The term ‘emotional cost’ could sound unfamiliar in other professions, but when applied within real work situations, it simply portrays the emotional nature of being a Registered Nurse.

From day to day of their normal routines, nurses are concerned about patients’ fear and suffering. However, the cost of providing this nursing care can contribute to caregiver distress or also refer to compassion fatigue (CF).

Jenny Watts, a researcher and psychology PhD student at the University of Leicester, found that nurses who empathise with highly distressed patients can share patients’ emotional reactions and can develop the similar symptoms.

Hospice and palliative units

In hospice or palliative care units, nurses are continually exposed to prolonged emotional stress. They are also often witnesses to constant suffering and loss when a chronically ill patient dies.

Even though nurses play a vital role in caring for patients who are suffering, the work environment itself plays a big part for a nurse to be predisposed towards distress. In Florida, a study investigating the risk of compassion fatigue among 216 hospice nurses revealed that 78% of the sample was at moderate to high risk for compassion fatigue, with approximately 26% in the high-risk category.

Emergency room

Sharing similar work environments, Emergency Department (ED) nurses also regularly witness human suffering of pain, traumatic injuries, violence and death which consequently posed them to greater risks for developing compassion fatigue (CF).

Additionally, a research involving 24 ED nurses from Two Trauma Centre located in the United States reported high compassion satisfaction by 87.5% of respondents, while all participants reported average to high burnout and average to high secondary trauma stress. High burnout was identified in 29.2% of participants and high secondary trauma by 91.7% of participants.

Consequences of nurses suffering from compassion fatigue

Compassion fatigue affects nurses’ confidence level in providing care. Nurses who are often overwhelmed with complex care assignments will initially express sadness over the patient and feel guilty because they feel that they cannot rescue their patients from harm or pain.

Sometimes, nurses may even face difficulty sleeping due to the worries faced at work. Over time, compassion can exact an emotional toll on nurses’ personal lives and their roles as professional caregivers.

Support for nurses in dealing with compassion fatigue

Implement strategies to overcome CF

Various nursing positions and seniority within a nursing unit could propose helpful strategies to deal with CF. Experienced nurses and the nurse leader who might understand the norms and expectations of work-related distress would assist in developing effective strategies to enhance the work environment and promote work-life balance.

These may include changing the work related task and schedules, providing more time off and reducing overtime hours, or encouraging staffs to get involved in volunteer activities, conference or other projects.

A veteran nurse in an oncology unit also suggested the introducing of counselling skills to all nurses, saying “Leadership also needs to give nurses the counseling skills that enable nurses to work effectively with patients and families”.

Develop healthy rituals

Nurses always attempt to meet the needs of others but often neglect their own needs. Compassion fatigue requires nurses to live a healthy lifestyle and adapt replenishing strategies that can promote physical, emotional and spiritual wellbeing. The nurse may need to be encouraged to try self-care rituals, such as a yoga class, massage, meditation, or tai-chi.

In fact, the Relaxation Centre placed in the hospital system can assist nurses to respite and develop self-esteem within a brief period. Through a comfortable setting, this centre could help nurses to diminish stress and feel more relaxed while receiving a light massage and reiki.

Caring for others can cause nurses to face emotional, physical and spiritual exhaustion. Even though nurses are aware of the significant impacts of CF, many still choose to remain in the job because it comes with many opportunities and benefits.

Additionally, helping a patient to get through their suffering and manage the chronic disease is a wonderful feeling that they would not get from any other profession. MIMS

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