Critical care nursing can be an intensely satisfying profession. At the same time, it can also be enormously draining.
A recent study adds to previous research that has focused on emergency, pediatric, oncology and hospice nurses to find out what factors place critical care nurses at higher risk of compassion satisfaction as well as its antithesis: compassion fatigue.
“Although nurses obtain professional satisfaction from their work, repeated exposure to the aftermath of critical illness puts them at high risk for compassion fatigue,” says lead author Tara Sacco, MS, RN, CCRN, AGCNS-BC, ACCNS-AG, visiting assistant professor at St. John Fisher College, Wegman School of Nursing, and a clinical nurse specialist at University of Rochester Medical Center, Rochester, New York.
“Our findings provide a snapshot into issues related to nurses’ professional quality of life, with implications for efforts to create healthy work environments.”
The study, published in the August Critical Care Nurse, is based on a survey of 221 adult, pediatric and neonatal critical care nurses at a western New York academic medical center. When researchers looked at the responses and then used the Professional Quality of Life Scale to gauge levels of compassion fatigue and compassion satisfaction, they found that critical care nurses scored within the average range for compassion satisfaction, burnout and secondary traumatic stress.
What’s more, scores among the units were not significantly different.
“From an organizational perspective, this finding is positive because no single unit had a high degree of burnout or secondary traumatic stress,” researchers observe. “Thus, the current work environment appears to foster a healthy balance, and work environment interventions can be directed to increasing levels of compassion satisfaction rather than to preventing compassion fatigue. “
Then they broke down the results by factors such as the nurse’s sex, age, educational level, patient acuity, and whether or not he or she experienced a recent work change. That’s when significant differences in levels of compassion satisfaction and compassion fatigue became apparent, and that’s where the findings get interesting.
Female nurses in the study had significantly higher levels of compassion satisfaction than male nurses (although researchers note this finding should be interpreted with caution since just five percent of respondents were men).
The study also found:
“A possible conclusion,” researchers write, “is that older nurses have more professional and life experience and therefore are better prepared to cope with the challenges of critical care nursing.”
On the flip side, nurses age 40 to 49 and nurses working on mixed-acuity units had significantly higher burnout and higher secondary traumatic stress scores.
Change, too, was linked with lower professional quality of life. Specifically, the study found that nurses who had a change in nurse manager or nurse leader staff within the last year had significantly lower mean compassion satisfaction scores and higher burnout scores.
“This finding is important because it suggests that units with a stable leadership structure have an environment more supportive of compassion satisfaction,” the researchers write. “Therefore, efforts to retain qualified critical care nurses and nurse managers should be emphasized.”
Along similar lines, nurses who experienced a unit redesign such as the opening or splitting of a unit within the last year scored higher for secondary traumatic stress.
“Because change is a constant within the health care environment, this finding suggests that nurses are at higher risk for compassion fatigue as their work environment evolves,” the researchers note. “Nurse leaders would be smart to implement support systems to guide staff through these times of evolution.”
The study has several limitations, researchers write, including its small sample size. They suggest a larger, multi-institutional investigation to further explore the issue.
We’d like to know how these results compare to your experience. Are the findings similar to what you’ve observed? What factors do you think most contribute to compassion satisfaction and compassion fatigue among critical care nurses?
Leave us a comment below!