Running head: THE IMPACT OF COMPASSION FATIGUE 1

The Impact of Compassion Fatigue and Patient Care

Mitchel R. Taylor

Brigham Young University – Idaho

Dr. Erin Bennion

July 12, 2018

THE IMPACT OF COMPASSION FATIGUE 2

The Impact of Compassion Fatigue and Patient Care

Background

Nurses are vulnerable to experiencing compassion fatigue. Caregiving as a career

requires nurses to put other individuals’ needs first before their own which can lead to their own

physical and mental neglect (Saleh, Awadalla, El-masri, & Sleem, 2014). Among those,

emergency room nurses are the most likely to experience high stress and emotional strain on the

job. In a study conducted by the Emergency Nurses Association, approximately 86% of

emergency nurses have experienced moderate to high levels of compassion fatigue and anywhere

from 55-85% of nurses in any department will develop compassion fatigue of some level or

another in their career (Hooper, Craig, Janvrin, Wetsel, & Reimels, 2010). The percentage of

nurses that are statistically liable to compassion fatigue is alarming and high compared to other

helping professions.

Compassion fatigue is on the rise among nurses. Some of the defining characteristics of

compassion fatigue include fatigue and exhaustion. In the last year, 21% of employees in the

health care providing profession reported that the amount of overtime that they were required to

work had increased adding to their exhaustion (Hooper et al., 2010). This statistic has

consistently been on the rise for the past several years and has been particularly significant

concerning nurses. Increased overtime and workload has a direct positive correlation to the

development of compassion fatigue

Post-Traumatic Stress Syndrome or PTSD is a common precursor to compassion fatigue

of which nurses are subject to experiencing on a regular basis. In another study, a group of 282

health care providers were evaluated, 82% of whom were caring for traumatized clients, at least

55% percent of them met at least one criteria for PTSD and about 15% percent of them met all
THE IMPACT OF COMPASSION FATIGUE 3

three criteria of PTSD as defined in DSM-IV (Kiley et al., 2018). PTSD is one of the symptoms

that commonly leads to compassion fatigue. Nurses, especially ER or trauma nurses, care for

traumatizing case loads which takes a toll on emotional stability and exhaustion. The sometimes

harsh environments and challenges associated with nursing leaves nurses vulnerable to other

types of mental disorders like severe anxiety and depression.

Significance

A higher prevalence of compassion fatigue among nurses influences them to leave the

profession exacerbating the existing nurse deficit turning the problem into a worsening cycle. In

a study of 460 health providers, 56% reported having high amounts of emotional exhaustion, a

key symptom of compassion fatigue, 50% of them considered quitting their jobs (Kiley et al.,

2018). This will in turn put more workload and stress on the remaining nurses and increase the

prevalence of compassion fatigue. This is potentially catastrophic because the current nurse

workforce is aging which will result in a high percentage of nurses retiring within the next 5-15

years. This will increase an already high nursing shortage in the country and further add to the

increase of compassion fatigue within the existing nurses. A survey conducted by the National

Council of State Boards of Nursing and The Forum of State Nursing Workforce Centers revealed

that 55% of the RN workforce in the country is 50 years old or older (National Council of State

Boards of Nursing, 2015). An increasing nurse shortage will then increase overtime and

workload requirements placed on each individual nurse. Increased overtime in the workplace,

which is expected to increase, is directly related to higher rates of compassion fatigue.

Compassion fatigue is expected to increase among healthcare workers because of the

aging population which increases the workload of healthcare workers such as nurses. By 2030,

the Baby Boomer generation will require substantial amounts of health care and more medical
THE IMPACT OF COMPASSION FATIGUE 4

professionals to accommodate for the needs of an older population or they will exhaust current

resources and healthcare professionals (Knickman & Snell, 2012). This will increase the

prevalence of compassion fatigue in existing healthcare workers as they are forced to increase

their workloads to compensate for the healthcare worker to patient ratio.

Medication errors among nurses are sometimes caused by the effects of compassion

fatigue. Sleep deprivation and fatigue increase the likelihood of medication errors and patient

safety compromise (Kolthoff & Hickman, 2016). Some of the hallmark symptoms of compassion

fatigue are difficulty sleeping, emotional and physical exhaustion and even confusion which are

of concern when dealing with potentially harmful and even lethal medications. Fatigue, lack of

sleep and confusion can greatly disrupt the brains ability to preform calculations and inhibit the

ability to notice mistakes. This decreased ability to function by a nurse puts all the patients under

the nurse’s care in a vulnerable position and leaves them at risk for being a recipient of

medication errors. Compassion fatigue debilitates a nurses’ abilities and decreases the nurse

work force causing a decrease in quality patient care.

