2025 Article #4
Perceived Quality of Work Life and Risk for Compassion Fatigue Among Oncology Nurses: A Mixed-Methods Study
Ellen Giarelli, EdD, RN, CRNP, Jami Denigris, BSN, OCN®, Kathleen Fisher, PhD, MaryKay Maley, DNP, APN, and Elizabeth Nola
Purpose/Objectives: To examine factors that influenced the nurse’s perceived quality
of work life and risk for compassion fatigue (CF). The specific aims of the study were to
describe the (a) relationship among nurse characteristics and perceived quality of work
life, (b) relationship between personal life stress and perceived quality of work life, and
(c) the nurse’s beliefs about his or her risk for CF.
Research Approach: A descriptive, mixed-methods study.
Setting: A hematology-oncology unit in a large urban teaching hospital in Pennsylvania.
Participants: 20 oncology nurses.
Methodologic Approach: Descriptive study using questionnaires and in-depth interviews.
The variables were nurse characteristics, personal life stress, and quality of work life. Data
were analyzed descriptively and thematically. Scores on the self-report questionnaires
were compared to themes.
Findings: Personal life stressors, measured by combining the Impact of Events Scale and
Life Events Scale, identified powerful or severe impacts on well-being for 30% of nurse respondents in this study, theoretically placing them at risk for CF. However, qualitative data
did not complement the results of the Life Events Scale, and 55% of the nurses described
their overall work experiences as “life-affirming and rewarding.” The participants provided
multiple sources of their work-related stress, including subcategories of communication
breakdown, work environment/institution, and care-driven factors.
Conclusions: Overall, oncology nurses experienced positive reinforcement at work and they
had little concern about individual or organizational effectiveness. Positive experiences
offset the negative and balanced out the risk for CF.
Interpretation: The identification of personal and social contributors, as well as solutions to
work-related stress, supports the philosophical premises (i.e., conceptual model) that the
circumstances that place a nurse at risk for CF are socially constructed. Nurses can achieve
greater empathy through self-understanding and translate this learning to patient care.
Discussion Starting Points:
Please choose two for your response:
How does this research article compare to our practice, policy and or procedure?
What are the advantages and disadvantages to the proposed recommendations in the article?
What are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital?
Was the correct method used? Why or why not?
How does this research article compare to our practice, policy and or procedure?
ReplyDeleteI have been an Oncology Nurse for more than 20 years and have proven time and time again that CF is very real as we are dealing with a cancer diagnosis that is life changing not only for the patient but for the whole family. Based on this article it esn't only lool at the professional aspect of the caregiver but goes beyond taking into consideration (a) relationship among nurse characteristics and perceived quality of work life, (b) relationship between personal life stress and perceived quality of work life, and (c) the nurse’s beliefs about his or her risk for CF.
While our institution gives emphasis on our educational and professional growth, it lacks the emphasis on taking into consideration our personal life stressors and in effect missed the caregiver's perception on the quality of work life which is a huge influence resulting in CAREGIVER FATIGUE.
What are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital?
Implementing the article in our unit will be very beneficial especially that it will play a big influence on how the nurses will perceive that quality of work life and lessen CF and in return nurses can achieve greater empathy through self-understanding and translate this learning to patient care. While this is very beneficial for the caregivers the disadvantage is convincing leaders and administration to put out the resources to seriously look at each of the caregivers and get to personally know them and understand not only their professional but personal lives as well.
How does this research article compare to our practice, policy, and or procedure?
ReplyDeleteWe do not have a policy or practice/procedure concerning caregiver compassion fatigue. The quality of work life is subjective to every individual caregiver and can be difficult to pinpoint.
PSJMC does offer mental wellness resources/services. Lyra offers on-site support and counseling to help caregivers with stress, balancing home/work life. The Spiritual Care department is also available to assist caregivers with emotional and spiritual support.
