Compassion Fatigue in Nursing Practice: Workplace Culture and Enabling Factors

This article discusses the impact of compassion fatigue on nursing practice and the importance of workplace culture and enabling factors in preventing it. It also explores the attributes of a productive workplace culture and the consequences of implementing them.

Running Head: NURSING DEVELOPMENT 1
Nursing Development
Name
Professor
Institutional Affiliation

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Introduction
Secondary traumatic stress is another name for compassion fatigue that is indicated by
compassion loss gradually over time. It is common among people who work with trauma patients
directly like nurses, therapists, psychologists, first responders, health unit coordinators an anyone
who assists others. Compassion fatigue has negative results on both the care provider and the
patient. It has been present in Melbourne in recent years. It is also essential to ensure that there
are important workplace cultures which helps the nurses to be aware of the values, attributes and
enabling factors in their practice. Proper recommendations are required to enhance compassion
fatigue.
Overview
The compassion and empathy described by health care, emergency and service experts in
regards to the community can prove physically, economically costly and mentally. Exposure to
victims experiencing trauma or distress can have adverse impacts on the experts’ cognitive and
physical health well-being and safety. Compassion fatigue is characterized by exhaustion,
irritability, negative coping behaviors like the use of alcohol and drug abuse, anger, decreased
capability to sympathize and empathize and minimized satisfaction sense at work and lack
capability to create decisions and care for the sufferers (Cocker & Joss, 2017). These adverse
impacts of giving care are agitated by the traumatic substance severity to which the care provider
is exposed like having a contact directly with the sufferer especially when vulnerability whose
nature is graphic. The nurses give compassionate care to sufferers who encounter sicknesses and
occurrences that are often sudden, disfiguring and life-threatening. Though nurses get
professional satisfaction from their job, their recurrent aftermath of crucial diseases put them at
high risk for compassion exhaustion.

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Nursing practice in Melbourne has shown compassion fatigue in recent years. Moreover,
the nurses have been exposed to adverse conditions especially in the hospital emergency
departments and intensive care units. Furthermore, despite the technological use in hospitals, the
nurses are outnumbered by the patients hence they become exhausted. Additionally, there is an
intense workload and short rest time periods between shifts, repeating tasks, poor resilience, lack
of meaningful recognition and lack of support from the management (American Nurses
Association, 2015). As a result, healthcare managers and employers have very little conclusive
evidence to prevent compassion fatigue. Studies have indicated that emotional intellectual and
physical effects of giving expertise services have been addressed by focusing on the
identification the prevalence and predictors of compassion fatigue in a specialized occupational
team like nurses and community health experts.
Patient-centered nursing in intensive care differs from other healthcare departments. This
critical setting and challenges faced by nurses have turned out to compromise the capability of
providing effective patient-centered nursing. Critical care health experts have compassion
satisfaction and fatigue mid-range levels. The working environment, training, maturity, and
experience also have an implication on the level of compassion satisfaction and exhaustion.
Nurses remain in their role as health care givers despite the high levels of compassion fatigue
(Boyle, 2011).
Research has shown that the nurses also get a sense of compassion satisfaction that is
known as the absolute feels received from assisting others through experiences that are
traumatic. Supportable professional quality of life is attained by sustaining a healthy balance
between the good and bad caring aspects. The balance place between compassion satisfaction
and compassion fatigue must be attained in the workplace and encouraging the essentiality of a

