Compassion Fatigue and Burnout in Nursing: Enhancing Professional Quality of Life

255 Pages·2012·0.95 MB·English

by  Vidette Todaro-Franceschi

COMPASSION FATIGUE AND
BURNOUT IN NURSING
VidetteTodaro-Franceschi,RN,PhD,FT, hasbeenanursefor30yearsandhas
worked in a variety of acute and long-term care settings in medicine, surgery,
and critical care as staff nurse, administrator, clinical specialist, educator, and
consultant. She is an associate tenured professor and coordinator of the Clinical
Nurse Leader Graduate Program at Hunter-Bellevue School of Nursing, Hunter
College, and Doctoral Nursing Faculty at the Graduate Center, both of the City
University of New York. A nurse scholar and educator in the areas of end-of-
life/palliativecare,bioethics,andleadership,Dr.Todaro-Franceschiistheauthor
of the book The Enigma of Energy: Where Science and Religion Converge along
with many articles and several chapters. She has performed seminal research
on ideas of energy, synchronicity, bereavement healing, end-of-life care, and
professional quality of life. A passionate speaker, she has presented nationally
andinternationally.
Dr. Todaro-Franceschi is an End-of-Life Nursing Education Consortium
(ELNEC) trainer and a Fellow in Thanatology (ADEC). She is on the academic
advisory board for Annual Editions: Death, Dying and Bereavement, and is a peer
reviewerforanumberofprofessionaljournalsincludingtheJournalofHospiceand
Palliative Nursing, MedSurg, Nursing Science Quarterly, the Journal of Holistic
Nursing,andAlternativeTherapiesinHealthandMedicine.
COMPASSION FATIGUE AND
BURNOUT IN NURSING
Enhancing Professional Quality of Life
Vidette Todaro-Franceschi, RN, PhD, FT
Copyright#2013SpringerPublishingCompany,LLC
Allrightsreserved.
Nopartofthispublicationmaybereproduced,storedinaretrievalsystem,ortransmittedin
anyformorbyanymeans,electronic,mechanical,photocopying,recording,orotherwise,
withoutthepriorpermissionofSpringerPublishingCompany,LLC,orauthorizationthrough
paymentoftheappropriatefeestotheCopyrightClearanceCenter,Inc.,222RosewoodDrive,
Danvers,MA01923,978-750-8400,fax[phone],[email protected].
copyright.com.
SpringerPublishingCompany,LLC
11West42ndStreet
NewYork,NY10036
www.springerpub.com
AcquisitionsEditor:AllanGraubard
Composition:TechsetCompositionLtd.,Salisbury,UK
ISBN:978-0-8261-0977-4
E-bookISBN:978-0-8261-0978-1
12131415/54321
TheauthorandthepublisherofthisWorkhavemadeeveryefforttousesourcesbelievedtobe
reliabletoprovideinformationthatisaccurateandcompatiblewiththestandardsgenerally
acceptedatthetimeofpublication.Becausemedicalscienceiscontinuallyadvancing,our
knowledgebasecontinuestoexpand.Therefore,asnewinformationbecomesavailable,
changesinproceduresbecomenecessary.Werecommendthatthereaderalwaysconsult
currentresearch,specificinstitutionalpolicies,andcurrentdrugreferencesbeforeperforming
anyclinicalprocedureoradministeringanydrug.Theauthorandpublishershallnotbeliable
foranyspecial,consequential,orexemplarydamagesresulting,inwholeorinpart,fromthe
readers’useof,orrelianceon,theinformationcontainedinthisbook.Thepublisherhasno
responsibilityforthepersistenceoraccuracyofURLsforexternalorthird-partyInternetWeb
sitesreferredtointhispublicationanddoesnotguaranteethatanycontentonsuchWebsites
is,orwillremain,accurateorappropriate.
LibraryofCongressCataloging-in-PublicationData
Todaro-Franceschi,Vidette.
Compassionfatigueandburnoutinnursing:enhancingprofessionalqualityoflife/Vidette
Todaro-Franceschi.
p.;cm.
Includesbibliographicalreferencesandindex.
ISBN978-0-8261-0977-4--ISBN978-0-8261-0978-1(e-book)
I.Title.
[DNLM:1. Nurses--psychology.2. Burnout,Professional--psychology.3. Empathy.
4. Philosophy,Nursing.5. QualityofLife. WY87]
610.73--dc23
2012023136
Specialdiscountsonbulkquantitiesofourbooksareavailabletocorporations,
professionalassociations,pharmaceuticalcompanies,healthcareorganizations,and
otherqualifyinggroups.
Ifyouareinterestedinacustombook,includingchaptersfrommorethanoneofour
titles,wecanprovidethatserviceaswell.
Fordetails,pleasecontact:
SpecialSalesDepartment,SpringerPublishingCompany,LLC
11West42ndStreet,15thFloor,NewYork,NY 10036-8002s
Phone: [phone]or212-431-4370;Fax: [phone]
Email: [email protected]
PrintedintheUnitedStatesofAmericabyBangPrinting
Dedicated to my colleagues—
nurses everywhere—and especially my students....
May you always work heartfully, assured that those whose lives
you touch will be forever changed.