Personally speaking, I went through a very difficult year, not only emotionally but physical challenging at times. Compassion fatigue did not affect me, on the contrary, my personal challenge only encouraged me to provide better care to my patients. My perceived quality of work life did was not affected but in fact, became more rewarding.
Was the correct method used? Why or why not?
I believe this study was too small, only 20 oncology nurses we surveyed and interviewed. It is unclear if they were surveyed only once and how long after they were interviewed. It would be interesting to see if performing a study across a set length of time (months) would yield different results.
What are the advantages and disadvantages to the proposed recommendations in the article?
ReplyDeleteThe advantages of this study is to understand the risk of compassion fatigue, by understanding it can help with retention. This article is proposing that oncology nurses that experience positive reinforcement during work can balance the risk for compassion fatigue. The advantage of understanding this is to help with retention and reduce nurses quitting from burn out. The disadvatanges is trying to understand that work related stress and all the subcategories listed are subjected factors. Although one person may experience less risk for compassion fatigue, another person can have it even if they both share the same risk factors.
Was the correct method used? Why or why not?
I don't think this method was an accurate representation of risks for compassion fatigue for multiple reasons. The participants in this study were not enough to adequately collect data on compassion fatigue and the setting only focused on one unit in one hospital. The findings are very subjective since it only reflects in one hospital unit. A more effective study would be to use multiple hematology-oncology units from different hospitals in order to understand the risk of compassion fatigue. Every hospital and every unit runs differently and with increased participants, there would be a greater difference in percentage of "life affirming and rewarding" and "severe impacts on wellbeing." The mixed method study is still very subjective from the self report questionaires and there were large variables that could have drastically affected the data.
How this research article compare to our practice, policy, and or procedure?
ReplyDeleteOncology nurses are particularly prone to burn out and compassionate fatigue due to cancer treatments, diagnosis, patient's emotional an physical pain and patient's death. Personal life stressors contributes to the burn out along with short stuffing and high acuity workload.
Prolonged exposure to work and personal life stressors leads nurses to leave a workplace.
Our hospital offers on site support and cancelling. Our unit has a designated room for nurses to take a break in peace. However, nurses often suppress their feelings and avoid expressing their emotions. As a unit, we need to provide supportive work environment. Encourage coworkers to express their feeling and help getting support that they needed. making sure that nurses get their break and guide them in difficult decisions. Specially the new nurses that are more prevalent to stress.
What are the advantages and disadvantages of implementing this article recommendations on your unit?
The advantages of implementing this article would be to understand the the level of stress that nurses are dealing with on our unit. Also, would help to provide a support to those nurses that they needed. We could establish more supportive work environment. Therefore, nurses would be more satisfied at work that will benefit patient's care and nursing retention.
The disadvantages would be to actually implement the study. It takes time, resources and money. The study would have to be simplifying. Not all nurses would be agreeable to expressing their personal grief and work related fatigue.
Marzenna Messina
How does this research article compare to our practice, policy and or procedure?
ReplyDeletePSJMC does not have a policy regarding compassion fatigue. It does have on site counseling available for all staff. Also, the spiritual care department is available and provides support individually and as a unit. Treating compassion fatigue is tricky. How this presents is different for everyone and may not be obvious to the individual that they are experiencing it. It is also difficult for management to address, but I think discussing the subject would greatly help with nurse retention. One way to do this could be during yearly evaluations. Creating a space for this discussion gives employees an opportunity to voice their concerns and receive resources.
Was the correct method used? Why or why not?
The study used a questionnaire and in-depth interviews to collect data, and it included work and life stressors. It is unclear if this was done over a period of time. Compassion fatigue is an intricate subject that fluctuates based on the nurse's personal life and shift. I imagine it is difficult to quantify for a study. In addition, only 20 subjects were included. The article addresses an important topic and is a good way to start the conversation. Good project for the unit (and use for next year's clinical ladder!).
How does this research article compare to our practice, policy and or procedure?
