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International Journal Of Health And Nursing

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International Journal Of Health And Nursing Question: Briefly explore an area of nursing practice and identify professional development or research needs.     Answer: Provides A Clear And Concise Introduction That Justifies The Choice Of Topic: Compassion fatigue is a combination of depleted states of emotional, physical and spiritual conditions due to the providence of care for patients in significant distress and pain. Nolte et al. (2017) points out that the complex demands of the patients healthcare needs in overburdened healthcare system can be a significant stressor on the nurses. This can result in the reduced ability in the providence of care, compassion fatigue and burnout syndrome (Finzi-Dottan and Kormosh 2016; Sorenson et al. 2016). Compassion fatigue also associated with the loss of satisfaction from performing the job properly, as a result of secondary stress (American Nurse Today 2018). However, Sheppard (2015) and Sorensen et al. (2016) pointed out the lack of clarity and ambiguity related to our understanding of compassion fatigue. The purpose of this essay therefore is to explore the effect of compassion fatigue on mental health nurses.    Demonstrates Knowledge And Understanding Of The Chosen Topic In The Context Of A Particular Nursing Specialty: Emotional stress can be caused due to emotional burden experienced while providing care for individuals in trauma or distress, and can be due to a single incident of exposure or an accumulation of stress (The American Institute of Stress 2018). Studies by Hegney et al. (2014) suggested an association between anxiety and depression with burnout and secondary trauma. While studies by Khamisa et al. (2015) also pointed out that stress and burnout can impact the mental well being of the nurse, and can adversely affect the efficiency, productivity and the quality of care provided by the nurses. Among mental health nurses, exposure to inpatient aggression and work stress can lead to post traumatic stress and distress (Lee et al. 2015). The term compassion fatigue was coined by Carla Joinson,, after noticing the reduced ability of nurses, who experienced psychological stress, to nurture patients. Various authors have suggested that the state of weariness is due to chronic or long term exposure to trauma, to challenging circumstances and the continuous service provided by nurses. Compassion fatigue is different from burnout, both having physical and psychological factors that causes a loss or reduction in motivation, but differs in their triggers and critical attributes. They further argues that burnout can be experienced by anyone (triggered by job requirements, job expectations, lack of resources, interpersonal factors, business or organizational policies, that affects the efficiency and efficacy of the person), however compassion fatigue is only experienced by those who actively demonstrate compassion on a daily basis. Mental health nurses, having to care patients often are exposed to the stress while demonstrating compassion towards the patients and while supporting or helping their families. Such factors are significant stressors for work. Different symptoms associated with compassion fatigue, categorized into 3 groups: Work related symptoms (like avoidance or fear of working, reduced ability to empathize with patient or family, frequent absenteeism, reduced joy or enthusiasm in work); Physical Symptoms (like headache, muscle tensions, fatigue, digestive dysfunction, sleep dysfunction, cardiac symptoms); and Emotional Symptoms (like mood swings, anxiety, restlessness, oversensitivity, substance abuse or substance dependency, depression, anger, resentfulness, forgetfulness and lack of attention or focus and lack of objectivity). Harris and Griffin (2015) additionally pointed out the antecedents of compassion fatigue (like spiritual commitment, emotional investment, and professional and personal support given to patients) that can reduce inner conviction and resiliency, thereby causing inadequate performance and reduction in holistic health. The figure below shows the interactions of the different components towards the causation of compassion fatigue. Figure 1: Compassion and Fatigue Concept Map; source: (Harris and Griffin 2015) Demonstrates The Ability To Source And Appraise The Best Available Evidence To Support The Discussion: Watson’s theory of human caring is based on the empathic relation between the nurse and patient, in the development of relationship based nursing practice (RBN) (Watson 2012). At the core of the concept is the utilization of empathy and communication towards the patient and their family. Three types of relationship that are needed to develop RBN, namely, relationship between patient and their families, relationship with self, and relationship with