Megan Brooks

May 14, 2013

Compassion fatigue among nurses is garnering greater attention as data highlighting the scope and impact of the problem accumulate. To deal with the issue, institutions are designing creative approaches.

Katrina Fetter

Compassion fatigue is "a very common problem in oncology nursing, but it exists in all specialties," Katrina Fetter, RN, BSN, OCN, staff nurse and assistant manager at Lancaster General Hospital in Pennsylvania, told Medscape Medical News.

"We are doing a better job of recognizing it now than in the past. There are articles coming out almost monthly that reference compassion fatigue and/or burnout," she noted.

Nurses addressed this concerning issue at the Oncology Nursing Society (ONS) 38th Annual Congress in Washington, DC.

Fetter, who led a 4-hour session on compassion fatigue together with Katherine Janzen, RN, MN, assistant professor at Mount Royal University in Calgary, Alberta, Canada, said that oncology nurses are at particular risk because of the "high level of loss and the fact that we build stronger relationships with patients because of their frequent flyer admissions."

In oncology nursing, "we get to know patients better and it's hard to see such a high percentage of patients be lost. Nurses go through periods of grief," Fetter pointed out.

She said telltale signs of compassion fatigue or burnout include absenteeism, poor productivity at work, fatigue, body malaise, forgetfulness, back pain and stiff neck, and difficultly paying attention.

Recognizing that it's a problem is only half the battle, Fetter said. "Addressing the problem will take education; getting nursing schools to educate about compassion fatigue, for example."

Having an open dialogue about it with staff and getting nurses to journal their thoughts are also helpful, she added.

"We do a lot of recognition and closure activities when someone passes away. Being willing to take the time to take care of yourself is important. It's hard for nurses to do that in general," Fetter said.

Recognizing the need to address compassion fatigue, the nursing leadership at the Memorial Sloan-Kettering Cancer Center in New York City developed a working group to develop ideas. With input and help from the integrative medicine service and nutrition department, they created a Day of Rejuvenation.

The goals of the day were to provide an outlet for reducing stress, to educate staff on methods to refocus, and to allow free time during the shift to care for self. The staff partook of massages, stress management classes, relaxation technique classes, chair yoga, and nutritious snacks with soothing music, all away from their patient care assignments.

Janine Kennedy

"The day was a huge success," said Janine Kennedy, RN, MA, OCN, clinical nurse specialist in the Urgent Care Center at Memorial Sloan-Kettering, who spoke about it at the ONS Congress.

Ninety percent of the staff felt that their levels of stress decreased after attending various programs that day, she told Medscape Medical News.

"I was amazed to see their stress levels diminish as the day progressed. They vocalized such enjoyment and appreciation that their concerns about compassion fatigue and burnout were being heard and addressed," Kennedy said.

"We made sure we held this program away from the clinical area so that the nurses truly felt they were being removed from their stressful surroundings. It was easy to get the staff to go to the various programs because we were able to get additional nurses — our Compassion Fatigue Workgroup members — to come in and cover assignments," she explained.

Kennedy said she'd like to make the Day of Rejuvenation an annual event, or maybe even offer it several times a year. "As the demands on oncology nurses increase, organizations need to balance increasing patient care needs with protecting time for nurses to care for self," Kennedy said.

This research did not receive outside funding. The authors have disclosed no relevant financial relationships.

Oncology Nursing Society (ONS) 38th Annual Congress: Poster 136207. Presented April 26, 2013.

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