The Experience of Professional Compassion Fatigue Among Hospice and Palliative Care Nurses

Saturday, 16 November 2013: 3:55 PM

Christina S. Melvin, MS
Department of Nursing, University of Vermont, Burlington, VT

Learning Objective 1: The learner will be able to define Professional Compassion Fatigue and identify its negative effects on nurses caring for the dying.

Learning Objective 2: The learner will be able to discuss strategies for preventing and treating Professional Compassion Fatigue.

Hospice and palliative care are a nursing specialty. However, nurses providing this type of care over extended periods are experiencing negative physical and emotional consequences. 

Figley (1983) identified negative physical and psychological manifestations as Professional Compassion Fatigue (PCF), reasoning that nurses were at a particular risk because empathy and compassion are nursing’s core values.  Nurses experience negative effects (nightmares, intrusive thoughts, anxiety, etc.) vicariously through their interactions with the suffering, traumatized, wounded and the dying. LaRowe (2005, p.21) described PCF as a “heavy heart, a debilitating weariness brought on by repetitive, empathic responses to {the} pain and suffering of others”.

Implications of these effects are twofold. First, the world’s population is aging. In many developed countries (US, New Zealand, Canada and United Kingdom), it is estimated that by 2020, the number of older adults will increase dramatically. Second, in these same countries, there is a projection of a shortage of nurses. Therefore, keeping nurses healthy and in the workforce becomes critical.

This descriptive qualitative research study examined six hospice and palliative care nurses with a minimum of ten years of experience in this field. The study received IRB approval. Three themes emerged: risk for PCF with exposure to repeated deaths over extended periods of time; negative physical and emotional consequences of providing hospice and palliative care; and the need to develop healthy coping strategies (including boundary setting).  

Strategies for identifying PCF as well as interventions to support nurses struggling with symptoms of PCF are discussed. One strategy identified was the need to develop safe emotional support for these nurses. Measures to prevent PCF as well as treat it should it develop are imperative in preserving nursing’s workforce in the area of hospice and palliative care.