Compassion Fatigue Resulting From Disenfranchised Grief

Death is inevitable. It is one of the only certainties in life. Regardless, people are often uncomfortable discussing death. Nyatanga (2016) posits that the idea of no longer existing increases anxiety and emotional distress in relation to one’s mortality. Because of the difficulty in level of care for end-of-life patients, the patient and the family often need professional assistance for physical and emotional care. Many family caregivers are not professionally trained in medicine, and this is where hospice comes into play. Hospice aims to meet the holistic needs of both the patient and the patient’s family through treatment plans, education, and advocacy. There is a duality of care to the treatment provided by hospice staff in that they do not attempt to separate the patient’s care from the family’s care. Leming and Dickinson (2011) support that hospice, unlike other clinical fields, focuses on the patient and the family together instead of seeing the patient independent of the family. Many times in hospitals, the medical team focuses solely on the goal of returning the patient back to health in order for them to return to their normal lives. They do not take into account the psychological and spiritual components of the patient’s journey and the journey that the family must take as well. For treatment of the patient, Leming and Dickinson agree that hospice does not attempt to cure patients, and instead concentrates solely

(Colin Murray Parkes, 1998) 2.Healthcare Assistant response to emotional and psychological needs of a dying person Two common problems arise when people come close to death: fear and grief. Fear is the reaction to danger, while grief is the reaction to losses that will occur in a fatal illness. ( Barry Greenwald, 2011) Analysing the five stages of grief, I concluded that: •

Occasionally, a major disaster strikes people with whom the viewer in an industrialised country can personally identify without difficulty. Jonathan Benthall (1993) suggests that Western media can at times be preoccupied by the fate of a ‘single, identified person such as a boy who has fallen down a well in Italy, or examples such as hostages, hijack victims, or small children whose lives could be saved by expensive advanced surgery’ [p.196]. Although the literature on what motivates charitable giving is relatively sparse, a series of recent studies in decision psychology have produced some interesting findings that support Benthall’s statement. Small and Lowenstein (2007) conducted a field experiment that demonstrated when asked to contribute

Compassion fatigue, sometimes called secondary trauma, is when an individual is around a person’s/people’s trauma so that that they themselves begins to be impacted emotionally, mentally, spiritually, and/or relationally. A person can also experience a form of compassion fatigue, known as vicarious trauma, when a traumatic event doesn’t happen to them directly but they do witness the event. Individuals like caregivers, doctors, counselors, social workers, chaplains, etc. are very susceptible to compassion fatigue because in their line of work caring for individuals who have been traumatized is come place.

Figley (2002a) defined “Compassion Fatigue” as a sense of helplessness and confusion around an emotional investment in helping those who are suffering. Compassion Fatigue has been linked to 10 variables. Starting variable begins with Empathic Ability, the ability to notice the pain of others. Following with Empathic Concern, noticing the pain of others and wanting to help the other person. Thirdly is Exposure to the client, the more time face to face with a consumer. Consecutively follows Empathic Response – taking the steps and making an effort to help reduce or alleviate the suffering of the consumer through understanding. Afterward becomes Compassion Stress, the stress one feels from the additional empathy towards another. Sixth is

On the contrary, fewer years of experience has been determined to increase vulnerability to compassion fatigue (Sprang et al., 2007). Novice nurses and trainees are especially prone to compassion fatigue due to a lack of experience and unrealistic expectations. As Corey (2007) pointed out, beginner nurses are often faced with increased feelings of nervousness and stress due to initial job placements, and with disappointment when the positions do not meet their perceived notions of what they thought their career would be like. Many nurses must deal with the uncertainty of starting their careers and become aware of the organizational constraints set forth by their employers (Killian, 2008). Vredenburgh et al. (2009) concluded that younger and

Finally the third hypothesis was that work drain and history of traumas would have a supportive relationship with compassion fatigue and emotional self-awareness would have a negative relationship with compassion fatigue. The third hypothesis is looking at feeling drained at work and a person’s own personal history of trauma would positively correlate with compassion fatigue and that if a person had insight into their own emotional state that person would score lower on compassion fatigue. The therapists sense of powerlessness (.32), work drain (.32), emotional self-awareness (-.24), and personal trauma history(.23) greatly impacted Compassion Fatigue.