Neuman Systems Model

The Neuman systems model provides a holistic perspective that centers on actual or

potential stressors that could be detrimental to a person’s health or wellbeing as well as the

response that is elicited as a result of those stressors. In dealing with stressors, Neuman’s theory

utilizes primary, secondary and tertiary interventions to cope with stressors and reduce them

altogether (Skalski, DiGerolamo, & Gigliotti, 2006). The Neuman systems model views the

subject as a unique system with its own equipped responses to stressors. There are a variety of

basic assumptions that this theory identifies.

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Stressors exist that are both known and unknown that can affect a subject. In response to

stressors that result in a negative outcome, people develop a set of defenses that provide

protection called a line of defense (Verberk & Fawcett, 2017). A normal line of defense which

demonstrates what is a normal state for the subject, and a flexible line of defense which is a

protective buffer for the subject’s normal state (Turner & Kaylor, 2015). The flexible defense

might include, social support, hardiness, religion, beliefs, and any other number of variables. If a

stressor is too strong for the flexible line of defense, it will break through that line of defense and

provoke reactions such as stress and illness that are not normal for the subject.

Homeostasis for a subject’s system is continuously in a process of input, output and

compensation creating balance. The Neuman systems model suggests that the subject is in a

dynamic, constant energy exchange with the environment around it (Neuman, 1996). Different

energies, including stressors and variables, affect the balance of a system. When the balance is

thrown off, it means that either the input or output exceeds demand and the compensational

abilities of the system cannot cope or keep up with the demand.

The Neuman systems model focuses on prevention as the primary intervention and then

utilizes secondary and tertiary intervention afterwards. Primary, secondary, and tertiary

interventions focus on preventing stressors, and the responses they elicit, from having negative

effects on the subject (Turner & Kaylor, 2015). Primary intervention takes place before a stressor

effects the subject and prevents a reaction from happening all together. Secondary intervention

takes place after the patient has reacted to a stressor and involves preventing it from getting

worse and causing further damage and then removes the stressor. After a subject has been treated

with secondary intervention, then tertiary intervention attempts to recover the subject to stability

and keeps the reaction from happening again.

THE IMPACT OF COMPASSION FATIGUE 6

The Neuman System Model Theory and Compassion Fatigue

The Neuman systems model acknowledges that there are numerous stressors, all with

different potentials to affect a subject. Those stressors can influence an individual in a constant

setting or abrupt force (Skalski et al., 2006). Work environment, fatigue, sickness, trauma and

stress are a few examples of those stressors. Specifically, increased overtime and workload have

been identified as key stressors that cause compassion fatigue (Maytum, Heiman, & Garwick,

2004). When healthcare professionals do not have enough time away from work to relax and

engage in personal interests then work as a stressor itself has the potential to cause damage.

An adequate nurse workforce is threatened by stressors that cause compassion fatigue.

Nurses work long hours under stressful conditions resulting in fatigue, injury, and job

dissatisfaction (Stone, Hughes, & Daily, 2008). If a subject’s flexible line of defense cannot

buffer the intensity of these stressors they can elicit certain responses, such as quitting. The

Neuman system model suggests that the flexible line of defense is easily broken depending on

the number and intensity of stressors (Neuman, 1996). Dissatisfaction, fatigue and injury are

some of the many stressors that may provoke such a response as quitting, and lead to a declining

nurse workforce.

Patient safety is threatened as a result of compassion fatigue. Safety is one of the most

important feelings that a patient wants and needs to have when inside a healthcare facility. This

safety is compromised when healthcare professionals are not mentally or physically healthy. The

probability of health care provider based medical errors increases substantially when their own

needs are not being met (Stone, 2008). When health care professionals have needs that are not

met, their internal environments cannot compensate for the demands required thus throwing

them out of balance. Maintaining a healthy balance is a key competent in dealing with stressors
THE IMPACT OF COMPASSION FATIGUE 7

in the Neuman systems model (Turner & Kaylor, 2015). An imbalanced internal system makes

providers more susceptible to compromising patient safety by inadequate care, medication errors

or misdiagnosis.

