Unit-Based Compassion Fatigue Education Program

Suping Bao, PhD(c), ANP-BC DNP Coordinator: Dr. Shelley DeVore PhD Chair: Dr. Donna Taliaferro

Goldfarb School of Nursing at Barnes-Jewish College of Nursing

INTRODUCTION
Compassion is one of the fundamental values of nursing profession. Society expects nurses to provide compassionate care. Nurses are vulnerable to Compassion Fatigue. Compassion fatigue is the reduced capacity or interest in being empathic or bearing the suffering of others (Boscarino, et al., 2006, p.2). Compassion fatigue is composed of two components: burnout and secondary traumatic stress (Figley, 2001). As much as 37% of oncology nurses maybe at high risk to develop compassion fatigue (Potter, 2010). Compassion fatigue negatively impacts patient safety, patient satisfaction, nurses quality of life, and nurses professional quality of life.

RESULTS
Sample: Registered Nurses (N=20) Sex (male: female) 1:19 Age Range Worked at Oncology Unit (Years) (Years) 22-58 0.8-26 Weeks 2weeks 6
40 35 30 25 20 15 10 5 0 Comp Burnout STS Pre Post

1week 1

Participated 3week 8

4weeks 5

PURPOSE
To test the feasibility of a unit-based compassion fatigue (CF) education program. Research Question: Will a unit-based compassion fatigue education program on an oncology unit decrease nurses burnout and secondary traumatic stress levels, and increase nurses compassion satisfaction levels as measured by the Professional Quality of Life IV (ProQOL IV)?

Most of the subjects who were not able to complete the 4-week program were too busy with work when the sessions were available, even though they had planned in advance to participate. Two of the participants had a vacation during the study period. There were statistically significant reductions in Burnout and Secondary Trauma Stress (STS) scores following participation in the CF intervention (z=-2.018, p=0.044 and z=-2.314, p=0.021, respectively). The mean Compassion Satisfaction scores increased, however, not to a statistically significant level.

METHODS
Design: one-group pretest-posttest design. Setting: a large Midwest Comprehensive Cancer Center. Inclusion criteria: Registered Nurses working on an oncology unit. Exclusion criteria: currently working less than 60 hours per month. Procedure: a trained CF facilitator facilitated a weekly 30-minute session for 4 consecutive weeks. Sessions were available during shifts 3 days a week. Instrument: ProQOL IV is a 30 item Likert-like scale. Scale was administered immediately before the first session and immediately after the 4th session. The instrument has three subscales: Compassion satisfaction (CF) Burnout Secondary Traumatic Stress (STS) Statistics: Descriptive statistics is used to describe characteristics of the sample. Wilcoxon Signed Rank Test is used to test significant differences between repeated measures. A non-parametric technique is used due to its less stringent assumption requirements and its suitability for a smaller sample. Structure of the sessions: each session begins with listening to selected harp music for 10 minutes, ancient Chinese stretching exercises for 5 minutes, and followed by interactive discussions regarding compassion fatigue for 15 minutes. In Weeks 1and 2, discussions focused on the CF concept and the social, physiological, cognitive, and emotional mechanisms of compassion fatigue. In Weeks 3 and 4, discussions focused on different techniques that might be used to prevent compassion fatigue, such as Loving Kindness Meditation, Cultivate Gratitude, and Best Possible Selves approaches. The basic cognitive techniques are based on the Accelerated Recovery Program developed by Gentry (2002).

CONCLUSIONS
Nurses and their manager welcomed this unit-based compassion fatigue educational program utilizing a combination of modalities. A unit-based intervention could be useful in decreasing compassion fatigue and increasing nurses professional quality of life. A compassion fatigue prevention program should be routinely provided to oncology nurses working in hospitals. More sessions and more flexible schedules for the sessions should be available to nurses at their work places. More stringent research is needed to test and refine effective delivery methods that prevent or ameliorate compassion fatigue for different specialties and settings.

ACKNOWLEDGEMENTS
Chris Seckman, DNP, RN Kevin Mallinson, PhD, RN, FAAN Patricia Potter, PhD, RN, FAAN Tina Scaturro-Kindle, BSN, RN Catherine Limbaugh, MSN, RN, ACNS- BC, OCN Sarah Olsen, BSN, RN