We Grieve Too

One Inpatient Oncology Unit's Interventions for Recognizing and Combatting Compassion Fatigue

Katrina L. Fetter, RN, BSN, OCN


Clin J Oncol Nurs. 2012;16(6):559-561. 

In This Article

Combating Compassion Fatigue

Given the turnover rate, the unit felt compelled to address the psychological stress and CF symptoms the staff was experiencing. The goals for the unit were to better support the nursing staff, patients, and families throughout end-of-life care and, ultimately, to significantly reduce the unit's CF. A bereavement support program was launched in October 2009. The unit's initiatives were to provide the inpatient oncology team with methods to combat CF and provide a universal symbol for the unit to bring awareness to the patients receiving end-of-life care.

A consistent theme in the literature was enhancing professional and social support so that staff can speak openly about their feelings (Figley, 2002). To address this, a remembrance tree was created on the unit (see Figure 1). The tree was placed on a bulletin board in a staff-only area of the unit and was changed with each passing season. Names and obituaries of patients who recently passed away are placed on the board. The remembrance tree acknowledged the passing of these patients in a communal area where staff could discuss memories of the patients together, and, hopefully, find some peace and closure. Aycock and Boyle (2009) found that the use of a counselor or psychologist is helpful, but loses effectiveness in the time it takes to get an appointment.

Figure 1.

Remembrance Tree
Note. Photo courtesy of Lancaster General Health. Used with permission.

Figley (2002) noted that one way to combat CF was to instill in the nurses feelings of satisfaction and achievement when helping their patients. The use of journals and bereavement cards proved effective in providing closure for nursing staff by reminding them of the impact they had on their patients. Bereavement cards were sent to the families of patients who have passed away, and journal entries were written by staff members about patients with whom the unit was particularly close. The staff wrote fond memories, funny anecdotes, and well wishes to the patient's loved ones. After a few weeks of entries, the journal was mailed to the family of the lost patient. Taking the time to think about what to say and actually writing it can provide a moment of self-reflection and self-care for the nurses (Aycock & Boyle, 2009).

Another way to battle CF is by providing nurses the opportunity to participate with the family in end-of-life care and bereavement support (LeBaron & Moore, 2007). To accomplish that, two specific measures were implemented. A magnet with a picture of a dove on it was placed on the outside door frame of rooms where a patient was being provided with end-of-life care. That dove signified to interdisciplinary staff that quiet and privacy is of the utmost importance in and around those rooms. Also, a bereavement care package program was established and care packages were given to the families of dying patients to use while they were with their loved one in the hospital. The packages were kept in the nursing unit and contained a variety of items that could be helpful to family members of a patient at the end of life, including CDs with soothing music, a CD player, bibles, blank journals, an empty picture frame, ceramic angel figurines, a plug-in candle, rosary beads, and a stress-ball squeezer.