Businesses across the world deal with absenteeism and poor productivity in their workforce on a daily basis. In any capacity, nursing is one of the most physically and mentally demanding professions. Due to the physical and mental demands of the job, absenteeism, turnover and burnout rates for nurses are on the rise (Svrakic, 2012). Compassion fatigue is a growing phenomenon throughout all healthcare mediums. Smart, English, James, Wilson, Daratha, Childers and Magera (2014) discovered positive and negative impacts of job satisfaction influences nurse’s ability to deliver quality patient care. Furthermore, healthcare workers that have a good balanced work and home life provide better superior patient care than that of others that

Harr, and Moore (2011) explored the psychological effects of compassion fatigue and compassion satisfaction on social work students in field placement. To support their research, they conducted a study in 2007 and 2008 with BSW and MSW students in the field of social work, at public universities at the end of each semester. Students were then invited to participate in this study at the end of each semester. The results of this study discovered that these social worker students are more motivated and committed to the profession and have higher scores of compassions satisfaction than instrument average. Students' scores on risk for burnout also were higher than other helping professionals, their risk for compassion fatigue during the field experience

Compassion fatigue occurs when caregivers give all they can to their loved one, not realizing that they, too, need love and care. Taking time for yourself allows you to be a better caregiver, giving your loved one the care and focus they need.

Witt Sherman (1998) suggests that palliative care must be offered to family members of patients with terminal illnesses to address the physical, emotional, and social needs associated with being the caregiver of a person with a terminal illness, stating “the clinician needs to acknowledge the caregivers efforts and assess his or her relationship with the patient and other family members, while encouraging the expression of fears, concerns, loss, and grief. It is important to put the caregiver in touch with respite services before stress, emotional and physical exhaustion, and depression take their toll” (Witt Sherman, 1998). As an intern at a cancer institute, this writer assesses for the mood and needs of patients’ family members by initiating discussions about how they are coping with the patient’s illness. This writer attempts to empower caregivers by asserting the need for self-care at a time when they are devoting most of their time and energy to the family member they are caring for and providing them with the knowledge that the services offered by the Psychosocial Oncology department are available to them, as well as the patient.

Death is something all of us in some ways fear due to the fact that it is a venture into the unknown. But all of us will eventually have to experience it either by losing someone we know or in our own dying. Death is an inevitable part of life and individuals deal with it in various ways. Elisabeth Kubler-Ross’ five stages of grief and Abraham Maslow’s hierarchy of needs are two theorist that explain ways people deal with dying, death and grief. Experiencing in the medical field is inevitable. Understanding series such as hospice care and palliative care is crucial for medical staff. And, it is crucial to know the appropriate time to consider theses services and when to discuss DNR (Do Not Resuscitate). The person interviewed

Family members of palliative or end of life patients tend to be very stressed about their loved one and are often worried about the outcome, whether the circumstances were foreseen or not. Due to a family member being incapable of carrying out normal roles, there are shifts in the family’s identity and function of roles in their daily routines (Brier, Del Gaudio, Kissane & Zaider, 2011). Many families show significant resilience and adaptation when facing stress such as this, but a substantial minority of families become highly distressed when a family member has palliative or end-of-life illness, condition, or acute event (Brier et al., 2011). This stress and worry can lead to grief and bereavement before and after death. This causes coping mechanisms to begin functioning for the family members at the time of diagnosis or discovery or imminent end-of-life. Each is family member is different and some may have a more difficult time in dealing with the death of their loved one. These coping strategies related to grief will be further discussed as it pertains to the family.

Compassion fatigue, which is also known, as secondary traumatic stress is a natural effect that occurs as a result of taking care of patients who are in pain, stressed, suffering, or traumatized.

The field of palliative care offers nurses unique opportunities to engage with families on multiple levels. According Stayt (as cited in Ingleton, Chatwin, Seymour & Payne, 2011), “If nurses perceive role confusion during the care of dying patients and their families this increases the degree of stress experienced, limiting effectiveness in proving care and compounding their grief response” (p. 212). Clarifying nursing roles is vital to providing quality care to patients and families. Stuart, O’Connor, Peters and Bloomer (2010) argue that the “first priority” is to provide suitable care for the patient and family thereby “reinforcing the value of palliative care” (p. 55). The purpose of this paper is to explore certain specific roles of nursing with palliative care families. A few important nursing roles when interacting with palliative care families include: counselor, educator, and advocate. The first component of this paper will examine these common nursing roles when interacting with the families of palliative care patients. Then specific challenges to these nursing roles will be evaluated. Finally, nursing implications and evidence-based interventions to overcome these role challenges will be assessed.