Nurses can apply science of caring to combat compassion fatigue

The heart of healthcare is stressed. With longer shifts, staffing shortages and healthcare changes taxing our nurses, it's no surprise that up to 80 percent report suffering compassion fatigue at some point in their careers, according to recent studies.

NAU's Dorothy Dunn, assistant professor and doctor of nursing, has been actively researching the intentionality of compassion energy—the converse of compassion fatigue—in order to help nurses balance life and profession.

"As a family nurse practitioner specializing in gerontology, I asked myself this question: Why is everyone leaving nursing and for those who stay, why are they still here?" Dunn said. "The answer? Those who stayed have a desire to care for someone compassionately."

Dunn explained that nurses will grow and thrive if they understand how to self-generate vigor as compassion energy, preventing compassion fatigue or burnout. The concept—grounded in the theoretical frameworks of Rogers' Science of Unitary Beings and Watson's Caring Theory—incorporates the recognition of human energy fields and how they are mutually affected.

Many nurses default to putting up emotional walls by distancing themselves from the perceived vulnerability of suffering. In contrast, Dunn's research revealed when nurses engage with patients from a place of caring, compassion and presence, the moment becomes energized and focused on meeting the needs of others which energizes the nurse.

"My research results challenged the effectiveness of what was being taught in nursing school in the 1980s, such as don't cry when an infant dies and keep your boundaries up," Dunn said. "In fact, three assumptions emerged that directly oppose the old ways of practicing nursing."

Dunn's assumptions are as follows:

• Compassionate presence: Being fully present in the moment with intent to have compassion, not sympathy, pity or altruism, for the other.
• Pattern nurturance: By truly being in the moment with the patient and paying attention to interconnectedness, patterns will emerge. For example, when caring for patients suffering dementia, paying attention to patterns will reveal ways to recognize how to more quickly meet patient needs.
• Intention to know: By focusing on truly getting to know your patient and what matters most to them, nurses create an energetic exchange that is uplifting and balanced for both the nurse and the patient. For example, many times a psycho-social need is what matters most, as opposed to a medical need. A patient exhibiting high blood pressure who did not expect to be admitted to a hospital may worry most about the dog at home that needs to be fed. Once the need is recognized and met, both emotional and physical healing can occur and blood pressure will likely drop.

"Another point to make is that nurses must recognize the signs of compassion fatigue and understand that the key to managing it is self-care," Dunn said. "If nurses take care of their own needs first and intend compassion energy with patients, balance can be achieved."