Use of a Quiet Room to Decrease
Risk for Compassion Fatigue
Kate Forrest, BSN, RN, ONC
Evidence-Based Fellow
San Francisco, CA
June 20, 2013
Problem
All nurses are at risk for compassion fatigue.
• Compassion fatigue is a set of symptoms that arise
from compassionate care for those in distress or
suffering.
• Defined as “a disorder that affects those who do their
work well” and “the cost of caring”. (Figley, 2002)
Without intervention, nurses’ ability to care is
compromised.
Figley, C. (2002). Treating Compassion Fatigue. New York : Brunner-Routledge.
2
John Muir Health – proprietary and confidential
Background
Reduction of compassion fatigue has benefits that
extend well past the individual including:
Increased staff retention
Increased patient satisfaction
Reduced sick time
Increased staff morale and productivity
Aycock, N., & Boyle, D. (2009). Interventions to manage compassion fatigue in oncology
nursing. Clinical Journal of Oncology Nursing, 183-191.
3
John Muir Health – proprietary and confidential
Setting
• 572-bed acute care level 2
trauma center.
• 4 West: a 19-bed Medical
Surgical Trauma nursing
unit
4
John Muir Health – proprietary and confidential
Methods
Intervention
A “quiet room” was established for staff to use during
their break time.
Pre and Post Survey
Survey was administered to measure the risk of
compassion fatigue, burnout, and potential for
compassion satisfaction.
5
John Muir Health – proprietary and confidential
Staff Engagement
Kate- Rugs, meditation cushions
Janine- Chakra banner
Karina- Stereo, blankets, books
Sheena- Water fountain
Rose- Inspirational quotes, wall
hangings
Karen- Pillows, potpourri,
decorative items
Marina- CDs, stereo,
mattress, curtains,
lantern lights
Yennsy- Affirmations
Anna- Aromatherapy
hand soap and lotions
6
John Muir Health – proprietary and confidential
Staff Education
7
John Muir Health – proprietary and confidential
8
John Muir Health – proprietary and confidential
9
John Muir Health – proprietary and confidential
10
John Muir Health – proprietary and confidential
Risk for Compassion Fatigue
PRE & POST Survey
n=24
20
18
Number of Respondants
18
16
14
11
12
10
9
8
6
5
4
4
1
2
0
PRE
POST
11
High-Extremely High
9
5
Moderate
4
1
John Muir Health – proprietary and confidential
Low-Extremely Low
11
18
Risk for Burnout
PRE & POST Survey
n=24
20
19
18
18
Number of Respondants
16
14
12
10
8
6
5
6
4
2
0
PRE
POST
12
0
0
High-Extremely High
0
0
Moderate
5
6
John Muir Health – proprietary and confidential
Low-Extremely Low
19
18
Potential for Compassion Satisfaction
PRE & POST Survey
n=24
16
14
Number of Respondants
14
14
12
10
7
8
6
6
4
4
2
1
2
0
0
PRE
POST
13
High-Extremely High Potential
6
14
Good Potential
14
7
Moderate Potential
4
2
John Muir Health – proprietary and confidential
Low-Extremely Low Potential
0
1
1. How do you care for yourself and manage stress at
work?
2. How do you currently spend your breaks
(not including eating) and how do you feel afterwards ?
PRE Intervention Narrative
Responses
Talking to co-workers
Take a nap/close eyes/put feet up
Healthy lifesstyle
Watch TV
No breaks/breaks get interrupted
Deep breathing
7% 6%
42%
10%
POST Intervention
Narrative Responses
Use 'Quiet' Room
16%
19%
14
John Muir Health – proprietary and confidential
27%
73%
15
John Muir Health – proprietary and confidential
Conclusion
Demonstrates the need for compassion fatigue prevention
and encouragement of staff self-care in acute patient
care settings.
Successful small test of change that has already been
requested to be adopted permanently and replicated
house-wide within the medical center.
Adds to the increasing body of knowledge on the subject of
staff wellness, self-care, and prevention of compassion
fatigue, and burnout.
16
John Muir Health – proprietary and confidential
“The
expectation that we can be
immersed in suffering and loss daily
and not be touched by it is as
unrealistic as expecting to be able to
walk through water without getting
wet.”
(Remen, 1996)
17
John Muir Health – proprietary and confidential
References
• Aycock, N., & Boyle, D. (2009). Interventions to manage
compassion fatigue in oncology nursing. Clinical Journal of
Oncology Nursing, 183-191.
• Coetzee, S. K., & Klopper, H. C. (2009). Compassion fatigue within
nursing practice: A concept analysis. Nursing and Health Sciences,
235-243.
• Edward, K.-l., & Hercelinskyj, G. (2007). Burnout in the caring nurse:
learning resilient behaviors. British Journal of Nursing, 240-242.
• Figley, C. (2002). Treating Compassion Fatigue. New York :
Brunner-Routledge.
• Najjar, N., Davis, L. W., Beck-Coon, K., & Doebbeling, C. C. (2009).
Compassion fatigue: A review of the research to date and relevance
to cancer-care providers. Journal of Health Psychology, 267-277.
• Remen, R. (1996). Kitchen Table Wisdom. New York: Penguin
Group.
18
John Muir Health – proprietary and confidential