COMPASSION FATIGUE: UNDERSTANDING THROUGH STORY-TELLING
Background: story-telling has been shown to calm and heal the story-teller, and often exerts a positive effect on the listener. This technique can be helpful in the classroom with students, and in patient education. Story-telling exemplifies the art of nursing, and provides a holistic means of understanding illness and health experiences. While nurses are often the listeners in story-telling, nurses can learn from each other through story-telling; in fact, story-telling provides a safe and meaningful method of sharing experiences and validating feelings. Many nurses are reluctant to admit to having any symptoms of compassion fatigue, as even the term can be perceived as stigmatizing.
Method: learning modules, story-telling, and journaling. Graduate nursing student volunteers (N=59) were presented with 10 learning modules over 10 weeks; learning modules described symptoms of compassion fatigue, including burnout and secondary traumatic stress. In an attempt to reduce the stigma of compassion fatigue, many of the modules contained videotaped stories told by expert nurse leaders and educators, who narrated their own stories and experiences of compassion fatigue. Students submitted weekly journals describing their reactions to the stories told by the expert nurses, and then described their own emotional triggers and physical or mental symptoms of compassion fatigue.
Results: At the beginning of the research study, the majority of volunteers self-described themselves as having no symptoms of compassion fatigue. Furthermore, most volunteers described compassion fatigue as something that happens to “other nurses”, “weak” nurses, “emotional nurses”, but will “never happen to me”. After watching the first nurse expert tell her story about compassion fatigue, about 33% of the volunteers admitted to having similar feelings or experiences shared on the video-tape. Still the majority of the sample felt different from the expert: “better equipped to handle the stress”, “tougher than she is”, “know how to prevent it better than she did”. There was little change after watching the second nurse expert tell her story. After the third nurse expert (also the primary investigator) shared her story with compassion fatigue, the nature of the student journals changed significantly. The great majority of student volunteers began to identify feelings of emotional distress and symptoms of compassion fatigue. Volunteer comments included: “listening to your story made me feel it was OK to say I have compassion fatigue”, “thank you, your story was so validating to me”, and “if someone like you could have compassion fatigue, then it really could happen to anyone.”
Implications: story-telling can be therapeutic for the teller and the listener, especially as a means to validate feelings or experiences. Situations or interactions in the clinical setting can leave a nurse feeling vulnerable, afraid, sad, or distressed; unfortunately those feelings can often be followed by guilt or shame. Hearing a story from a peer, colleague, or respected leader in which a similar feeling or experience is shared, can help to reduce the guilt or shame and even validate the feelings.