EMERGENCY NURSES' EXPERIENCES OF COMPASSION FATIGUE
Background: Professional quality of life is affected by the work (organizational features and required tasks), client (patient and family), and person (nurses’ actions and characteristics) environments. These domains are consistent with the commonly accepted nursing professional metaparadigm that contains the themes of environment, person, and nursing. Professional quality of life is composed of positive compassion satisfaction and negative compassion fatigue. Compassion fatigue is further delineated into burnout and secondary traumatic stress. Burnout is characterized by overwhelming exhaustion, feelings of detachment, and a sense of ineffectiveness. Secondary traumatic stress refers to negative emotions driven by exposure to work-related trauma. Emergency nurses are especially at risk for developing compassion fatigue due to their frequent exposure to traumatic events and high levels of work-related stress.
Method: A secondary analysis was conducted of four semi-structured interviews in which emergency nurses were asked to describe their perceptions and experiences related to compassion fatigue. Thematic analysis consisted of identifying common feelings, emotions, triggers, and experiences.
Results: All four nurse participants described symptoms of compassion fatigue related to burnout and secondary traumatic stress. The first identified theme was the reported signs of burnout, which included feelings of ineffectiveness and mental exhaustion while at work. Secondly, the nurses recounted symptoms and triggers of secondary traumatic stress, which involved strong emotions related to caring for patients and their families in the emergency department. These “traumatic experiences” were related to “seeing things happen” at work and described by the nurses as “intense,” “shocking,” “upsetting,” and “my worst fear…it was a little too close to home.” These emotions led to a subsequent need to “depersonalize your patients” in order to do the work. In addition, the nurses reported overwhelming physical exhaustion from the required tasks and night shifts, leaving them “completely drained…both mentally and physically.” The symptoms of compassion fatigue extended well beyond the work setting. These included negative and inappropriate emotions at home, difficulty sleeping, and worrying about patients, worrying about forgotten tasks at work, and worrying about their own family’s health.
Implications: Compassion fatigue can contribute to a decreased professional quality of life, diminished job performance, and turnover. Results indicate that emergency nurses experience a variety of burnout and secondary traumatic stress symptoms, and that the detrimental effects can extend to outside of work. More research to explore emergency nurses’ experiences of compassion fatigue is needed. Additionally, emergency nurses require effective education and interventions aimed at decreasing the lasting negative effects of their work.