Compassion fatigue is a result of imbalanced or overwhelming stressors. The Neuman

systems model aims to treat this issue with primary, secondary and tertiary interventions

(Neuman, 1996). The Neuman systems model views primary prevention as the first action to

dealing with stressors. Primary preventions goal is to prevent injury and complication before

they can happen by preventing exposure or opportunity to the causative agent (Jansen et al.,

2017). Compassion fatigue, like other injuries or complications has a causative agent which are

stressors. Primary prevention is the primary focus in dealing with those stressors. If this is

ineffective or ignored, then secondary and tertiary interventions are used.

Research Methods

Decreased prevalence of compassion fatigue in the healthcare system will lead to

increased patient safety, patient care, and a decrease in the nursing shortage through primary

prevention. The Neuman systems model identifies stressors as a key component, as well as

primary prevention as a way to deal with stressors. As stressors that cause compassion fatigue

are identified then primary prevention strategies can be constructed to prevent compassion

fatigue and the phenomenons that result from it such as medication errors, compromised safety,

and a diminishing nurse work force.

Research Design

This study will be a quantitative study using a correlational design. Quantitative research

utilizes a controlled design to evaluate phenomena through precise statistical data (Rutberg &

Bouikidid, 2018). Quantitative studies require a large number of participants in order to give
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statistically relevant information. They can be used to evaluate and make generalizations about

the population of interest and suggest a final course of action. A correlational design examines

the relationships among variables (Grove, Gray, & Burns, 2014). In evaluating phenomena, it

can connect certain variables together suggesting that a causal or influential relationship may

exist by identifying positive and negative correlations. These studies frequently use

questionnaires, poles, and surveys to obtain their information and data. A quantitative

correlational design was selected for this study for several reasons. This design will help identify

relationships between stressors that cause compassion fatigue. It will also identify any positive or

negative correlational relationships between those stressors and medication errors, compromised

patient safety, and the diminishing nurse workforce.

Research Population

The research population for this study will be registered nurses in the state of Idaho. The

state of Idaho was selected to maintain a geographically enclosed area with the same state

nursing regulations and for geographical efficiency of the researchers. This study will include

nurses who have worked a minimum of two consecutive years. This is because compassion

fatigue is a condition that results from a buildup of stress over an extended period of time.

Nurses not having worked a sufficient amount of consecutive time may not have worked long

enough to experience compassion fatigue or some sort of reaction to prolonged stressors. This

study will include nurses who are work full time. Nurses who work full time are more constantly

exposed to the stressors leading to compassion fatigue that want to be identified and are more

likely to work extended hours of overtime.

Registered nurses who have been diagnosed with a mental illness prior to working as a

nurse will be excluded from the study. It is common that compassion fatigue can lead to mental
THE IMPACT OF COMPASSION FATIGUE 9

illnesses which is a point of interest in this research. But, nurses who already have a mental

illness have other variables affecting their stability which could skew the desired results and data

in this study. Nurses who work in family practitioner offices, the operating room, and clinics are

excluded from the study. Nurses in these settings are excluded from the study because these

environments are often slow paced, without emergency or trauma situations, and eliminate many

of the stressors that lead to compassion fatigue that will be evaluated. Nurses working on their

own research at these hospitals will be excluded from the study. Nurses involved in research are

not specifically providing individual patient care which is needed in this study because focusing

on research rather than individualized patient care will take away from experiencing the stressors

that lead to compassion fatigue. This study will require a large sample size to acquire sufficient

data. This study will require 1,200 nurses to participate. For the purpose of the study, the first

1,200 participants to respond will make up the data sample and further information from

respondents will not be included in the evaluation.

Methods and Measurements

The method of research for acquiring data in this research will be a survey. The

researchers will collaborate with hospital administrators and the IBR committee in each hospital.

The survey will then be given to nurse managers and the survey will be sent to all nurses within

those hospitals who meet the inclusion and exclusion criteria via email with a link that will take

participants to a secure site with a Qualtrics survey. The survey will then be submitted by

participants and collected, and the data compiled. The survey will consist of questions requiring

the participant to answer yes or no and the use of Likert scales. Data will be measured and

evaluated by recording the answers from each survey and tallying up the numerical data. The
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compiled data will then be statistically analyzed, and statistical correlations will be identified

along with any trends and patterns.

