Impact of Exposure to Patient Death or Near Death on Compassion Fatigue in Pediatric Intensive Care Nurses

Kyle S. Richardson, BSc, RN; Meredith MacKenzie Greenle, PhD, RN, CRNP, CNE

Disclosures

Am J Crit Care. 2020;29(4):285-291. 

In This Article

Abstract and Introduction

Abstract

Background: Compassion fatigue affects up to 40% of health care professionals who work in intensive care settings. Frequent exposure to the death of patients, particularly children, may put nurses at risk for compassion fatigue, but the relation between these is unclear among those working in pediatric intensive care units.

Objectives: To examine the relationship between exposure to the death or near death of a pediatric patient and compassion fatigue, specifically the outcomes of compassion satisfaction, burnout, and secondary traumatic stress.

Methods: Pediatric and neonatal intensive care nurses were surveyed about their exposure to patient death and near-death experiences. They were asked to respond to the Professional Quality of Life Scale, which has 3 subscales that measure compassion satisfaction, burnout, and secondary traumatic stress. Bivariate and multivariate linear regression modeling was used to identify correlates of these outcomes.

Results: Of the 65 respondents, 94% were female, 41% were aged 31 to 45 years, and 71% had a bachelor's degree. No significant relationship was found between nurses' experiences of patient death or near death and their compassion satisfaction, burnout, or secondary traumatic stress. Significant correlates of compassion satisfaction and burnout included educational level and an age-experience interaction.

Conclusions: No relationship seems to exist between nurses' experiences of patient death or near death and their compassion satisfaction, burnout, or secondary traumatic stress. Further research is needed to evaluate the impact of educational attainment on nurse outcomes and determine how best to support nurses who are at risk for compassion fatigue.

Introduction

Approximately 40% of health care professionals working in intensive care settings experience compassion fatigue, a syndrome of chronic distress related to exposure to the suffering of others.[1] In the Compassion Satisfaction-Compassion Fatigue model, compassion fatigue is defined as a syndrome that encompasses the negative aspects of work as a helping individual, whereas the diametric term compassion satisfaction refers to the positive aspects of helping work.[2,3] Burnout and secondary traumatic stress are components of compassion fatigue.[2] Burnout is characterized by emotional exhaustion, depersonalization, and diminishment of one's personal accomplishments.[2,4] Secondary traumatic stress relates to traumatization via indirect exposure to a traumatic event, such as hearing about or witnessing a patient's suffering.[2,4]

Low compassion satisfaction and high burnout and secondary traumatic stress are associated both with poorer outcomes for patients and nurses,[5–7] and with a higher likelihood that a nurse will leave their hospital unit or the nursing profession entirely.[7] Higher burnout among nurses is negatively correlated with patient satisfaction.[5]

Nurses working in pediatric intensive care may be particularly vulnerable to the negative aspects of helping work. Burnout is high among nurses in this setting; in a recent study, 37% of nurses working in pediatric intensive care units showed symptoms of burnout.[8] Results of another study indicate that such nurses had lower compassion satisfaction and higher burnout and secondary traumatic stress than did nurses working in any other pediatric unit.[9] Because of the high illness severity of patients in pediatric intensive care units, nurses working there are more likely to be exposed to patient death.[9] The death of a patient can be devastating for a nurse, and for the entire nursing unit, and the intensity of their grief may be heightened when the patient is a child.[10,11] However, the relationship between exposure to patient death and compassion fatigue among nurses working in pediatric intensive care units is unclear.

The goal of this study was to determine whether a relationship exists between the frequency of exposure to patient death or resuscitation events and the positive and negative aspects of helping work among nurses working in a pediatric intensive care unit. We hypothesized that greater exposure to patient death or near-death events would correlate with lower compassion satisfaction and greater burnout and secondary traumatic stress.

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....