Death anxiety and compassion fatigue in critical care nurses
It may be argued that altruism, or the selfless concern for others, was fundamental to the discipline of nursing; however, with the evolution of nursing, there has been debate within the profession and among service users about whether this element has been lost. Nurses deal with increasingly complex and stressful situations, both patient and performance related. Additionally, demands on the service and capacity constraints continue to place a significant burden on nurses and other health professionals. There are concerns that the cost of caring has had an impact at a personal and performance level within the nursing profession, highlighted particularly by the negative experiences described by NHS service users in the Francis report. Debate continues about the definition of ‘compassionate care’ and how we measure its delivery. Resolving these concerns is a high priority for recruitment and retention strategies within both the NHS and private sector healthcare organisations.
Compassion fatigue or secondary traumatic stress was first recognised in the 1950s in nursing and other frontline professionals, such as first responders and fire fighters, who dealt with traumatic incidents (Beck, 2011). Subsequently, ‘compassionate care’ has featured in a number of key policy documents, in particular those published following the Francis report (Francis, 2013; NHS England, 2016). Debate continues about the definition of compassionate care and how its delivery is measured. In a systematic review to define compassion, Perez-Bret et al (2016) came to the conclusion that:
‘Compassion originates as an empathic response to suffering, as a rational process which pursues patients' wellbeing, through specific, ethical actions directed at finding a solution to their suffering’.
Compassion can be seen in the sensitive understanding of another's suffering by those delivering care, and who then seek solutions to relieve that suffering and promote wellbeing. Sinclair et al (2016) identified six themes of ‘perceptions of compassionate care’. These consisted of the following:
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