Ethical Considerations

Informed consent will be obtained by facility directors and individual participants within

the facilities. Informed consent requires that the participants in the study understand how and

why the study is being performed (Grove et al., 2014). Nurses in this study are the population at

risk for not being properly informed of the purposes and methods of the study. In order to

eliminate this potential error, prior to participating, participants in this study will understand

exactly how this study will be performed. They will know who is conducting the study and what

the data collected will be used for. They will know exactly how the study will affect them and

what the potential risks are of participating in the study. Participants will be allowed to ask any

questions they desire and will be given any information about the study that they need. Each

participant will need to verify understanding of the instruction about the study and sign a consent

form in order to participate in the study.

Confidentiality will be provided to all facilities and participants included in the study.

Confidentiality is the safe management of information in order to maintain autonomy of

participants (Grove et al., 2014). Nurses and hospitals in particular will be sharing personal

information and are at risk in this study which puts them into potential risk as well. Many

healthcare facilities and nurses may decline to participate in the study if they feel that shared

information can be linked back to them as it may hurt their reputation and business. Likewise,

employees may not be willing to participate and may not be honest with the information they

provide if they feel like their input might be traced back to them and affect their careers or social

environment. To ensure confidentiality of those involved, no names of facilities or participants

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will be mentioned in the study. The survey will be submitted to a secure website after completion

that only the researchers have access to. Confidentiality of both the facilities and participants will

be maintained in this manner.

Beneficence is a priority in this study aimed at improving patient care and improving

conditions for working nurses. Beneficence is working for the improvement of those being

studied and above all, doing no harm (Grove et al., 2014). Nurses are the participants being

studied in this researched which puts them at greatest risk of being harmed in this study. In this

study participants will be treated with respect and no actions that may harm them as a result of

the study will be taken. The aim for beneficence in this study is to identify information allowing

for the decrease of stressors leading to compassion fatigue. This will lead to the improvement of

patient care and safety and the decrease in the nurse work force.

Annotated Bibliography

Abbaszadeh, A., Elmi, A., Borhani, F., & Sefidkar, R. (2017). The relationship between

“compassion fatigue” and “burnout” among nurses. Annals Of Tropical Medicine &

Public Health, 10(4), 869-873.

These four authors are colleagues at the Shahid Beheshti University of Medical Sciences

in Tehran, Iran. They all work in the School of Nursing and Midwifery as instructors.

They conducted a qualitative study using a descriptive correlative design to distinguish the

relationship between burnout and compassion fatigue among nurses working in ICU units

within different hospitals in Tabriz, Iran. A strength of this study was the resemblance of

the sample population to the actual population. They used two-stage cluster sampling to

obtain the sample population for the study to ensure that an equal number of nurses from

different hospitals were randomly selected. One weakness of this study was the small
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sample size selected to participate in the study. 191 participants were selected which is

minor to the high number of participants that a descriptive correlational study requires.

This is a high-quality study because it is easily replicable and the methods in the study are

clear and uncomplicated. It can also be easily generalized to the broad population of

nurses because the sample was taken from many different hospitals rather than from just

one or a few. This study can be used by hospitals and clinics that employ nurses by

helping them predict compassion fatigue and burnout within their facilities and make

adjustments to prevent it. The intended audience for this study are hospital administrators,

instructors, and nurses. The link between this study and the impact of compassion fatigue

is that as identification of compassion fatigue is identified and acknowledged more often,

then the negative effects that it will have on patient care will decrease.

Lobo, V. M., Ploeg, J., Fisher, A., & Peachey, G. (2017). Critical care nurses’ perceptions of the

outcomes of working overtime in Canada. Nursing Outlook, 6(15), 400-410.

These four researchers have their doctorate degrees and work at McMaster University in

Hamilton, Ontario, Canada. They all work as clinical lecturers in the School of Nursing

and Dr. Ploeg is the scientific Director of the Aging, Community and Health Research

Unit. This study is a qualitative study using an exploratory design to interview 28 full-time

nurses who work in critical care. The purpose of the study was to explore and evaluate

critical care nurses' perceptions on the outcomes of working overtime. The sample

population of nurses from critical care units were selected from 11 different hospitals in

Ontario, Canada. A strength in this study is that participants were taken from 11 different

critical care units to sample a wider population and evaluate diverse perceptions in

different locations. A weakness and limitation in this study is that qualitative data was
THE IMPACT OF COMPASSION FATIGUE 13

received by self-report in interviews. This may have made participants reluctant to report

the negative outcomes and mistakes that resulted from their own. This is a high-quality

study because the results have a greater transferability and can be generalized more easily

because of the larger diversity of hospitals that participants were selected from. The

findings in this study are useful because it provides detailed explanations and testimonials

of experiences from nurses who have directly experienced the negative effects of working

overtime. These findings can help promote a reduction in required overtime work hours

and improve conditions for nurses. The intended audience for this study are facilities that

employ nurses such as hospitals and clinics. This literature links to the impact of

compassion fatigue and patient care because extended work overtime is a key variable in

causing compassion fatigue and facilitating patient care errors.