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positive work-life balance (Chassin & Loeb, 2013). Moreover, the degree of knowledge and skill
and low risk for compassion fatigue depends on the maturity of the nurse and the experience. It is
vital for the nurse to have the required experience so that they can cope up with the challenges of
working in the medical field. Compassion fatigue in Australia is always measured using the
approved Professional Quality of life (ProQoL) scale. The whole concept of ProQol is a
complicated milieu of attributes of the work settings, the victim's symptoms and their
vulnerability to primary and secondary trauma in the working environment. The hospital
management believes that all nurses are leaders in any context from the bedside to the
boardroom. They need leadership skills regardless of the background so that they can assist
every victim on his or her journey to health.
Evidence of analysis
I observed that as an ER nurse, one is in the first hour of a shift and a baby is brought in
that has been in an accident. The sufferer is five years old and in a horrific figure and distress.
Everybody rushes to prepare the trauma room. As the baby is being rushed in and place onto the
table, she is pronounced dead by the lead doctor. The rest of the shift will be spent in assisting to
console and support the family members of the patient as they file into the waiting area one by
one. It is a way of helping the family to get through the night. The nurse is bound to be
exhausted because he or she will spend a lot of time with one person
Also, a development nurse in a new post was allowed to assess the number of
occurrences recorded on one of the wards. The number of sufferers falling in a month was high.
On talking to the staff, there was an acceptance that it happens when individuals get old. I
noticed that nothing changed and that no one seemed to take responsibility for the problem. The
personnel seemed to be careless about this experience, and I had a strong feeling that individuals

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just wanted to preserve the status quo and not to focus on the practice essentially. There was a
lack of creativity in how individuals worked, and there was lack of communication between
professional authorities. There was no comprehension of the values underpinning how the
personnel worked. After some time, there was a new ward nurse who was collaborating, and her
decision making was transparent. As development nurse, she helped in developing practice and
enhance care for the patients. Her responsibility was clear, and she also took accountability of
the personnel. The ward personnel was now willing and committed to improving the care for the
victims. The energy and the commitment in the team were terrific and worked together to
achieve the goal of the organization.
Analysis of the current compassionate culture
Workplace culture in healthcare context affects the motivation and success of the staff.
The impacts of unsuccessful and toxic cultures have resulted in critical results for the sufferers’
results, personal wellbeing and also wastes good economic resources. Workplace culture and its
capable effects relationship highlight the demand to recognize, comprehend and make best
cultures in healthcare particularly at the level of providing care, service users and staff interface
(Flarity, Gentry & Mesnikoff, 2013). Culture is not about people but societal surroundings that
affect the way individuals behave and the societal norms that are accepted. Five attributes are
identified that will be considered necessary for productive workplace culture.
The first attribute is specific values shared in the workplace. This has been acknowledged
as designating successful culture in healthcare and business (Harris & Griffin, 2015). The
concept of analysis validates the requirement for a consistent set of value and principles that are
common and shared in the healthcare workplace. This means that the hospital ensures that the
nurses and other experts have values that are respected to ensure the safety of the patient and the

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victim. The benefits are safety, leadership development, and participation with all stakeholders
encompassing service users, high support and challenge, lifelong learning and person-
centeredness. In Melbourne healthcare settings, individuals learn not to blame others but correct
their mistakes. The experts are assisted to both learn from and examine into their practice and
develop their effectiveness and also develop others' effectiveness (Hinderer et al., 2014). These
values helped in valuing both patients and caregivers which in turn assisted in achieving respect,
mutual trust and instill faith. Respect is paramount in all areas of health.
The second attribute is that the ten values are realized and exposed in practice, some
visions and missions are with individual and collective responsibility. The hospital management
ensures that they practice what they say hence all the values are realized in practice, and the
sufferers experience them. There is a reflection of the mission and the vision every day with
motivated, self-directing, collaborative personnel who take individual and shared responsibility
and accountability (Houck, D, 2014). The values help in guiding the decision-making process in
different activities within the hospital.
The following attribute is adaptability, innovation and creativity maintain workplace
effectiveness. Research has indicated that strong cultures alone do not ensure efficiency. A
positive attitude helps in preserving flexibility with continuous development. It encourages the
staff and stakeholders to enhance creativity and innovation. Moreover, changes create a way of
solving issues within the facility and create new opportunities for individuals to showcase their
skills. The technological innovations have become an essential driver in attaining more effective
use of resources. Creativity enhances workforce and creates change which also encompasses
working methods. It also helps in preventing exhaustion among nurses during their practice
(Maiden, Georges& Connelly, 2011).

