Compassion Fatigue Among Nurses and Nursing Assistants at a Long-Term Care Facility on the Navajo Nation

Abstract

Background: Compassion fatigue (CF) impacts medical professionals, especially the nursing staff. Nursing staff who work at long-term care (LTC) facilities commonly experience CF, comprised of burnout (BO) and secondary traumatic stress, related to increased patient-to-nurse ratio, physical demands of patient care, and patient workload. Quality improvements addressing CF are slowly rising among the American Indian population. Scarce data exist on rates of CF among LTC facilities in American Indian tribes. Outcome: This project studied the prevalence and severity of CF among the nursing staff at a rural LTC facility located on the Navajo Nation and provided an educational workshop to prevent and manage CF. Design: A quantitative descriptive approach described how CF impacted the nursing staff. Prevalence and severity of CF and the effectiveness of an educational intervention were evaluated using quantitative surveys at baseline and post-intervention. Setting: A long-term care facility, located on the Navajo Nation with approximately 60 residents and over 60 clinical staff. Participants: A target of 10 participants, with a minimum of five and maximum of 25 were comprised of licensed nurses and nursing assistants with the exclusion of administrative nurses. Methods: Participants completed a pre-intervention survey to collect baseline sociodemographic and workplace characteristics. The Professional Quality of Life (ProQOL) scale screened for prevalence and severity of CF before and after the intervention. Post-intervention, survey questions evaluated the satisfaction of the workshop. Intervention: A one-hour educational workshop provided strategies on how to recognize and address CF and an opportunity for reflective journaling that focused on responses to emotional triggers about CF. Findings: Six participants participated in this project, 10% of the nursing staff. Post-intervention, nursing staff’s high level of compassion increased from 33% to 67%, and low level of burnout and secondary traumatic stress increased from 17% to 50%, 33% to 67%. For reflective journaling, 83% of participants reported journaling with 2-6 entries. The most challenging aspects of work included a lack of teamwork and the short amount of time to complete the workload. Dissemination: An executive summary with evidence-based recommendations was shared with the administrative staff. Conclusion: The participants likely experienced compassion fatigue. Utilization of the ProQOL self-assessment survey tool helped screen for the prevalence of CF among nursing staff. Future workshops need to focus on reviewing intervention techniques to reduce the level of CF experienced by nursing staff. Overall, participants reported the workshop increased their level of knowledge in recognition of compassion fatigue.