Does “You’re too kind!” apply to you?
Think back to the beginning of your nursing career. Was it five, 10, 15 or more years ago? What has changed about the time you spend with patients? Clinically, what now consumes most of your time?
I recall when, as a student nurse at Pennsylvania Hospital in Philadelphia, I cared for a worker from the shipyards named Mr. O’Reilly (not his real name). He was one of eight patients I was assigned to on a medical ward, and we developed a strong relationship. Looking back, perhaps I was too compassionate.
I was able to spend a great deal of time with Mr. O’Reilly. He ate when I was present but had no interest in oral nutrition when I was off-duty. Early in his hospitalization, I had an emergency appendectomy and was out of work for a month. During that time, I was told that Mr. O’Reilly asked for me on a daily basis. His condition deteriorated, and three weeks later, he passed away. As a naïve student, I thought his passing was my fault. After all, he would have eaten had I been there. Perhaps he would have eventually recovered.
Too few hours in a 12-hour shift?
Emma Carroll writes about her experience as a mental health nurse in 1997. Her position was the best job in the world, one in which she could develop therapeutic, trusting relationships with patients. Fast-forward to 2014, and her typical day had changed. Time was at a premium, and there were not enough hours in the shift to complete what needed to be done. How could she possibly type up an initial assessment, develop a care plan, and make necessary referrals for new admissions in just 20 minutes?
One day, a patient who was suicidal needed to be stabilized, and Carroll found herself sighing as she juggled her schedule and canceled appointments. When she had a minute to herself, she reflected that this was not the type of nurse she wanted to be. What had happened to her compassion? What had happened to caring, to nursing? Had her compassion led to compassion fatigue?
Compassion fatigue is a combination of physical, emotional, and spiritual exhaustion associated with the care of patients who have significant pain and physical distress. In any setting in which care is provided, compassion fatigue is a possibility. Mental health professionals, preceptors, and others can help validate the presence of compassion fatigue. Awareness of the problem is critical to developing an intervention.
As a student caring for Mr. O’Reilly, I tried to be all things to all people. There was no “label” for it at the time, but I was a candidate for compassion fatigue. The way I saw it at the time, I had allowed a patient to die because I was not there to feed him. I also took home patients’ laundry, and I did everything above and beyond the call of duty to provide care and service.
Are you too compassionate? Do you find yourself over-involved? Do you avoid self-care? Do you have problems coping with work/home/life balance? We all need downtime. We all need positive self-care strategies and healthy rituals to cope with something like compassion fatigue. This includes activities that replenish personal energy levels and enhance overall well-being.
A commitment to taking care of one’s self includes having adequate nutrition, hydration, sleep, and exercise. The nurse may need to be encouraged to try a new approach to self-care, such as a yoga class, massage, meditation, or tai chi. Some facilities have onsite relaxation or respite centers where staff may unwind. They may offer Reiki, light massage, or healing-touch treatment. If an entire area cannot be designated, perhaps a room can be transformed by adding soothing colors to the walls and providing calming music, a waterfall, and comfortable seating.
Can you be too compassionate? Sadly, the answer is yes. As professionals, nurses must strike a balance between work and home, to know when to say no, to live your own life. Think back to the start of your nursing career when you had time for you. Maybe it’s time to re-create that balance.
Sharon M. Weinstein, MS, CRNI, RN, FACW, FAAN, author of B Is for Balance, published by STTI Publishing, is a motivational speaker, consultant, educator, and certified environmental and physical wellness specialist. To read a sample chapter from B Is for Balance, click here. To visit her website, click here.