Saleh, A. M., Awadalla, N. J., El-masri, Y. M.., & Sleem, W. F. (2014) Impacts of nurses’

circadium rhythm sleep disorders, fatigue, and depression on medication administration

errors. Egyptian Journal Of Chest Diseases And Tuberculosis, (63), 145-153.

These four authors are colleagues at Mansoura University, Egypt. They work in different

departments including the Department Chest Medicine and Sleep Disordered Breathing

Unit, Public Health and Community Medicine and the Nursing department. They

conducted a quantitative study using a descriptive cross-sectional exploratory design. The

objective of this study was to explore the impact that nurses’ circadian rhythm sleep

disorders, fatigue, and depression have on medication administration errors. A total of 52

nurses were selected at the Oncology Center of Mansoura University and were given a

series of questionnaires. A strength that this study had was that the results were

meticulously analyzed and organized into easily readable and applicable statistics and
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concluded with a convincing P value with p= 0.02. A weakness of this study was its

relatively small sample size for a quantitative study. Another limitation of this study was

that it was done within a single facility providing little diversity between nurses. This

study is a moderate-quality study because the study lacks diversity with the sample

population inhibiting the results from being generalized to the broad population. The

intended audience of this study are researchers and facilities that employ nurses and will

help them identify the correlation between fatigue, sleep disorders, and depression with

medication errors and compromised patient care. This will help them create new policies

to improve nursing work environments and schedules. This literature links to the impact of

compassion fatigue and patient care because compassion fatigue can lead to medication

errors and encompasses both fatigue and depression as defining characteristics.

Steege, L. M., & Rainbow, J. G. (2017). Fatigue in hospital nurses, “supernurse” culture is a

barrier to addressing problems: A qualitative interview study. International Journal Of

Nursing Studies, 67(4), 20-28.

Dr. Steege and Dr. Rainbow both have their doctorate degrees and work together in the

School of Nursing at the University of Wisconsin. Lindsey leads an interdisciplinary

research team studying human factors and ergonomics in healthcare systems of which

Jessica is a part of. In this study the researchers conducted a qualitative exploratory

design. The purpose of the study was to explore nurse identified sources, barriers to

addressing, and consequences of fatigue. Interviews with participants were done using a

semi-structured interview that included questions allowing participants to expound

on nurse fatigue levels and the consequences of fatigue. One strength of this study was

that the structured design allowed the researchers to obtain exactly the information they
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were looking for. The study allowed nurses to state their emotional position regarding

fatigue in their work and then expound on it. A weak point in this study is its

transferability and population diversity. The study, including its sample population, was

all conducted within the same hospital which makes it difficult to generalize the findings

to other hospitals and settings. This is a high-quality study because it was very meticulous

in following ethical considerations and kept participants’ personal information and

identities confidential. This study can be used by hospital administrators and nurses alike

to identify risks leading to fatigue and how they can prevent it. This study links with

compassion fatigue and patient care because many of the same perpetuating variables that

lead to physical fatigue in nurses also lead to compassion fatigue. Those same variables

that lead to fatigue are risk factors that can decrease the quality of patient care.

Implications

Nursing Knowledge

There is a great deal of knowledge that can be gained as a result of this study. Nurses in

the workforce are overstressed and suffer from both physical and emotional exhaustion which is

already well known. The goal of this study is to pinpoint the causes of that exhaustion and

identify the significant consequences that they have with patient care. After this research study is

conducted, the findings will be suggestive of cause and effect between variables and stressors

that cause compassion fatigue and compromised patient care. The data from the survey that

participants will fill out will allow the researches to make correlations between stressors like,

extended overtime, witnessing disturbing situations, limited self-care, etc., with negative

consequences like medication errors, missed assessments, and other mistakes. This will raise

awareness of the stressors and circumstances in which nurse’s work and what they are expected
THE IMPACT OF COMPASSION FATIGUE 16

to endure on a daily basis. It will also raise awareness of what the consequences are for patient

care that are a result of those stressors.

