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Presented by Jennifer Montgomery April 30, 2015 Slide 2 St. Francis of AssisiPatron Saint of Compassion He relinquished a life of wealth & chose a humble life to care for the sick, the disenfranchised, the poor, prisoners, and believed no one should ever die alone at the end of their earthly life. Slide 3 https://www.youtube.com/watch?v=3Dr3NikrP1M&feat ure=player_embedded Slide 4 Compassion fatigue has been described as the cost of caring for others in emotional and physical pain. It is most often characterized by deep physical and emotional exhaustion and a marked change in the caregivers ability to feel empathy for their patients, loved ones and co-workers. This is most often seen in increasing cynicism at work, a decrease or complete loss of a sense of enjoyment and accomplishment in our career. Eventually this can morph into depression, secondary traumatic stress and stress-related illnesses. Slide 5 Compassion fatigue is the negative aspect of our work as helpers. There are two parts. The first part concerns things such as exhaustion, frustration, anger and depression typical of burnout. Secondary Traumatic Stress is a negative feeling driven by fear and work-related trauma. It is important to remember that some trauma at work can be direct (primary) trauma. In other cases, work-related trauma be a combination of both primary and secondary trauma. Compassion fatigue is the negative aspect of helping those who experience traumatic stress and suffering. Compassion Satisfaction is the positive aspect of helping. Compassion Satisfaction Slide 6 Burnout is one element of the negative effects of caring that is known as Compassion Fatigue. Most people have an intuitive idea of what burnout is. From the research perspective, burnout is associated with feelings of hopelessness and difficulties in dealing with work or in doing your job effectively. These negative feelings usually have a gradual onset. They can reflect the feeling that your efforts make no difference, or they can be associated with a very high workload or a non- supportive work environment. Slide 7 Nurses are short-handed, understaffed, and overworked. We are only an accidental needlestick or bodily fluid splash injury away from exposure to deadly diseases. We get aches and pains from lifting and tugging on people bigger than we are. We watch people die. We see families grieve. Often we work double shifts to meet the needs when staffing is overstretched. We are tired. Yet we love nursingmost days. But we need support and help to cope (Turley, 2005) Slide 8 In 2002 a staffing survey was given by the ANA to nurses. In analysis of that survey the ANA found that the most common responses from nurses regarding how they felt as they left their job each day were as follows: Exhausted and Discouraged (50%) Discouraged and saddened by what I could not provide for my patients (44%) Powerless to affect change necessary for safe, quality patient care (40%) Frightened for the patients (26%) Do you find yourself agreeing with any of the responses? Slide 9 https://www.youtube.com/watch?v=sVxl5LGAQwo&feature=player _embedded Slide 10 Lombardo, B., Eyre, C., (Jan 31, 2011) "Compassion Fatigue: A Nurses Primer" OJIN: The Online Journal of Issues in Nursing Vol. 16, No. 1, Manuscript 3. Slide 11 The consequences of a stressful work environment can have a significant impact on nurses. Currently there are 3.1 million registered nurses in the US; they comprise the largest group of healthcare workers in the country (Health Resources and Services Administration, 2010). A nursing occupational hazard of providing empathic, relationship-based care to patients and families is the development of compassion fatigue. The impact of compassion fatigue on nurses can be profound. The bottom line for nursing administrators is that employee stress and burnout incur significant financial obligations to agencies; specifically, estimates, nationally, based on government, industry, and health groups, place the cost of stress at approximately $250 to $300 billion annually. This includes estimates of the dollar effects of reductions in operating effectiveness, poor decision making, medical expenses, and attrition resulting from stress. It is important for nurses to become knowledgeable about compassion fatigue symptoms and intervention strategies and to develop a personal plan of care so as to and achieve a healthy work-life balance. Equally as important is that healthcare systems invest in creating healthy work environments that prevent compassion fatigue and address the needs of nurses who are experiencing compassion fatigue. Slide 12 