Calling the Shots: Nursing News and Notes

Tired of your Job? Fatigue or Burnout?

Tired of your Job? Fatigue or Burnout?

Thursday, February 26, 2015

Most nurses choose their field because of their compassion, caring, and desire to help others. However, the problem of nursing burnout and compassion fatigue has exposed an irony. Many nurses don’t take proper care of themselves. When nurses are heavily burdened, but not taking care of themselves, it leads to burnout or fatigue.

Burnout can affect more than ⅓ of nurses on the job. And, when a nurse has experienced on-the-job burnout, he or she may also subsequently suffer compassion fatigue. Nurse burnout affects the healthcare system in many ways. Most importantly, nurse burnout is causing high rates of turnover in the field -- turnover rates that are not being offset by new nurse graduates.

Nurses can become burnt out because they believe they lack social support, or are unable to control their work schedule or assignments. Their work environment may be too chaotic or too monotonous, or they can’t maintain a good work-life balance. Short staffing is often the primary contributor. Further, extended work hours and little time for rest breaks can lead to nurses’ disturbed sleep patterns, elevated stress hormones, poor dietary choices, and mental health issues.

Compassion fatigue is different from burnout in the sense that it is often rooted in a nurse’s extreme empathy for a patient and/or his or her family. Also known as secondary post-traumatic stress disorder, compassion fatigue causes emotional, physical, and spiritual exhaustion from witnessing and absorbing the problems and suffering of others. It most often affects caring individuals who are prone to neglecting their self-care. Compassion fatigue can affect nurses in many ways and in different aspects of their lives. Symptoms can include:

  • Emotional:
    •  Anger
    •  Apathy
    •  Breakdown
    •  Cynicism
    •  Desensitization
    •  Discouragement
    •  Dreams, flashbacks, preoccupation (r/t patient experiences)
    •  Feelings of being overwhelmed
    •  Attitude of hopelessness
    •  Irritability
    •  Lessened enthusiasm
    •  Sarcasm
  • Intellectual:
    •  Boredom
    •  Concentration impairment
    •  Disorderliness
    •  Weakened attention to detail
  • Physical:
    •  Increased somatic complaints
    •  Lack of energy
    •  Loss of endurance
    •  Loss of strength
    •  Proneness to accidents
    •  Weariness, sense of fatigue, exhaustion
  • Social:
    •  Callousness
    •  Feelings of alienation, estrangement, isolation
    •  Inability to share in or alleviate suffering
    •  Indifference
    •  Loss of interest in activities once enjoyed
    •  Unresponsiveness
    •  Withdrawal from family or friends
  • Spiritual:
    •  Decrease in discernment
    •  Disinterest in introspection
    •  Lack of spiritual awareness
    •  Poor judgment r/t existential issues
  • Work:
    • Absenteeism
    • Avoidance of intense patient situations
    • Desire to quit
    • Diminished performance ability (i.e., medication errors, decreased  documentation accuracy/record-keeping
    • Stereotypical/impersonal communications
    • Tardiness

Facilities that wish to prevent burnout and compassion fatigue, as well as aid those nurses who experience those conditions, can ensure that employee assistance programs are in place. Employers can also develop other support systems, such as:

  • On-site counseling by a psychiatric advanced practice nurse, therapist, counselor, social worker, or chaplain trained in the provision of emotional support for healthcare providers experiencing real or potential compassion fatigue.
  • Support groups for staff offered during evening or weekend hours, or in retreat settings.
  • De-briefing sessions to identify helpful and non-helpful approaches to pivotal events in clinical practice.
  • Massage sessions to provide both mental and physical breaks from the stress of caregiving.
  • Bereavement interventions, for example funeral attendance, memorial service participation, and the sending of sympathy cards to families, to help caregivers with grief resolution.
  • Attention to spiritual needs through pastoral care, involving nurses in prayer sessions and more.

Do you suffer from burnout or compassion fatigue?  Have you overcome it?  Leave a comment below sharing your experiences.

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