Nursing Theory

The theory that was used in this study was the Neuman systems model theory. The

Neuman systems model theory focusses on identifying stressors that elicit a negative response in

the subject and then treating the subject with primary prevention strategies (Turner & Kaylor,

2015). The results of this study support this theory because the study will identify the stressors

that elicit negative responses in nurses, specifically compassion fatigue and the delivery of

unsatisfactory patient care. The study will also produce findings that provide a strong basis upon

which further research can be done while still using the Neuman systems model theory. Now that

this study will have identified stressors, the theory can be further used to find which primary

preventions strategies work to prevent these stressors from affecting nurses and ultimately

patients.

Nursing Practice

If this study shows that the stressors that were investigated with the survey are related to

compassion fatigue and compromised patient care then hospitals and facilities that employ nurses

can make necessary changes. First, they will be able to institute policies and programs that help

protect the physical and emotional wellbeing of nurses. Some of these may be limitations on the

amount of required overtime that nurses can work, workload size given to each individual nurse

while working, company provided counseling programs for employees who witnessed traumatic

events and who are emotionally stressed, increased amount of paid time off, or other beneficial

policies. Second, facilities and nurses will be more conscientious of the impact that stressors

have on patient care. Facilities and nurses alike will be able to identify stressors that they are
THE IMPACT OF COMPASSION FATIGUE 17

subject to that could elicit future responses. With this foresight in mind, they will be able to

adapt accordingly and make necessary changes in order to prevent inadequate patient care.

Improved Patient Care

This study will improve patient care by increasing patient safety. As changes are made to

improve stress levels for nurses and decrease compassion fatigue prevalence, then the amount of

compromised safety incidences for patients will decrease. For example, medication errors will be

less likely to be made by nurses who are sleep deprived and exhausted. And important symptoms

of patients will not be missed because their nurses are overwhelmed with their workloads which

decreases the amount of time they have to preform thorough assessments. The amount of safety

that is provided to patients by nurses will increase as nurses are more mentally and physically

equipped to do so by their own circumstances.

This study will improve patient care by promoting quality care. If changes are made to

prevent stressors among nurses, then patients will also recover from their original diagnosis and

illnesses much faster and more efficiently. Nurses who are being affected by fewer stressors and

who have more energy are much more likely to provide proficient medical care and go the extra

mile for their patients. Nurses will put more effort into making sure that patients are recovering

the best they possibly can and are as comfortable as they can be. Patients will recognize that they

are receiving quality care and that the nurses are doing everything they can for them which

increases both patient outcomes and satisfaction.

This study will also promote more cost-effective care to patients. The human body can

sometimes only recover as fast as it is allowed to. As nurses are able to provide more quality care

and make less mistakes then patients will recover faster. Taking that into account, patients who

recover faster don’t need to stay in the hospital as long and will spend less money for prolonged
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hospital or medical facility stays. Also, patients who receive more quality care with certain

treatments will recover quicker and will result in the need to pay for less treatment.

Recommendations

A recommendation that would also be effective in identifying which stressors cause

compassion fatigue and decrease quality patient care could be done through a qualitative

exploratory study. In this study it would be beneficial to select a sample of nurses from a wide

range of locations to provide variety. Then their experiences, opinions, and data would be

recorded directly in semi-structured interviews. This would allow participants to voice openly

and directly about what they think the biggest stressors are in their lives and work environments.

They would be able to describe how those stressors affect their work and their own quality of

patient care. This would give more detailed information about certain stressors and possibly

provide new stressors that have not been previously recognized.

This study was performed for the improvement of nurse conditions and patient care, but

the results can transfer to other departments and professions. Compassion fatigue and the

stressors that cause it are not only found in nursing practice. The same stressors can affect all

caregiver professions including CRNAs, doctors, physical therapists, etc. The results of this

study may be applied to these professions as well because these individuals work much of the

same hours, in the same environments and circumstances, and are employed by the same

facilities. Because the results of this study are so transferable to these professions they may be

used in the same way to improve the quality of those professions and the patient care they

provide.

The results of this study can be implemented in many ways. The main desired implication

of this research is to decrease compassion fatigue in nurses by eliminating or diminishing

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stressors that they deal with. Consequently, it is hoped that facilities that employ nurses will use

this research as a basis and influence to develop policies and programs to reduce the prevalence

of compassion fatigue. After this is done patient care will improve as a result, but the physical

and mental health needs of nurses are what needs to be addressed first. As facilities address the

stressors that cause compassion fatigue then the nurse profession satisfaction will increase and

hopefully influence others to pursue the nursing career.

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