ReplyDelete- This article speaks to our unit’s oncology specialty. Because of the nature of our specialty, we do get “frequent flyers” that we have come to know on a somewhat higher level than nurse to patient relationship. Many of us have taken care of cancer patients from when they were first diagnosed up until their death due to cancer complications. It is almost inevitable not to get attached to your patients. That relationship, and the eventual end does take a toll on our nurses. I also speak to other nursing units/specialties because I’m sure that they experience some form of caregiver fatigue like we do, but on another level. With the added social anxieties (especially when COVID happened), caring for patients (and to some extent their families) does take a negative mental toll that in turn results in caregiver fatigue.
Was the correct method used? Why or why not?
- I do not believe the correct method was used as the study group was only 20 nurses. I think the study could be improved if a larger group was studied and included other high acuity units.
How does this article compare to our practice, policy, and/or procedure?
ReplyDeleteThere is no current policy to directly address compassion fatigue, which is described as the psychological, physical, and/or emotional toll of helping others. Compassion is one of the main values of our hospital, along with dignity, justice, excellence, and integrity. While we maintain is as a core value, it is important to look out for the effects of compassion fatigue in ourselves and our colleagues. This phenomenon is linked to burn out and feelings of dissatisfaction with work. While we have resources available like Lyra and on-site counseling, compassion fatigue is a big issue among nursing as a whole and oncology specifically as we deal with patients with extreme pain and poor prognosis.
Was the correct method used? Why or why not?
The method used in this article was a descriptive, mixed-methods study. This method combines a quantitative, data approach with a qualitative, descriptive approach to create a complete picture. I think this is the correct method when tackling a question of compassion fatigue among oncology nurses. Data and numbers alone cannot capture the full picture of what us nurses are going through. You need stories and emotions in order to convey the depth of the issues. Only then will you be able to accurately create change.
How does this article compare to our practice, policy, and/or procedure?
ReplyDeleteRight now, we don’t have a specific policy that directly addresses compassion fatigue, which is the mental, physical, or emotional strain that comes from caring for others. Compassion is one of our hospital’s core values, along with dignity, justice, excellence, and integrity. While we focus on compassion as a value, we also need to pay attention to the toll it can take on staff. Compassion fatigue is closely tied to burnout and job dissatisfaction. We do have resources like Lyra and on-site counseling, but compassion fatigue remains a major issue in nursing.
Was the correct method used? Why or why not?
Yes, the study used a descriptive, mixed methods approach, which combines numbers (quantitative data) and descriptions (qualitative data). This was the right method to use because compassion fatigue isn’t just about statistics it’s about real emotions and experiences. Numbers alone can’t show the full impact on nurses, but stories and personal accounts help paint a clearer picture.
Article #4
ReplyDeleteHow does this research article compare to our practice, policy and or procedure?
Our hospital provides mental health services that include Lyra which can be used at home for counseling, spiritual care that can help caregivers, patients, and families that might need support, and our unit offers a room designated for caregivers to de-stress if needed. However, our hospital does not offer any time to be able to access these necessities if needed. For example, if a patient passes away we have 1 hour to fill out paperwork, call family, etc, which can be time consuming which leads the nurses no time to de-compress which then becomes compassion fatigue. As soon as we discharge a patient (it can be a verbally abusive, high stress, death, or even just a busy patient) we are then bombarded with another admission giving nurses no time to comprehend what just happened. The room that was once a “caregiver only” room to de-stress has now become a room used for case managers and doctors to hold meetings throughout the dayshift. I think our hospital needs to revisit this and help nurses while on duty of caring for others to help avoid compassion fatigue.
Was the correct method used? Why or why not?
The method used for this survey would be inaccurate because although they did use questionnaires and in-depth interviews for this some things were unclear. For example, the 20 nurses that were used for this survey were not told if they are new grads or nurses with experience. I think that would play a big part in the survey results.