Some participants said they gained verbal support from coworkers, family, and spouses. Findings from the current research study address this gap in the literature by providing a qualitative study with the purpose of understanding the experiences of RNs who care for older adults in SNFs and factors that contribute to compassion fatigue. Ariapooran, S. (2014). They need to ensure that patients in severe conditions have the care they need to optimize the patients' health outcomes. The stress of this can cause a nurse to emotionally withdraw as a means of self-preservation. Compassion fatigue comprises two components: burnout and secondary traumatic stress (STS). Although the protocols are not perfect, they are helping improve patient outcomes. Another participant reported that she daily rationed out her compassion based on what she felt she had left, stating, “I'm definitely picking and choosing who I am giving my compassion to.”. The longer the duration of the nurse–patient relationship, the greater the chance the nurse may become overly involved with the patient, possibly leading to blurred professional boundaries (Melvin, 2012; Nolte et al., 2017). Can you think of ways to improve the relationship between Catholic health ministries and nursing schools to develop more focused training for nurses getting ready to enter practice? Journaling was used to include the researcher's pre-understandings identified prior to data collection, during data collection, and with data analysis in an attempt to acknowledge preconceived notions and changing pre-understandings. The hermeneutic circle is the process of understanding the shared meaning by conducting multiple interviews, which assists in learning new ways of viewing a phenomenon as participants and researchers engage in dialogue over time (Annells, 1996). They are present at immediate and concrete levels to care for the physical and emotional/spiritual wellbeing of both the patient and the family. Nurses caring for older adults in SNFs are faced with a variety of challenges, both organizational (e.g., lack of support, physically strenuous work, high quality of care demands with limited resources) and patient related (e.g., multiple comorbidities, emotional and cognitive struggles, losses of function, independence and health, end-of-life [EOL] care, feelings of inability to change some aging health outcomes), which are compassion fatigue risk factors (Huskamp et al., 2012; Kolthoff & Hickman, 2017; Kubicek et al., 2013; Mooney et al., 2017). This shared meaning represented the way participants coped with compassion fatigue and situations that energized them, in addition to the need for further help to cope. Open-ended questions fostered conversation and were designed not to be answered by yes/no responses (Percy et al., 2015). If I don't have time to do this basic human comfort, something's gotta change.” As a result of work environment challenges, three participants left or planned to leave the SNF care setting. Nurses must claim responsibility for applying learned coping methods and self-care practices that include balancing personal and professional lives, rest and relaxation, proper nutrition, and hydration (Nolte et al., 2017; Sheppard, 2016). This education would encompass teaching the rationale for increased infection control measures, routinely providing information on the patient's condition and treatment, and providing the family with contact numbers and names for answering questions or addressing concerns. Data collection occurred over a span of 2 months. Nursing administration could also help nurses understand the importance of self-care (for instance, proper sleep, work-life balance) in the prevention of compassion fatigue, and try to adjust schedules that allow for nurses to spend more quality time with their families. One participant said, “I just think I'm slinging meds like I'm slinging hash. The moral anguish that leads to nurse desensitization in compassion fatigue can impact the nurse's ability to establish authentic relationships with COVID-19 patients. In the meantime, the nurse in the room is doing his or her best to help the patient overcome the life-threatening health complications. Delays in the delivery of care also contribute to the mental exhaustion nurses experience when caring for patients infected with COVID-19. & Kazanjian, A. While the intent of clustered care is to minimize exposure to the virus, this practice also diminishes the time spent with the patient. Phenomenology, a philosophy and research method, can assist in the understanding of complex and situational nursing questions (Munhall, 2012). Nurses experiencing compassion fatigue may have decreased focus leading to patient errors, use sick time more often, become less engaged with patients and families, and even leave their jobs (Ariapooran, 2014; Hegney et al., 2014; Joinson, 1992; Sheppard, 2016). Although some reported findings align the description of compassion fatigue among SNF nurses within current literature, other findings support nuances in the meaning of compassion fatigue among SNF nurses. This problem justifies … Sorenson, C., Bolick, B., Wright, K. & Hamilton, R. (2016). The impact of compassion fatigue on nurses can be profound. As the population of older adults being cared for in skilled nursing facilities (SNFs) continues to rise, the shortage of trained nurses in SNFs is compounded when emotional saturation or compassion fatigue causes nurses to leave the profession (Hawkley et al., 2018; Sheppard, 2016). They are dependent on other nurses to deliver the needed supplies to them and this takes time, especially when the unit is understaffed. May 28, 2019. These nurses have to think fast and deal with a lot of emotional distress on a day-to-day basis. 2. Limited health care resources are placing greater demands on nurses to provide quality care for patients with complex needs (Nolte et al., 2017). Several participants reported being forgetful or scattered and even experiencing memory loss. Fleming, V., Gaidys, U. Some nurses leave the profession due to compassion fatigue. The COVID-19 pandemic has catalyzed many changes in the delivery of health care. (Ed.). During the course of the three interviews, two participants self-identified with symptoms of compassion fatigue. Compassion fatigue for nurses can manifest in physical, emotional, and psychological symptoms, such as headaches or gastrointestinal issues, anxiety, forgetfulness, feeling hopeless, reduced empathy, and a lost sense of pride as a nurse (Nolte et al., 2017; Sheppard, 2015, 2016). These symptoms of cognitive dysfunction affected their personal lives and their daily work. )1 Compassion fatigue has a direct impact on personal knowing, aesthetic knowing and ethical knowing patterns. These physical, emotional, and work-related issues affect patient care, nurse–patient relationships, and nurses' professional quality of life (Sorenson et al., 2016). CHANGES IN FAMILY VISITATION POLICIES Multiple interviews with each participant were conducted because understanding of the phenomenon could change over time and the participant–interviewer relationship could become more casual allowing further exploration of participants' meanings (Fleming et al., 2003; Koch, 1996). Accessed July 5, 2020. In addition, the number of response team members may need to be restricted to minimize cross contamination of the virus. This reality can cause dread and anxiety at home when thinking of or planning to go to work. Findings in the current study, which are unsupported by existing literature, provide a new perspective that contributes specifically to gerontological nursing literature about SNFs. Many hospitals limit the number of patient visitors or began to prohibit visitation completely during the pandemic. Whatever happened to qualitative description? Compassion fatigue is the physical and mental exhaustion and emotional withdrawal experienced by those caring for sick or traumatized people over an extended period of time. In particular, nurses need to focus on preventing medical complications associated with COVID-19, which may cause them to question their ability to compassionately provide holistic care to the patient. All participants were female. Some participants lost interest in engaging in social activities and even isolated themselves from family or friends. Diminished time at the bedside could cause fears of missing an acute change in the patient's condition that would lead to a life-threatening event. Three participants sought employment outside the SNF setting due to compassion fatigue. This situation can cause frustrating mental conflicts where the RNs worry about their ability to attend to physical versus spiritual needs of their patients. Participants said that they relied on their own personal support systems, including coworkers and family, to help grieve. If the participant met eligibility and wished to participate, then a private meeting room in the participant's desired location was determined. After IRB approval, a list of SNFs and their associated leaders was obtained using public listings, such as in the Arizona Health Care Association and Arizona Department of Health Services directories. Participants were also prompted with a simple open-ended statement: “Tell me a bit about yourself and your current role in nursing.” This introductory statement was used with each participant.

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