Violence, Compassion Fatigue and Compassion Satisfaction in the Emergency Department
The purpose of this study was to examine the relationships between perception of workplace violence and compassion satisfaction and compassion fatigue among staff members in a Level 1 Shock Trauma center.
Background
Workplace violence in healthcare settings is a significant problem, particularly in emergency departments. In addition to being exposed to violence in the workplace, emergency department workers can experience compassion fatigue. There is no research available investigating the relationships between compassion fatigue, compassion satisfaction, perceptions of and exposure to workplace violence among emergency department workers.
Methods
A cross-sectional design was used to survey all emergency department staff members. The survey included demographic questions, questions regarding workplace violence including perceptions of tolerance, types and frequency of violence experienced. The Professional Quality of Life: Compassion Satisfaction and Fatigue v. 5 tool was used with permission.
Results
A total of 153 people representing 13 disciplines completed the online survey.
Females were more likely to report experiencing violence. Verbal abuse was the most frequently reported form of violence experienced. All forms of violence were perpetrated by patients more frequently than by family/visitors. RNs reported experiencing more violence than any other discipline.
Most respondents (64%) agreed that violence is an expected part of the job. Tolerance to violence and expectation of violence were significantly correlated (r = -.198, p = .016).
Significant differences in compassion satisfaction (F(10,135)=2.47, p=.010), secondary trauma (F(10,135)=1.97, p=.000) and burnout (F (10,135)=3.50, p=.042) were found between disciplines, however, only demonstrated significantly higher burnout among RNs as compared to unit secretaries (p=.048). Males reported significantly higher burnout than females (t(144 =-2.37, p=.019). There was a significant main effect in compassion satisfaction (F(4,141)=2.5, p=.045) and burnout (F(4,141)=2.82, p=.027) by age, however, no significant post hoc contrast differences were found. Compassion satisfaction was significantly lower among those working variable shifts than those working day shifts (F(3,142)=2.81, p=.050).
Compassion satisfaction was significantly higher among those who reported their tolerance to violence as higher than their coworkers compared to those whose tolerance was about the same as their coworkers (F(2,143)=8.63, p=.000). Burnout was significantly lower among those who reported their tolerance to violence as higher than their coworkers compared to those whose tolerance was about the same as coworkers (F(2,143)=4.62, p=.018).
Among RNs, those with 21 or more years of experience reported significantly lower burnout than any other group (F(3,53)=5.6, 0-4 years p=.006; 5-10 years p=.016; 11-20 years p=.006) and significantly higher compassion satisfaction than those with only 0-4 years of experience (F(3,53)=2.8, p=.001).
Implications
Emergency departments strive to maintain safety. They also want to retain satisfied employees. While these results represent only one study, the most experienced nurses had low burnout and high compassion satisfaction. Specific interventions addressing staff expectations of and tolerance to violence in the workplace might be effective in retaining staff members with low burnout and high compassion satisfaction. This presents an interesting paradox. Ideally violence in healthcare settings would be eliminated; however, having a high tolerance to violence might protect emergency department employees from burnout and promote compassion satisfaction.