Healthcare workers supporting people affected by cancer face an increased risk of stress or compassion fatigue.73-75
Causes of stress may include:73, 75
- complex healthcare states and comorbidities
- the high level and intensity of interpersonal relationships
- increasing acuity
- individuals' expectations of care
- technological advances requiring increasingly sophisticated nursing skills
- decreased length of hospital admission
- the necessity of dealing with the dying process.
In palliative care, unique factors may magnify the risk of compassion fatigue. These include:76
- accumulated losses
- emotionally charged care
- sustained and exclusive focus on terminal illnesses and terminal care
- mortality issues of the clinician (existential, spiritual, or personal).
Cancer nurses must examine their own thoughts, feelings and attitudes regarding death and dying so as to better recognise and understand how to cope with their own aversive thoughts and emotions. Peer support from experienced cancer nurses may facilitate this process in novice nurses.77 Research has shown that nurses who receive death communication education, become more comfortable with discussion of life and death concerns with individuals and their families.78
The clinical importance of compassion fatigue has been highlighted through its impact on outcomes such as:
- increased medical errors79
- increased turnover and absenteeism80
- decreased quality of care81
- decreased satisfaction expressed by recipients of care82
- significant impact which burnout has on the professional and personal lives of affected personnel.75, 83
Protective practices for health care professionals are recommended to:76
- help compartmentalise work from the rest of life - identify ways to leave the job behind
- clarify and support staff in establishing professional boundaries
- promote emotional and physical health
- include regular self-care techniques for managing stress.
Aycock, N., & Boyle, D. (2009). Interventions to manage compassion fatigue in oncology nursing, Clinical Journal of Oncology Nursing. 13(2):183-19184
Wenzel, J., Shaha, M., Klimmek, R., & Krumm, S. (2011). Working Through Grief and Loss: Oncology Nurses’ Perspectives on Professional Bereavement, Oncology Nursing Forum. 38(3): E272-E28285
Access Justin’s story 7: end of life and complete the following:
Reflect on a situation where a person has asked if medication administered to their loved one will hasten death.
- How did / would you respond?
- Discuss evidence-based communication strategies you might use in this situation.
Access current literature (see resource link) and self-care resources at the following links:
- Discuss strategies you could develop and promote in your practice setting to support your self-care and that of nursing colleagues to reduce the impact of workplace stress and compassion fatigue.