Increasing costs to health care providers: Of note, other than retirement, one in five nurses will leave her/his job due to dissatisfaction, notably including burnout and stress (Aiken, Clarke, Sloane, Sochalski, & Silber, 2002). Of related significant concern, current annual registered nurse turnover rates are estimated by the Joint Commission on Accreditation of Health Care Organizations (2002) to range from 18% to 26 %, with recent cost estimates for each nurse-turnover ranging from $62,100 to $67,000 (Jones, 2005). Specifically, this can add $1 million in additional costs to an organization for every 15 nurse positions that are left vacant due to turnover. Slide 13 Health related problems : Danish researchers reported on a 15-year study of 12,000 nurses finding that nurses struggling with excessive work pressure had double the risk for a heart attack. A British study that tracked 6,000 workers for 11 years found that those who regularly worked more than 10 hours a day had a 60% higher rate for heart disease than those that put in 7 hours Slide 14 For managers ideas for the work environment: Stress reduction classes: Offer live classes and computer based sessions about self-care stress reduction techniques. Be sure to tailor sessions so that they make sense for busy staff nurses. Create space for relaxation: Social support has been shown to reduce the effects of stress and senior leadership can help foster opportunities for nurses to interact by providing a place for them to meet. Mentor and buddy programs: Having someone to vent to and engage in joint-problem solving can mitigate the effects of stress. Slide 15 For managers ideas for the work environment: Recognition and reward: Although often considered a short-term boost, simple recognition and reward activities done on a regular consistent basis can lift nurses spirits and can go a long way in making a bad day into a good one. Manager Involvement: Building a supportive and healthy work environment reduces the stress that nurses feel. Managers can provide positive feedback and support through stressful situations. They can use opportunities such as unit staff meetings to solve problems and share stress reduction techniques. Training and education: Offer continuing education and frequent training. Counseling: Utilize you employers EAP program or department of Spiritual Services which can provide assistance and training to specifically prevent nurse burnout. Slide 16 For nurses and other health-care providers in your own life: Involvement in activities that you enjoy: Find activities that you enjoy doing and stay involved with them. It could be something as simple as attending a book club or volunteering at the animal shelter. Eat healthy, exercise and sleep: Be sure that you are eating healthy foods, exercising and getting an adequate amount of sleep each night. Meet with your (nurse) manager: Meet with your nurse manager to discuss how you are feeling. Water: Be sure to drink as much was as possible throughout the day. 6- 10 8oz glasses a day are recommended. You can also obtain your daily water intake by consuming 100% veggie or fruit juices, fruits, vegetables, and tea. Slide 17 Led by Daniel Burkholder, foreground right, nurses at Georgetown Lombardi Comprehensive Cancer Center do stretching exercises. Other activities intended to ease stress and prevent burnout include journal writing, dance, quilting and painting. (MARVIN JOSEPH/THE WASHINGTON POST) Slide 18 Nurses at Inova Mount Vernon Hospital were offered knitting classes last year by a local nonprofit, Project Knitwell, as a way to cope with workday stress and as a team-building experience. Nurse manager Freda Osei says that she was skeptical at first, thinking she wouldnt be coordinated enough to knit. Instead, she says, It was great just learning a new skill. It was so calming. After I learned the initial stitches, I just went home and kept going. Slide 19 One hospital system has promoted self-care for nurses through a Relaxation Center where nurses can go for brief periods of respite. At this Center nurses can receive reiki, light massage, or just relax in a quiet and comfortable setting. The staff have enthusiastically expressed positive feedback regarding the Relaxation Center. Many nurses have acknowledged feeling less stressed and more able to manage at work after using the Center. They often bring ideas for relaxation back from the Center to their work group. Another idea is to create a comfortable, relaxing environment in a designated place on the nursing unit. This can be done by transforming an available room into a relaxation area. Nurses can select a soothing color for the walls and