communication and management

skillsIncreasing self awareness and setting limitsPursuing reflective writing

Self Care will:

Minimize the harm from burnout, moral distress and compassion fatiguePromote personal and professional well beingImprove our job satisfaction marked by efficacy, energy and involvement in workImprove compassion satisfaction (the pleasure derived from being able to do one’s work well when helping othersImprove resilience (the ability to respond positively to challenging experiences)

References

Reilly, Morrison, Carey, Bernacki, O’Neill, Kapo, Perijakoil, Thomas., Caring for oneself to care for others: physicians and their self care. Journal of Supportive Oncology, Vol 11.,Number 2, June 2013

Cohen-Katz,J., Wiley SD., Capuano T., DM, Shapiro, S., The effects of mindfulness-based stress reduction on nurse stress and burnout: A quantative and qualitative study. Holistic Nurse Practice. 2004;186):302-308

Vanderbilt University. Wellness wheel Wellness Resource Center. http://www.vanderbilt.edu/studenttrec/wellness/wellness-wheel. Accessed September 2013