References

Angus DC, Truog RD. Toward better ICU use at the end of life. JAMA.. 2016; 315:(3)255-256 https://doi.org/10.1001/jama.2015.18681

Beck CT. Secondary traumatic stress in nurses: a systematic review. Arch Psychiatr Nurs.. 2011; 25:(1)1-10 https://doi.org/10.1016/j.apnu.2010.05.005

Black K. Health care professionals' death attitudes, experiences, and advance directive communication behavior. Death Stud.. 2007; 31:(6)563-572 https://doi.org/10.1080/07481180701356993

Bradshaw PL. Modernizing the British National Health Service (NHS)— some ideological and policy considerations. J Nurs Manag.. 2003; 11:(2)85-90 https://doi.org/10.1046/j.1365-2834.2003.00354.x

Braun M, Gordon D, Uziely B. Associations between oncology nurses' attitudes toward death and caring for dying patients. Oncol Nurs Forum.. 2010; 37:(1)E43-E49 https://doi.org/10.1188/10.ONF.E43-E49

Bray L, O'Brien MR, Kirton J, Zubairu K, Christiansen A. The role of professional education in developing compassionate practitioners: A mixed methods study exploring the perceptions of health professionals and pre-registration students. Nurse Educ Today.. 2014; 34:(3)480-486 https://doi.org/10.1016/j.nedt.2013.06.017

Christiansen A, O'Brien MR, Kirton JA, Zubairu K, Bray L. Delivering compassionate care: the enablers and barriers. Br J Nurs.. 2015; 24:(16)833-837 https://doi.org/10.12968/bjon.2015.24.16.833

Ciccarello GP. Strategies to improve end-of-life care in the intensive care unit. Dimens Crit Care Nurs.. 2003; 22:(5)216-222 https://doi.org/10.1097/00003465-200309000-00005

Coetzee SK, Klopper HC. Compassion fatigue within nursing practice: a concept analysis. Nurs Health Sci.. 2010; 12:(2)235-243 https://doi.org/10.1111/j.1442-2018.2010.00526.x

Curtis JR, Vincent JL. Ethics and end-of-life care for adults in the intensive care unit. Lancet. 2010; 376:(9749)1347-1353 https://doi.org/10.1016/S0140-6736(10)60143-2

The point of care. Enabling compassionate care in acute hospital settings. 2009. https://tinyurl.com/yx927tna (accessed 22 July 2020)

Report of the Mid Staffordshire NHS Foundation Trust public inquiry. 2013. https://tinyurl.com/omsm882

Hooper C, Craig J, Janvrin DR, Wetsel MA, Reimels E. Compassion satisfaction, burnout, and compassion fatigue among emergency nurses compared with nurses in other selected inpatient specialties. J Emerg Nurs.. 2010; 36:(5)420-427 https://doi.org/10.1016/j.jen.2009.11.027

International Organization for Migration. World Migration Report. 2018. https://tinyurl.com/yykaj2cg (accessed 21 July 2020)

Caring for migrant health-care workers. Lancet.. 2017; 390:(10110) https://doi.org/10.1016/S0140-6736(17)33044-1

Lilius JM, Worline MC, Dutton JE Understanding compassion capability. Human Relations. 2011; 64:873-899 https://doi.org/10.1177/0018726710396250

Klimecki OM, Singer T. Empathic distress fatigue rather than compassion fatigue? Integrating findings from empathy research in psychology and social neuroscience.(eds). New York: Oxford University Press; 2012

Mitchell AM, Sakraida TJ, Dysart-Gale Gadmer N. Nurses narratives of end of life care. J Hosp Palliat Nurs.. 2006; 8:(4)210-221

Moola S, Ehlers VJ, Hattingh SP. Critical care nurses' perceptions of stress and stress-related situations in the workplace. Curationis.. 2008; 31:(2)77-86 https://doi.org/10.4102/curationis.v31i2.989

Najjar N, Davis LW, Beck-Coon K, Carney Doebbeling C. Compassion fatigue: a review of the research to date and relevance to cancer-care providers. J Health Psychol.. 2009; 14:(2)267-277 https://doi.org/10.1177/1359105308100211

NHS England. Compassion in practice. Evidencing the impact. 2016. https://tinyurl.com/z4wfjon (accessed 21 July 2020)

Perez-Bret E, Altisent R, Rocafort J. Definition of compassion in healthcare: a systematic literature review. Int J Palliat Nurs.. 2016; 22:(12)599-606 https://doi.org/10.12968/ijpn.2016.22.12.599

Peters L, Cant R, Payne S How death anxiety impacts nurses' caring for patients at the end of life: a review of literature. Open Nurs J. 2013; 7:14-21 https://doi.org/10.2174/1874434601307010014

Qatar Population Review. 2018. http://worldpopulationreview.com/countries/qatar-population (accessed 21 July 2020)

Resuscitation Council UK. ReSPECT. 2018. https://www.resus.org.uk/respect/ (accessed 21 July 2020)

Sinclair S, Beamer K, Hack TF Sympathy, empathy, and compassion: a grounded theory study of palliative care patients' understandings, experiences, and preferences. Palliat Med.. 2017; 31:(5)437-447 https://doi.org/10.1177/0269216316663499

Truog RD, Campbell ML, Curtis JR Recommendations for end-of-life care in the intensive care unit: a consensus statement by the American College [corrected] of Critical Care Medicine [published correction appears in Crit Care Med. 2008 May;36(5):1699]. Crit Care Med.. 2008; 36:(3)953-963 https://doi.org/10.1097/CCM.0B013E3181659096

World Health Organization. Sixty-fifth world health assembly: daily notes on proceedings. 2012. https://tinyurl.com/y39l3yte (accessed 21 July 2020)

Winch S, Henderson A, Jones J. Recognizing the dialectic of compassionate care in the workplace: feedback from nurse educators. J Contin Educ Nurs.. 2015; 46:(5)228-232 https://doi.org/10.3928/00220124-20150420-03

Wong TP, Reker GT, Gesser G. Death attitude profile–revised: a multidimensional measure of attitudes towards death.(ed). New York: Taylor and Francis; 2004

Death anxiety and compassion fatigue in critical care nurses

13 August 2020
Professional
02 August 2020
Volume 29 · Issue 15

Abstract

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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Compassion fatigue
Death anxiety
Critical care nurses
Cultural and organisational influences