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The next attribute is the needs of victims and communities to drive necessary change.
Adjustments are required for nursing practice, and they are also inspired by the societal and the
victim’s needs (Occupational Safety and Health Administration, 2015). Additionally, both nurses
and the community deserve better healthcare services to enhance their wellbeing. The hospitals
in Melbourne protects its workers though they have some challenges. The exhaustion reduces
their power to serve the patients accordingly.
The last attribute is formal systems exists to enable constantly and assess learning
achievement and shared governance endlessly. There are legal systems present to ensure that
values are realized (Hegney et al., 2014). The formal systems assess the attainment of individual-
centered, secure and successful care that is a key to professional healthcare focus. It also
executes all learning in and from practice to make sure that revolution of practice is ongoing
(Potter et l., 2010). Furthermore, it enables the participation of the stakeholder in decision
making through executing the shared governance. It also contributes the environment of respect
for the personnel and decision making. The systems also encourage and recognize active learning
results and ascribe work-based learning l from a work-related activity like quality enhancement,
practice enhancement and even innovation to attain practice transformation in the healthcare
setting.
Enabling factors
There are two enablers categorized as either personal or organizational in their focus. The
personal element encompasses the presence of transformational leadership, especially inward
managers. Leadership plays an essential role in cultural change. The hospital leadership
management pays attention to role modeling values, culture, and attaining the common a shared
vision through the engagement of hearts and minds (Stamm, 2010). Transformational leadership

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facilitates the effectiveness of the workforce and is more influential in attaining satisfaction of
the job and the engagement of their organization. The leaders act with moral integrity using
psychological and learning approaches and different intelligence which ensures people and teams
adjusts themselves and their settings for the better. Plans for developing clinical facilitators an
leaders with necessary skills and values are vital for attaining cultural change.
The experts need assistance to explore their effectiveness to help the nurses and those
aspiring to be nurses to become more active. Besides, transparent expectations and roles are
recognized as vital enablers to a vibrant culture (The Schwartz Center for Compassionate Care,
2015). The hospital displayed their positions so that the nurses can identify their strengths and
find solutions for their weaknesses. The nurses also gave feedback to the management of the
hospital to make sure that necessary measures were taken to create a conducive working
environment that ensures the safety of the patient.
The organizational disaster involves transparent management that enables an approach to
decision making and leadership, the readiness of the organization and human resource
department that is supportive. The administration which is transparent is identified by devolved,
participative and processes where the experts are seen as seen as partners in a solution, not a
challenge (Smart et al., 2014). Excellent leadership at all levels, participative management, with
organizational and managerial aid for consistency, trust, mentorship, and empowerment assisted
in fixing values in nursing practice.
Organizational preparedness in regards to evidence-based practice and cultural change is
known as a preparation state for adjustment that is influenced by the history of the evolution of
the organization and its capability through its societal and technical plans to institute and
maintain the adjustment. The last organizational enabler is the human resource department aid

