In healthcare, where the prime commodity of concern is quality human life, fatigue on decision makers/ implementors is of great concern. Global analysis shows that the current demand for well-experienced nurses is predicted to increase with rising incidences of oncology despite improving cancer survival rates. These oncology nurses are among a vulnerable group for compassion fatigue. Their need traverses from primary care to research and education.
Generally, nurses face physical-psychological fatigue during shifts to different degrees due to the nature of their field such as workload, work hours & structures among others. The timing of work is often non-complementary to the human circadian rhythm (Weinstein, 2016). In the long run, nurses´ vital individual to group contribution is threatened by challenges associated with compassion fatigue (CF).
CF effects can be considered both a cause and an outcome in a cycle that plague human resource in health institutions. These direct and indirect causes and/or effects consequentially hinder good patient outcomes which in turn reflects negatively on health care personnel, institutions, and the entire discipline. Over time, they, in part, hinder the achievement of strategic health development goals.
Cumulatively, these dire outcomes often remain with health workers such as traumatized nurses who then may question their professional competency, develop a blurred conscience and opt to change their career. These threaten the integrity of the nursing profession. In Kenya´s healthcare system where nurse to patient ratios range between 9.7:10,000 to 0.1:10,000, such decisions result in straneous shortages. Eventually, the few professionals remaining are further overworked, burnt out and the cycle continues.
These physical, financial & psychological effects of compassion fatigue can have one or all of the following impact on clients, nursing, and institutions:
Increased risk of errors; One of the intellectual effects of CF is lowered performance due to high levels of fatigue. A consequence of which are lowered performance and productivity combined with the higher probability of errors & impairment, reaction time and critical thinking.
¨Fatigue affects the ability to think clearly. As a result, people who are fatigued are unable to gauge their own level of impairment. They are unaware that they are not functioning as well or as safely as they would be if they were not fatigued¨ Weinstein, 2016.
Sleep deprivation leads to cognitive weakness known as microsleep. Microsleep is brief sleep sessions lasting a few seconds where an individual is visibly awake with eyes open yet their mind does not process information resulting in attention lapses.
¨Reduced situation awareness can impair a nurse’s ability to respond to patient care needs. Importantly, researchers found that sleep-deprived participants did not recognize how poorly they were performing: they tended to think they were doing better than they were.¨ Rogers, 2008.
Reduced productivity; Research shows that performance levels drop as work periods become longer and sleep loss increases. The science explains that 17-hour wakefulness has equal performance effect to blood alcohol levels of 0.05% whereas 21 hours is commensurate with 0.1%.
These are linked to; Sleepiness, concentration depletion, Impaired recall, Reduced communication ability, lowered fine motor skills & hand-eye coordination. Further risking nursing care are lessened visual perception & response times.
Exposure to claims regarding patient accidents and psychological injuries; Evidently CF characteristics such as exhaustion, temper and petulance, ineffective coping mechanisms, apathy and impaired decision-making ability negatively affect patient care. These place health institutions & personnel are at risk of claims from both clients and employees.
Motivates nurses’ intention to leave the profession, evidently, from the decreased sense of satisfaction related to CF in combination with all the other effects. These findings are worrisome in light of the continued nursing shortage, a growing population & imperative health development goals.
High turnover rates & chronic understaffing in nursing is one of the most elevated of all professional groups. A study on occupational stress and turnover shows these are highly impacted by occupational stress which tilts organizational commitment & job satisfaction.
Increased sickness and absenteeism; Due to the signs and symptoms of compassion fatigue.
Injury; Increased risk for errors & reduced job performance from fatigue have negative implications for the health of personnel and patient outcomes. Substantial scientific evidence links shift work and long hours to sleep disturbances, injuries, gastrointestinal and mood disorders, obesity, metabolic syndrome, cardiovascular disease, cancer, and adverse reproductive outcomes.
Financial constraints & Substance abuse among nurses has been noted as one of the negative coping mechanisms which can cost not only revenue to employers but a loss of valuable human resource and most importantly, human life. Nurses, who carry the bulk of the burden when it comes to emotional fatigue, are the backbone of healthcare. Sadly, some nurses are susceptible to ineffective coping and defensive mechanisms such as substance use and withdrawal. Expenses from follow-up care, among others, eventually burden health care systems from massive interventional rehabilitation programmes to maintain these individuals´ career lives.
If you are a healthcare worker or engage in a stressful environment, it’s worth pausing to examine the impact on your life. Whether you or a colleague actually experience these challenges — and if so, how you can mitigate CF & the effects. In healthcare management, if you have employees who face these obstacles, consider that you do too. You owe it to them, patients, your organization and the entire healthcare field to provide the tools and resources that counter CF.