CONTENTS
Foreword DianaJ.Mason,RN,PhD,FAAN ix
Foreword NessaCoyle,RN,ACHPN,PhD,FAAN xiii
Preface xv
Acknowledgments xix
Part1 ProfessionalQualityofLife
1. Introduction:TheGood,theBad,andtheUgly 3
2. TransformingBothHealthandCare 13
Part2 Unity,Purpose,andtheGood:AnEthicofCaring
3. CompassionandContentment:BeingHeartful 29
4. ValuesandExcellencesinNursing 45
5. TheARTofReaffirmingPurpose 57
Part3 TheBadandtheUgly:CompassionFatigueandBurnout
6. AHeavyHeartHurts 75
7. IKnowWhatIOughttoDo! 91
8. BurntOutandSeeminglyHeartless 111
Part4 FacingDeath
9. BeingPreparedtoCarefortheDying 135
10. SharedHorrorsandAching,BreakingHearts 151
vii
viii Contents
Part5 BeatingtheOdds
11. CultivatingCollectiveMindfulAwareness 165
12. ImagineItandActualizeIt 185
AppendixA: ProQOLVersion5(Stamm,2009–2011) 197
AppendixB: PPACDR-I(Todaro-Franceschi,2010) 201
Resources 203
References 211
Index 225
FOREWORD
In her classic work, Ordered to Care, historian Susan Reverby (1987a)
wrote about the roots of nursing as a predominantly women’s pro-
fession. Women were expected to take care of infirmed close and distant
relatives. When caregiving moved outside of the home, it was women
whowereexpectedtoprovideit.Indeed,itwasoneofthefewoccupations
opentowomen.Caregivingwasviewedas“women’swork”—aviewthat
wecontinuetochallengetoday—and,assuch,wasnotvaluedbysociety.
Reverby(1987b)arguesthatnurseshavebeen,andcontinuetobe,ordered
tocareinasocietythatrefusestovaluecaring.Herworkhelpedmanyin
nursing to understand the complexity of the profession and nurses’ own
views of self-worth and their conduct. How can we feel good about the
workwedoifitisnotvaluedbysociety?
When society devalues what we do, it is hard to clutch the thread
thatholdstogetherthetapestryofcaring.Nursingisextremelydemanding
and challenging work. We are witnesses to tremendous trauma, both
physical and psychological. The work takes its toll when we, our col-
leagues,andthehealthsystemsinwhichweworkfailtounderstandthat
caring for the caregivers is essential if we are to provide high-quality,
humanisticcare.
We sometimes do our work in uncaring environments. Our health
care system is notorious for failing to deliver the right care in the right
way at the right time. Hospitals are often more concerned about nurses
administering medications than making sure that patients and their
family caregivers have the information and support they need to be able
to take care of themselves in the immediate post-discharge period.
Physicians continue to give “orders,” as if they had the certitude of the
Ten Commandments,even though our dutyistothepatient first.Nurses
who challenge the status quo or the “orders” of physicians quickly learn
that they can be disciplined and even lose their jobs and livelihood.They
leave work knowing that they have been unable to support patients in
ways their patients needed. Whether it is from unsafe systems of care,
insufficient staffing to provide the care patients and families need, or
being constrainedfrom advocating for patients as our consciencedictates
ix