assist in purchasing a small waterfall, comfortable chairs, a CD player, and/or a collection of relaxation CDs that can provide comforting stress relief. Slide 20 When a nurse manager noticed signs of mounting stress among her staff, she engaged someone to work on a meditation program with them. Six of her workers participated in a two-hour meditation session where they learned to calm and center themselves. Since that session last spring, she says, the people who participated seem less harried and haggard. We talk to each other about staying positive. The session was so successful that it is being repeated for a larger group. Slide 21 http://www.compassionfatigue.org/ http://www.compassionfatigue.org/ https://www.facebook.com/compassionfatigue https://www.facebook.com/compassionfatigue Slide 22 https://www.youtube.com/watch?v=KZenjH4qaFE&feat ure=player_embedded Slide 23 O merciful Father, who have wonderfully fashioned man in your own image, and have made his body to be a temple of the Holy Spirit, sanctify, we pray you, our doctors and nurses and all those whom you have called to study and practice the arts of healing the sick and the prevention of disease and pain. Strengthen them in body and soul, and bless their work, that they may give comfort to those for whose salvation your Son became Man, lived on this earth, healed the sick, and suffered and died on the Cross. Amen. Slide 24 Slide 25 The Atlanta Journal Constitution. (2013, March 15). Business. Retrieved from The Atlanta Journal Constitution : http://www.ajc.com/news/business/overcoming- compassion-fatigue/nWsrr/http://www.ajc.com/news/business/overcoming- compassion-fatigue/nWsrr/ Erickson, R. P., Grove, W. J., & PhD. (2007). Why Emotions Matter: Age, Agitation, and Burnout Among Registered Nurses. Online Journal of Issues in Nursing. Retrieved April 05, 2015, from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPerio dicals/OJIN/TableofContents/vol132008/No1Jan08/ArticlePreviousTopic/WhyEmo tionsMatterAgeAgitationandBurnoutAmongRegisteredNurses.html http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPerio dicals/OJIN/TableofContents/vol132008/No1Jan08/ArticlePreviousTopic/WhyEmo tionsMatterAgeAgitationandBurnoutAmongRegisteredNurses.html Hendren, R. (2010, June 15). Nurse Leaders. Retrieved from Media HealthLeaders :http://www.healthleadersmedia.com/content/NRS-252471/Seven-Strategies-to- Reduce-Nurse-Burnouthttp://www.healthleadersmedia.com/content/NRS-252471/Seven-Strategies-to- Reduce-Nurse-Burnout Hudnall, B. P., Higson-Smith, C. M., Hudnall, A. C., Piland, N. F., & Stamm, H. E. (2015, April 05). Handouts on Compassion Satisfaction, Compassion Fatigue, Secondary Trauma and Vicarious Trauma. Retrieved from Professional Quality of Life Elements Theory and Measurement: http://proqol.org/Handouts.htmlhttp://proqol.org/Handouts.html Slide 26 Hudnall, B. P., Higson-Smith, C. M., Hudnall, A. C., Piland, N. F., & Stamm, H. E. (2015, April 05). Handouts on Compassion Satisfaction, Compassion Fatigue, Secondary Trauma and Vicarious Trauma. Retrieved from Professional Quality of Life Elements Theory and Measurement: http://proqol.org/Handouts.htmlhttp://proqol.org/Handouts.html Hudnall, B. P., Higson-Smith, C. M., Hudnall, A. C., Piland, N. F., & Stamm, H. E. (2015, April 05). Promote Resiliency and Prevent Compassion Fatigue: The Helper Pocket Card. Retrieved from Professional Quality of Life Elements Theory and Measurement: http://proqol.org/Helper_Pocket_Card.htmlhttp://proqol.org/Helper_Pocket_Card.html Jonae-Ryan, S. (2013, October 24). Nursing. Retrieved from Fortis: http://www.fortis.edu/blog/nursing/ways-to- prevent-nurse-burnout/http://www.fortis.edu/blog/nursing/ways-to- prevent-nurse-burnout/ Karioth, S. (2011, April 28). Compassion Energy as a Way to Find Joy in What You Do. Florida. Parker-Pope, T. (2010, May 17). Well. Retrieved from Well Blogs New York Times: http://well.blogs.nytimes.com/2010/05/17/time-to-review-workplace-reviews/?_r=2 http://well.blogs.nytimes.com/2010/05/17/time-to-review-workplace-reviews/?_r=2 Roberts, B. (2013). Prayers to St. Agatha. Retrieved from St. Agatha: http://stagatha.webhero.com/aboutbev.html http://stagatha.webhero.com/aboutbev.html Schuster Lynch, J. (2013, June 10). Health and Science. Retrieved from The Washington Post: http://www.washingtonpost.com/national/health-science/with-nurses-at-risk-of-compassion-fatigue-hospitals- try-to-ease-their-stress/2013/06/07/b92b9e86-97e3-11e2-97cd-3d8c1afe4f0f_story.html http://www.washingtonpost.com/national/health-science/with-nurses-at-risk-of-compassion-fatigue-hospitals- try-to-ease-their-stress/2013/06/07/b92b9e86-97e3-11e2-97cd-3d8c1afe4f0f_story.html