Self-Care, Compassion Fatigue, and Burnout
By Shannel Hawkins
Shannel is a Licensed Professional Counselor at Hondros College of Nursing. She is available to assist YOU in areas of mental wellness.
In a profession as dynamic as nursing, the evolving health care demands; the changes in scope of practice and overlapping responsibilities are inevitable in our current and future health care system. In acknowledgement of the nurse’s scope of practice and a wealth of research working with healthcare professionals before and during the coronavirus crisis, it has become critical for healthcare professionals to pay attention to their emotional lives to remain effective and healthy themselves — especially in times of crisis (Fessell. D and Goleman D., May 2020).
A meta-analysis of studies about nurse burnout reported the following estimates about nurses in clinical practice: 31% had high emotional exhaustion, 24% demonstrated high depersonalization, and 38% had low personal accomplishment (Molina-Praena et al., 2018). Such research has encouraged the healthcare system and industry to take a closer look into the health and support needed for service career professionals. Results from a survey indicated that 70% of nurses report putting the health, safety, and wellness of their patients before their own, proving that now is the right time to make ourselves a priority
The condition of compassion fatigue was first identified by Joinson (1992) in a study of burnout in nurses who worked in an emergency department. The researcher identified behaviors that were characteristic of compassion fatigue, including chronic fatigue, irritability, dread going to work, aggravation of physical ailments, and a lack of joy in life.
When a nurse has burnout, it is associated with feelings of hopelessness and difficulties in dealing with work or in doing your job effectively. These negative feelings usually have a gradual onset (B. Hudnall Stamm, 2009). The 3 stages of burnout include stress arousal (irritability, anxiety, insomnia, forgetfulness/poor concentration, gastro-intestinal disorders, grinding teeth, headaches), energy conservation (lateness, procrastination/turning work in late, excessive time off, withdrawing from intimacy, fatigue, social withdrawal, increased substance use), and exhaustion (chronic sadness/depression, suicidal thoughts, chronic GI problems, chronic headaches, social isolation). They can reflect the feeling that your efforts make no difference, or they can be associated with a very high workload or a non-supportive work environment.
What does this mean for YOU? How can YOU better prepare for your nursing career?
Lastly, David P. Fessell and Daniel Goleman set out four areas that workers and leaders in the industry should pay attention to: self-awareness (giving themselves a moment to recognize their own emotional and physical needs), self-management (managing their emotions so they don’t snap), social awareness (also known as empathy), and relationship management (connecting with and motivating others). See chart-Harvard Business Review Emotional Intelligence How Health Care Workers Can Take Care of Themselves (hbr.org). Giving attention to these areas of your life will be intentional and strategic however, the investment in yourself is NECESSARY. Self-care is not optional; it is imperative. Yet—despite the promise of self-care in alleviating problematic employment circumstances—mistakes, misnomers, and misconceptions about self-care persist. For more than a decade, professionals have been intensively studying self-care as a scientific construct, testing clinical interventions, doing professional presentations/trainings, and developing resources to assist professionals in their quest to improve self-care. They provided a list of the fundamentals necessary for developing a Self-Care plan for yourself below (Grise-Owens, E., Miller, J., & Eaves, M., 2016):
• Individualized. The very term “self”-care encapsulates the notion that self-care is individualized. What works for others may not work for you. One of the biggest barriers to self-care is the myth of a “perfect,” magical, one-size-fits-all self-care strategy. But the “perfect” plan is the plan that works for you. To be successful in achieving your self-care goals, you need to devise a plan that considers your values, personality, and circumstances. If you’re not a gym person—that’s fine, do something else to be active. Not a social person? That’s fine; read a book. Take a nap. Call a friend. Plant a garden. Play in the sand. No matter the approach, just do you.
• Integrated. You’ve heard of the notion “work-life balance.” Well, there is really no such thing. We propose an important simplification: “life” balance. One of the myths about self-care is that it is something to do after work—usually to deal with work stress. Successful self-care is not only about doing things after work, but how you work. It’s about taking care of yourself throughout the day—rather than just recovering from the day. Successful self-care is a lifestyle and way of being. Integrated self-care means anything from seeking support from colleagues, to practicing mindfulness, to incorporating movement, to going to a yoga class, and any other strategy that mitigates stress at work, home, and life.
• Intentional. As much as we would like it to be so, self-care does not just happen. Rather, you must be intentional about engaging in self-care. Intentionality requires being purposeful in thought and action. A pragmatic strategy for this intentionality is to plan your day in such a way that you can consistently integrate attention to self-care. For example, you need to put that professional development course, or your golf lesson, or just taking a time out to breathe on your calendar —along with all those other obligations and commitments.
References:
American Nurses Association. What is the Healthy Nurse, Healthy Nation Grand Challenge? https://www.healthynursehealthynation.org.
American Nurses Association. Practice & Advocacy: Scope of Practice. https://www.nursingworld.org/practice-policy/scope-of-practice/
B. Hudnall Stamm, 2009. Professional Quality of Life: Compassion Satisfaction and Fatigue Version 5 (ProQOL). /www.isu.edu/~bhstamm or www.proqol.org.
Fessell D. and Goleman D. (2020). Emotional Intelligence: How Health Care Workers Can Take Care of Themselves. Harvard Business Review. Retrieved from How Health Care Workers Can Take Care of Themselves (hbr.org)
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Grise-Owens, E., Miller, J., & Eaves, M. (2016). The A-to-Z self-care handbook for social workers and other helping professionals. Harrisburg, PA: The New Social Worker Press.
Joinson, C. (1992). Coping with compassion fatigue. Nursing, 22, 116–120.
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Molina-Praena, J., Ramirez-Baena, L., Gómez-Urquiza, J.L., Cañadas, G.R., De la Fuente, E.I., & Cañadas-De la Fuente, G.A. (2018). Levels of burnout and risk factors in medical area nurses. Retrieved from https://www.mdpi.com/1660-4601/15/12/2800
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Smullens, S. (2012, Summer). Self-care and avoiding burnout. NASW Private Practice Section Connection, Summer 2012. http://www.sarakaysmullens.com/media/2012PrivatePracticeNLNASW.pdf.
U.S. Department of Justice, Office of Justice Programs. (n.d.). The vicarious trauma toolkit. https://ovc.ojp.gov/program/vtt/introduction