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(Lieshout van & Cardiff, 2011). This is a crucial department because it helps in maintaining the
values of the organization in regards to recruitment and selection, the performance of the staff
and the expectations as well as playing a role in enabling the organizational learning and
enhancement.
Consequences
The likelihood of developing a productive workplace culture within its attributes will be
increased by the enabling elements. This can be categorized into those that have impacts on
stakeholders and those affecting on other workplace culture. The objectives of the stakeholder
requirements would be attained and shown through the endless confirmation that sufferers,
service users and societies have their requirements met in a person-centered method involving
the receipt of both clinically successful and person-centered care (McCance, McCormack
&Dewing, 2011). The hospital ensured that the patients are cared for in an appropriate manner
that provides their safety. Person-centered is encouraged because it creates a good relationship
among the service users as well as the patients. The staff also show commitment and
empowerment which promotes the well-being of the team as well. It is associated with the
victims’ positive experiences and results. The personnel and individuals attain pre-stated goals
in areas of the victims’ safety, decreased waiting period, enhanced access and improved results
(Sacco, Ciurzynski, Harvey & Ingersoll, 2015). Besides, creativity is increased and the staff is
motivated to ensure effective workplace and culture.
Workplace culture has significant effects for various organizations and creating social
norms based on the values of all workers. Over the years in healthcare, there has been a concern
on organizational culture relating it to performance. Healthcare managers have ensured that the
workplace cultures and ensure that they positively influence the behaviors of the employees

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(McCormack &McCance, 2010). The enabling elements have impacted the nursing practice by
helping them to serve their patients effectively. The culture programmes hence need to be
enabling and not prescriptive so that the enabling factors, values and characteristics and other
cultures can be nurtured.
Recommendations
The framework aims at helping healthcare personnel to develop a productive workplace
culture. The hospital management can encourage the improvement of nursing practice by
investing in the event of transformational leadership and facilitation skills through the
development of skills and the resource. This is important for the nurses and patients because it
enhances the healthcare services (Royal College of Nursing, 2011). Nurses play an essential role
in maintaining the health care quality and the safety of the patient. A conducive environment is
necessary for nurses to carry out the required services that enhance compassion satisfaction.
Furthermore, nurses need time to rest and should not be overworked.
High levels of compassion satisfaction help to reduce the possibility of getting
compassion fatigue. It is fueled by the capability to give health care to those in custody and
become a successful assistant (Patterson et al., 2011). Compassion satisfaction helps the nurses
to connect with the patients and experience empathically that creates emotional connections that
evoke a response of kindness concern and warmth. This will make the patients to respond to
them in a peaceful manner. It is vital for nurses to identify personal coping strategies to prevent
compassion fatigue when they are offering their services.

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The nurses must also rediscover the passion and the purpose of their work. This will
determine whether the nurse is willing to work or not. The hospital management must ensure that
the nurses are aware of the purpose to avoid unnecessary challenges. Their passion for serving
other people drives them to offer more services willingly without prejudice (Manley, Sanders,
Cardiff & Webster, 2011). The nurses help individuals to understand their health care choices
and take what is better for them.
Moreover, the nursing leadership must always understand and create opportunities for
them to showcase their skills and make sure that they pose knowledge in regards to health. The
values of the hospital must be maintained to create a conducive environment for the nurses. Their
passion determines their level of compassion satisfaction which improves the services that they
have to offer. They have to know when they start not to be okay and create solutions that will
help them solve their issues (Moeller, 2018). It is essential for the nurses to understand
themselves so hence enhancing and improving the healthcare systems. This will enable them to
have endless empathy in regards to the safety of the patient. The hospital management must
make sure that every nurse is comfortable with their working conditions to reduce the levels of
compassion fatigue.
Technological advancement is also recommended since it encourages creativity to
enhance compassion satisfaction. This will give the nurses the opportunity to take
responsibilities of managing their work and provide personal care to the patient. Creativity and
innovation strengthen compassion satisfaction by creating new ways in the nursing practice.
Clinical leaders and facilitators must transform. Useful work cultures enable creativity that
manifests human flourishing which is its pointer ( Hunsaker, Chen, Maughan & Heaston, 2015).
It attains person-centeredness, the safety of the patient to enable all to flourish. Working with the

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enabling elements, values and characteristics ensure that the nurses will work to enhance
compassion satisfaction.
In conclusion, compassion and empathy are essential to all individual. Compassion
fatigue characteristics are irritability, exhaustion, irritability, anger and reduced ability to
sympathize and emphasize. It is necessary for the nurses to have compassion satisfaction to
ensure the safety of the patient.

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