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Compassion Fatigue, Burnout, and Secondary Traumatic Stress in Nurses

Caryln Little

Youngstown State University

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Abstract

The purpose of this research paper is to examine the factors that produce compassion

fatigue and to improve awareness. Nurses, especially those that deal with traumatic situations

such as emergency department and intensive care units are prone to develop compassion fatigue.

Components of compassion fatigue are burnout and secondary traumatic stress. Compassion

fatigue occurs when nurses experience exhaustion physically, mentally, and even spiritually

while caring for patients in traumatic situations. On the other hand there is compassion

satisfaction. Compassion satisfaction is where nurses feel satisfied with their jobs as well as the

quality of care that they are producing. Nurses need to develop techniques to combat burnout,

compassion fatigue, and secondary traumatic stress.

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Compassion Fatigue in Nurses

Compassion Fatigue
Compassion fatigue (CF) is an issue that is often under recognized and more prevalent

than many believe. Compassion fatigue was first described by a nurse as a concept from her

work with emergency department personnel. It has been defined as a combination of physical,

emotional, and spiritual depletion associated with caring for patients in significant emotional

pain and physical distress (Schroeter, 2014, p. 37). The patients are not the only people that

suffers, the nurse also suffers and it is not always apparent. Burnout and secondary traumatic

stress often are associated with compassion fatigue. Manifestations of emotional compassion

fatigue may include anger, apathy, cynicism, sarcasm, dreams, flashbacks, feelings of being

overwhelmed, hopelessness, and irritability. Intellectual manifestations may reflect boredom,

impaired concentration, inability to pay attention to detail, conflicting loyalties, and

disorderliness (Mason et al., 2014, p. 215). These issue should be researched to allow people to

know the signs and symptoms and how it can be treated.

Burnout
One component of compassion fatigue is burnout (BO), this tends to be a gradual process

of emotional exhaustion. Symptoms of burnout can include poor work quality, fatigue, mood

swings, substance abuse, anxiety, and negativity in relationships. A recent study of emergency,

intensive care, nephrology, and oncology nurses revealed that approximately 82% of nurses

surveyed exhibited moderate to high levels of BO (Hinderer et al., 2014, p. 160). These units

tend to be stressful, because of the complex care provided and mortality rates. Burnout will

decrease morale, productivity, recruiting and retention. It also will increase the turnover rates of

the unit. Burnout can be avoided by knowing the symptoms and determining stress triggers.
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Symptoms of BO include negative emotions, decreased enthusiasm for ones job; decreased job

performance; compulsive activities; and difficulty relating to family, friends, and coworkers

(Young et al., 2011, p. 228). More research needs to be completed so burnout in nurses can be

prevented as well as treated.

Secondary traumatic stress

The second issue associated with compassion fatigue is secondary traumatic stress (STS),

these are sometimes used interchangeably. Secondary traumatic stress is defined as the

emotions and behaviors that a person experiences as a result of being exposed to another

persons traumatic experience (Von Rueden et al., 2010, p. 191). As a result, nurses in the

emergency and intensive care units are more susceptible in developing secondary traumatic

stress, because of the care that they provide to patients with traumatic physical and mental

injuries. For those nurses who experience traumatic situations it is important to know the

symptoms of secondary traumatic stress and coping techniques. Health care workers who

provide care to trauma victims have identified prevention of stress, as a priority in their

perceived training needs (Von Rueden et al., 2010, p.192). Providing nurses with training to

recognize the signs and symptoms of secondary traumatic stress will allow nurses to practice

healthier caregiving.

Compassion Satisfaction
On the other end of the spectrum is compassion satisfaction, this gives the nurses a sense

of purpose and joy in their job. Nurses who experience compassion satisfaction will have more

meaningful interactions with their patients and will produce increased quality of care. The main

reward is the chance to see ones patients suffering less. This process allows nurses to experience

fulfillment and joy that revitalizes them and allows them to thrive in the workplace (Young et

al., 2011, p. 227). Nurses who have specialized training in the trauma or emergency departments
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are most likely to develop compassion satisfaction. In those who had specialized training to

work with trauma victims, CS may actually be more prevalent than BO and CF (Hinderer et al.,

2014, p. 160). If more studies were completed to prove this, then hospitals may be willing to

hold special training classes or further the education of their nurses.

Compassion fatigue, burnout, and secondary traumatic stress are a very big issue in the

nursing world. With the right education and support system, nurses could recognize and combat

these affects. Once nurses are further educated on these issues, there should be an increase in

nurses that experience compassion satisfaction. Nursing students should also be aware of these,

because they are highly susceptible to them as well. Compassion fatigue, burnout, and secondary

traumatic stress are under recognized, until more research is completed the nurses will suffer as

well as their patients.

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References

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Mason, V., Leslie, G., Clark, K., Lyons, P., Walke, E., Butler, C., Griffin, M. (2014).

Compassion Fatigue, Moral Distress, and Work Engagement in Surgical Intensive Care

Unit Trauma Nurses. Dimensions of Critical Care Nursing, 33(4), 215-25. doi: 10.1097/

DCC.0000000000000056

Schroeter, K. (2014). Compassion Fatigue: An Unwanted Reflection of Your Reality. Journal of

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Von Rueden, K., Hinderer, K., McQuillan, K., Murray, M., Logan, T., Kramer, B. Gilmore, R.,

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Young, J., Derr, D., Cicchillo, V., Bressler, S. (2011). Compassion Satisfaction, Burnout, and

Secondary Traumatic Stress in Heart and Vascular Nurses. Crit Care Nurs Q, 34(3),

227-234. doi: 10.1097/CNQ.0b013e31821c67d5