Spotlight on Compassion Fatigue for Oncology Nurses

TON - February 2012 VOL 5, No 1 — February 29, 2012

With the growing number of cancer survivors, survivorship planning is getting a lot of attention. An important aspect of cancer survivorship is the effects on nurses, who become “secondary survivors,” of the toll cancer takes on patients and families. As such, nurses need to be aware of the possibility of “compassion fatigue.”

“Check your own thermometer reading. On a quarterly basis, take the average number of deaths, codes, and times you are present for the delivery of bad news, and multiply this number by 4 for the yearly number, then multiply that number again by the number of years you have been an oncology nurse. That will show you that you have witnessed and been part of hundreds of these experiences. You need to treat your own feelings of loss as if you were a bereaved family relative,” Deborah Boyle, RN, told an audience of nurses and other members of the oncology clinical care team at a symposium called “New Perspectives in Oncology Practice” held in conjunction with The Chemotherapy Foundation Symposium. Boyle is an oncology nurse at the University of California Irvine Medical Center’s Chao Family Comprehensive Cancer Center in Orange.

She defined compassion fatigue as the cost of caring for others in emotional pain. Compassion fatigue is distinct from burnout, which is related to experiences and stresses that come from the work environment.

One of the problems Boyle sees is that nurses often “swallow” the pain they experience treating very sick and dying patients as part of their job and neglect to acknowledge their own emotional response, leading to the “wounded healer” phenomenon, she said.

“It is unrealistic not to expect to develop compassion fatigue. Our capacity for compassion and empathy is a core ability to do our work and also is at the core of our ability to be wounded by our work,” she noted.

Signs of compassion fatigue include depression, fatigue, labile emotions, difficulty accepting praise or negative feedback, lack of attention to self, impatience with family members, and frustrations in human encounters.

“Our sorrow accumulates. We need to recognize compassion fatigue and institute a self-care regimen, taking advantage of resources that may be available,” she continued. These include employee assistance programs, counseling, brown bag lunches, psychiatry nurse specialist support groups, and collegial acknowledgment of what a difficult job it is to work with people who have cancer.
Boyle suggested that end-of-life care be integrated into nursing school curricula, so that nurses can become skilled at taking care of dying patients.

Quoting a Native American proverb, she ended by saying, “‘Each time you heal someone, you give away a piece of yourself, till at some time you will require healing.’ Please leave this conference with a commitment to yourself!”

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