ORLANDO—Most nurses who care for patients with cancer are at risk for compassion fatigue and burnout and may leave the profession as a result, according to a new survey.
The results of the survey have implications for changing some aspects of nursing education and highlight the importance of the advanced practice nurse (APN) in providing more support for the nursing staff. APNs also may help nurses to be on the lookout for warning signs and characteristics of compassion fatigue, and may help healthcare institutions to recognize the risks and predictors of compassion fatigue, said Heather Askren, NP-C, RN, BSN, MSN, OCN, from St. Elizabeth Regional Health in Lafayette, Indiana, during her poster session.
“Cancer nurses provide a high level of care to acutely ill patients and their family members. They give medications and treatments and emotional support, and they also share pieces of themselves,” she said in an interview with The Oncology Nurse-APN/PA. “Looking at the nurses I was working with, I was seeing that they were having what looked like burnout issues.” Askren and her colleagues identified the prevalence of compassion fatigue using the Professional Quality of Life: Compassion Satisfaction and Fatigue Subscales—Revision IV (ProQOL RIV) by B. Hudnall Stamm. The scale is designed to diagnose compassion fatigue and burn out (Table). The researchers offered the scale to all 32 nurses on the medical oncology unit and received 20 responses, for a response rate of 63%. All of the respondents were women; 19 of the 20 where white; mean age was 38 years, ranging from 23 to 60 years. Most (74%) were married.
The survey showed that the mean risk score for compassion fatigue was 18, and ranged from a low of 7 to a high of 46. The mean risk score for burn out was 25, and ranged from 10 to 37.
The survey also showed that nurses aged between 40 and 49 years were at the highest risk of developing compassion fatigue compared with younger and older nurses. Other factors associated with a heightened risk were having a family member with cancer, having a bachelor of science degree in nursing or a diploma in nursing, and working in oncology for less than 5 years or for more than 10 years.
Insomnia, headaches, gastrointestinal complaints, fatigue, and job dissatisfaction were the most frequently reported symptoms in nurses caring for cancer patients, Askren said. Twelve nurses said they had insomnia and headaches; of these, eight said their headaches occurred two to three times per week and six nurses reported being unable to sleep two to three times per week. The second most common complaints were fatigue, in 10, and gastrointestinal problems, also in 10 nurses. Eight nurses complained of job dissatisfaction.
Askren said she tried support groups but these were not successful. “They just weren’t into coming in large groups and talking with each other,” she told The Oncology Nurse-APN/PA. “A lot of our staff is younger, and they’d rather get their support online than physically in a group with other nurses. It could also be a reluctance to admit they are having trouble with compassion fatigue and feel that this makes them a bad nurse. Of course, this is not the case, it’s just something we need to work on together to make it better.”
The fact that the 40- to 49-year-old age group had the most compassion fatigue and burnout could be due to their being part of the sandwich generation, taking care of children at one end of the age spectrum and aging parents at the other, she added.
Being an oncology nurse can be very stressful, and it is important for this to be acknowledged. “It is definitely not a sign of weakness. It goes with the territory. This study is important for cancer nurses to help educate them on the effects of compassion fatigue,” Askren concluded.
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