colleagues. Compassion fatigue is experienced by individuals who assists other in distress, and can be traumatized through their effort to show compassion and empathy to them, and can lead to a reduced self care and increased self sacrifice. The caregiver mostly experience the stress emotionally (and not physically) while caring for the patients. The emotional stress further affects the physical health, leading to different physical symptoms experienced a stressed individual. A decline in personal health of the nurse apart from poor performance, medical errors, poor judgment and a reduced quality of care, and even patient dissatisfaction. This can adversely affect the responses of the patients, cause financial instability of the organization, and also lead to a sense of apathy or indifference towards the patients, associated with a sense of hopelessness or helplessness apart from the physical symptoms experienced by the nurses. This can also lead to the propensity of the nurses to quit their jobs, which can have serious effect in the providence of proper care for the patients (Harris and Griffin 2015). This highlights the negative effect of compassion fatigue on both the nurse as well as the health outcomes of the patient, as well as on the efficiency of the healthcare system, and necessitates actions to manage the effects of compassion fatigue in mental health as well as other nursing specializations. Personal coping strategies, balancing work and life, adequate sleep, healthy and balanced diet, daily physical exercise and small vacations or breaks can be effective personal intervention strategies to manage compassion fatigue. Conclusion: The overview of the effects of compassion fatigue on the performance, efficiency, and well being of the nurses, as well as on the health outcomes and perception of the patients highlights the necessity to study further how the different stressors experienced by healthcare professionals in a high stress environment can be useful to devise strategies to mitigate these effects. Mental health nurses are frequently exposed to significant amount of stress while assisting patients and their families to cope up with the challenges of the health condition of the patient. This necessitates different intervention strategies that can assist the nurses to cope up with the stress in their job, and ensure the continued providence of quality care of the patient, as well as the maintenance of resiliency and psychological well being of the nurses themselves.    References: American Nurse Today. 2018. Compassion fatigue: Are you at risk? – American Nurse Today. [online] Available at: [Accessed 13 Jan. 2018]. Finzi-Dottan, R. and Kormosh, M.B., 2016. Social Workers in Israel: Compassion, Fatigue, and Spillover into Married Life. Journal of Social Service Research, 42(5), pp.703-717. Gilmore, C., 2012. Compassion Fatigue-What it is and how to avoid it. Kai Tiaki: Nursing New Zealand, 18(5), p.32. Harris, C. and Griffin, M. (2015). Nursing on Empty. Journal of Christian Nursing, [online] 32(2), pp.80-87. Available at:,.8.aspx#R6-8 [Accessed 13 Jan. 2018]. Hegney, D.G., Craigie, M., Hemsworth, D., Osseiran?Moisson, R., Aoun, S., Francis, K. and Drury, V., 2014. Compassion satisfaction, compassion fatigue, anxiety, depression and stress in registered nurses in Australia: study 1 results. Journal of Nursing Management, 22(4), pp.506-518. Khamisa, N., Oldenburg, B., Peltzer, K. and Ilic, D., 2015. Work related stress, burnout, job satisfaction and general health of nurses. International journal of environmental research and public health, 12(1), pp.652-666. Lee, J., Daffern, M., Ogloff, J.R. and Martin, T., 2015. Towards a model for understanding the development of post?traumatic stress and general distress in mental health nurses. International journal of mental health nursing, 24(1), pp.49-58. Nolte, A., Downing, C., Temane, A. and Hastings-Tolsma, M. (2017). Compassion fatigue in nurses: A metasynthesis. Journal of Clinical Nursing, [online] 26(23-24), pp.4364-4378. Available at: [Accessed 13 Jan. 2018]. Potter, R.N., Joyce Divanbeigi RN, M.S.N., Julie Berger DMin, B.C.C., Lori Norris, R.N. and Sarah Olsen RN, B.S.N., 2010. Compassion fatigue and burnout: Prevalence among oncology nurses. Clinical Journal of Oncology Nursing, 14(5), p.E56. Sheppard, K., 2015. Compassion fatigue among registered nurses: Connecting theory and research. Applied Nursing Research, 28(1), pp.57-59. Sorenson, C., Bolick, B., Wright, K. and Hamilton, R., 2016. Understanding compassion fatigue in healthcare providers: A review of current literature. Journal of Nursing Scholarship, 48(5), pp.456-465. The American Institute of Stress. (2018). Compassion Fatigue. [online] Available at: [Accessed 13 Jan. 2018]. Watson, J., 2012. The theory of human caring: Retrospective and prospective. Caring in nursing classics: An essential resource, pp.237-27.

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