Cross, Lisa. (2019). Compassion fatigue in palliative care nursing: a concept analysis. Journal of Hospice and Palliative Nursing
, 21 (1), 21-28
Summary
The main objective of the author in this article was to define compassion fatigue in the context of palliative care. According to the author, nurses are usually challenged to strike a balance between work stressors and everyday stressors. The author notes that palliative care nursing is an arduous specialty that requires time and continual contact with caregivers and patients who are suffering. The continued contact with individuals who are at the end stages of severe illnesses exposes palliative care nurses to psychological, emotional, physical, spiritual, and emotional distress that potentially limits their capacity or ability to give compassionate care. The main argument of the author is that compassion fatigue among nurses working in palliative care facilities can affect negatively patient outcomes and job satisfaction, and can consequently cause nurses to consider quitting their jobs, and leave a profession that is already affected by staff shortages. The author defines compassion fatigue, distinguishing the term from related concepts, to make relevant stakeholders understand what it is in the hope that these stakeholders will create the relevant interventions.
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Article Analysis
Firstly, the author’s argument is clear; that it is important to understand the definition of compassion fatigue in palliative care facilities in order to understand what nurses working in such facilities are likely to experience. One of the points the author raises is that compassion fatigue should not just be viewed as being similar to the normal fatigue or ‘burn-out’ in healthcare facilities. The author is able to make this distinction clear by arguing that nurses working in palliative care facilities often deal with patients suffering from serious illnesses, and mostly, that do not have any cure. In addition, such patients may be at the end stages of their lives. A palliative care nurse, as the author posits, will inevitably watch their patients deal with a lot of pain, and in most cases, die. Such experiences cannot be similar to nurses working in maybe maternity units or pediatric facilities. Secondly, a palliative care nurse must always have compassion in order to work in such facilities. End of life care in most instances require nurses to have a holistic approach because it is not just about giving medication to patients; a palliative care nurse will have to deal with the emotional, and spiritual aspects of the patient. Therefore, in regard to the distinction between compassion fatigue and other related concepts, the author makes succinct distinctions.
A prominent strength of the article is that the author provides attributes to compassion fatigue to make it easy for the target audience to understand what it is. The five attributes include: empathy imbalance, diminished performance, increased complaints, inability to share in suffering, and poor judgment. In essence, these are pointers to the relevant stakeholders to identify problems among nurses working in palliative care facilities; these are attitude or behavioral changes among nurses that can indicate that they are having issues with their work. On the same note, the author provides sufficient background information about the topic, especially about the origin of the concept of compassion care. According to the author, the first hospice facility that specialized in serving patients who were at the end stages of their lives started in 1967 in England before the same concept spread to the United States. However, the most useful information regarding the topic is that as much as palliative care nurses are supposed to demonstrate care and compassion towards their patients, it could reach a point when the stressful experiences take a toll on them, making their initial abilities to diminish or get adversely affected.
The most probable target audience of the article is the management of palliative care facilities. The author intends them to note that the nature of care in those facilities is likely to affect nurses adversely. Secondly, the author also intends to create awareness among the management of such institutions to recognize the signs that may indicate compassion fatigue among palliative care nurses and take the necessary interventions. The article is convincing starting from the beginning because of its specific approach. Nurses working in palliative care facilities go through unique experiences compared to nurses working in other units, and therefore, require a special approach in addressing their issues.
Impact on Nursing Practice
The first impact of the results is that there is need to look at different nursing subspecialties in their different contexts; challenges vary across the different subspecialties. Secondly, the management of palliative care facilities needs to have programs in place to address particularly the psychological or emotional needs of nurses. Although the common assumption is that nurses are properly equipped and have the strength to cope with the needs of their patients, it is important to realize that they are also human and will likely be impacted by experiences in their practice. Thirdly, stakeholders in healthcare, especially the management need to recognize compassion fatigue with the objective of promoting strategies for compassion fatigue. The fourth implication of the article to nursing is that the some aspects of the nursing education curriculum will have to be revised to prepare students face the reality of their practice. Nurses will have to be taught to express their feelings through talking to friends, management of healthcare facilities, as well as family members to at least get a reprieve of some of the bad or strenuous experiences they could be going through at work.
