NURSES AS PROVIDERS OF CARE REQUIRE SELF CARE

Nurses as Providers of Care Require Self Care to be at Their Best

All those who have flown on an airplane have heard the flight attendants safety
instructions, In the event of a loss of cabin pressure, an oxygen mask will drop from above. If
you are traveling with a child, place your mask on first ...
As a parent it may seem contradictory to take care of yourself first before helping your
child, but it is of the utmost importance. Those going into the field of nursing need to learn this
important lesson that you must take care of yourself first, so you can better serve others. Nurses
interact with patients more than any other member of the healthcare team. They are a crucial
component to patient care and of patient satisfaction. Hunsaker, Chen, Maughan, and Heaston,
(2015) noted thirty percent of the incentive payments provided by Medicare to hospitals are
based on approval scores of satisfaction (p.187). This means it is not only in the best interest of
the patients health for the nurse to be at his or her peak of performance, but also for the financial
health of the healthcare facility. Nurses who are experiencing compassion fatigue and burnout
are too exhausted to provide levels of care that help patients feel satisfied (Mendes, 2014).
Coetzee and Klopper (2010) defined compassion fatigue as a loss of the nurturing ability
that is essential to compassionate care (p. 237). Hunsaker et al. claimed the stress resulting from
helping a traumatized or suffering person may result in compassion fatigue, which develops as a
self-protection measure (2010). The researchers also stated compassion fatigue is different from
burnout as it may occur suddenly while burnout has a gradual onset (2010). Coetzee and Klopper
said symptoms of compassion fatigue include helplessness, anger, and suppression of emotions
and if compassion fatigue was left unchecked it could lead to permanent changes to a nurses
compassionate abilities (2010).

NURSES AS PROVIDERS OF CARE REQUIRE SELF CARE

The initial interaction the nurse has with a patient is during the American Nursing
Associations (ANA) first standard of care: Assessment (Potter, 2012). A first impression can
only be made once, and the value of a good assessment cannot be emphasized enough. The
nurse needs to be attentive to the patient, to gather correct information pertinent to establish
goals, interventions and a proper treatment plan. If the nurse is suffering from compassion
fatigue a poor assessment may be a consequence.
Also, the ANA Standard of Care 3: Outcome identification (Potter, 2012) may not be
individualized to the patient by nurses suffering from compassion fatigue. The nurse may dwell
on past experiences with patients who had the same diagnosis and think the outcomes will be the
same for the current patient (Reimer 2013). The nurse needs to recognize factors that may
interfere with goal attainment, but he or she must not assume each patient will have the same
outcome. The nurse must formulate patient outcomes that are derived from the nursing diagnosis
and identify measurable goals (Potter, 2012).
It has been found young nurses with the least amount of experience are most susceptible
to compassion fatigue (Coetzee & Klopper, 2010). This is something all students of nursing
need to be aware of. Coetzee and Kloppers research indicated a mentorship of more
experienced nurses may be effective in fending off compassion fatigue (2010). This falls in line
with the ANA Standard of Professional Performance 4: Collegiality as well as the ANA Standard
of Profession Performance 6: Collaboration (Potter, 2012). If the healthcare team strives to
promote teamwork and nurses work with other therapeutic regimes to find improved ways to
deliver care to specific patients, the feeling of the burden of care may be less individualized.
Mendes found it is much easier to recognize compassion fatigue in someone else than it is to see

NURSES AS PROVIDERS OF CARE REQUIRE SELF CARE

it in yourself, so as a healthcare team it is important to encourage one another and be sure

coworkers are making a conscious effort to renew themselves regularly (2014).
Nurses need to remember the overall success of the patients care involves a team of
healthcare professionals, the patients family or support group and the patient himself. In
Creating Moments that Matter, one oncology unit enhanced their nurse-patient relationship by
placing a journal at the bedside of a patient who was admitted for end-stage care (Reimer, 2013).
All staff, including physicians were encouraged to write memories of their relationship and
interactions with the patient. The intent was for the patient and his family to read the notes and
be reminded of his established meaningful relationships and the impact of his life on others. The
staff were able to gain a sense of satisfaction from this as well even though the patient was at end
of life (Reimer, 2013).

You are most helpful to those you serve when you wear your own oxygen mask.
Coetzee and Klopper mentioned preventative factors that have been suggested from prior
research include stress reduction practices like exercise, debriefing, counseling, as well as
regular spiritual or religious practice (2010) Eating right, exercising, engaging in hobbies and
having friends outside of work will help you to have the oxygen you need to perform at your
best. So, remember the lesson from the friendly flight attendant the next time you feel like you
need a breather, and put your oxygen mask on first. The clients you serve and coworkers you
work with will appreciate you being at your best!

NURSES AS PROVIDERS OF CARE REQUIRE SELF CARE

References

Angeli, E., Wagner, J., Lawrick, E., Moore, K., Anderson, M., Soderlund, L., & Brizee,
A. (2010, May 5). General format. Retrieved from
http://owl.english.purdue.edu/owl/resource/560/01/
Coetzee, S., & Klopper, H. (2010). Compassion fatigue within nursing practice: a concept
analysis. Nursing & Health Sciences, 12(2), 235-243. doi:10.1111/j.14422018.2010.00526.x
Hunsaker, S., Chen, H., Maughan, D., & Heaston, S. (2015). Factors That Influence the
Development of Compassion Fatigue, Burnout, and Compassion Satisfaction in
Emergency Department Nurses. Journal Of Nursing Scholarship, 47(2), 186-194.
doi:10.1111/jnu.12122
Mendes, A. (2014). Recognising and combating compassion fatigue in nursing. British
Journal Of Nursing, 23(21), 1146. doi:10.12968/bjon.2014.23.21.1146
Potter, P., Perry, A., & Stockert, P. (2012). Fundamentals of Nursing (8th ed.). N.p.:
vitalbook.
Reimer, N. (2013). Creating Moments That Matter: Strategies to Combat Compassion
Fatigue. Clinical Journal Of Oncology Nursing, 17(6), 581-582.
doi:10.1188/13.CJON.581-582