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

Results

Most participants were women (94%) and certified in intensive care (55%). The ages of the participating nurses were fairly evenly distributed, with 41% aged between 31 to 45 years. The majority (57%) had been practicing for more than 10 years. Table 1 provides demographic details of all nurse respondents.

We found no multicollinearity between the participant characteristics or between the outcomes (all variance inflation factors were ≤ 3.57).

Compassion Satisfaction

Using established cut points for low, average, and high compassion satisfaction,[2] we found that the participants were split almost evenly into groups who reported average (53%) or high (47%) compassion satisfaction. The Cronbach α was 0.86 for this subscale in our sample.

Contrary to our research hypothesis, we found no significant relationship between exposure to patient death or near-death experiences and compassion satisfaction among nurses in either the bivariate or the multivariate model. Nurses in the average and the high compassion satisfaction groups had been exposed to approximately 3 to 5 patient deaths or near-death experiences in the preceding month.

Other correlates were significantly associated with compassion satisfaction: educational attainment (β = 0.19; P = .048), experience (β = 0.74; P = .004), and the age-experience interaction term (β = −1.08; P = .01) (Table 2). The multivariate model explained approximately 64% of the variance in compassion satisfaction (R 2 = 0.64).

Educational attainment had a small impact on compassion satisfaction; for example, moving from a bachelor's degree to a master's degree was associated with a 0.19 increase in the compassion satisfaction score. Each additional year of experience was associated with a 0.15 increase in the score. A significant interaction was found between age and experience; that is, increasing age contributed to a protective effect beyond that provided by experience alone. Thus a 30-year-old nurse with 1 year of experience can be expected to have a higher compassion satisfaction score than a 30-year-old nurse with 10 years of experience.

Burnout

Per the cut points established in the literature for low, average, and high burnout,[2] participants reported low (55%) or average (45%) burnout. The Cronbach α was 0.77 for this subscale in our sample.

Similar to our findings for compassion satisfaction, no significant relationship was apparent between exposure to patient death or near-death experiences and burnout. Nurses in the low and the average burnout groups had been exposed to a mean of 3 to 5 patient deaths or near-death experiences in the preceding month.

Some correlates were significantly associated with burnout (Table 3), including educational degree (β = 0.20; P = .005), experience (β = 0.65; P = .001), and the age-experience interaction term (β = −0.85; P = .01). The multivariate model explained approximately 78% of the variance in burnout (R 2 = 0.78).

Level of education had only a small impact on burnout; in this case, moving from a bachelor's degree to a master's degree was associated with a 0.20 increase in the burnout score. Each additional year of experience was associated with a 0.65 increase in that score. Age, however, impacts the rate of increase; for example, a 30-year-old nurse with 10 years of experience would be expected to have a lower burnout score than a 30-year-old nurse with 1 year of experience.

Secondary Traumatic Stress

Per the established cut points for low, average, and high secondary traumatic stress,[2] participants reported low (62%) or average (38%) secondary traumatic stress. The Cronbach α was 0.76 for this subscale in our sample.

As with compassion satisfaction and burnout, we found no significant relationship between exposure to death or near-death experiences and secondary traumatic stress. Nurses with low or average secondary traumatic stress had been exposed to approximately 3 to 5 patient deaths or near-death experiences in the preceding month.

We identified no significant correlates for secondary traumatic stress (Table 4). The multivariate model explained approximately 52% of the variance in compassion satisfaction (R 2 = 0.52).

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