Toward a better understanding of compassion fatigue: overview
Background: as it is currently conceptualized in the widely-used Professional Quality of Life (ProQOL-5) model and instrument, compassion fatigue stems from the negative attributes of burnout (reactions to the work environment), and secondary traumatic stress (witnessing the distress of others), with a subsequent loss of compassion satisfaction (work-related satisfaction at a job well done). Nurses who are experiencing compassion fatigue usually feel physically and emotionally depleted. Outcomes of unresolved compassion fatigue include increased sick time, self-medicating with alcohol or other substances, distancing from patients and others, impaired social connectedness, and even prematurely leaving the profession.
Method: descriptive studies conducted among hospital-based registered nurses (n=16) and nursing graduate students (N=59) over a one-year period.
Content of papers:
Paper one: describes compassion fatigue among emergency department nurses, guided by the ProQOL model. Secondary data analysis from semi-structured interviews (N=4) led to themes that depicted the nurses’ experiences with compassion fatigue. Burnout was frequently descried but often minimized. Numerous examples of secondary traumatic stress were provided. Several distressing symptoms emerged that do not fit within the ProQOL conceptual model.
Paper two: describes compassion fatigue among oncology nurses, guided by the ProQOL model. Secondary data analysis from semi-structured interviews led to common experiences and associated feelings of distress. Again, stories of burnout and secondary traumatic stress were depicted, with each nurse describing the emotional duress associated with compassion fatigue.
Paper three: describes the prevalence of compassion fatigue symptoms among graduate nursing students (N=59), as measured by the ProQOL-5. The majority of students are hospital-based nurses who may be seeking a graduate degree as a means to escape the emotional distress of compassion fatigue; 69% of the sample appear at moderate to high risk of compassion fatigue.
Paper four: describes findings from two studies that explored compassion fatigue among two nursing populations, guided by the ProQOL. Findings stem from semi-structured interviews with hospital-based nurses (N=16) and weekly self-reflective journal submissions among graduate nursing students (N=59). Symptoms of burnout were described but were quickly normalized. Multiple experiences with secondary traumatic stress were recounted, and participants reported how these experiences significantly compromised professional, interpersonal, physical, and mental well-being. Additional elements that were not adequately captured in the compassion fatigue conceptual model (ProQOL-5) were identified.