整形外科とリハビリテーションのジャーナル

抽象的な

Burnout, Compassion Fatigue and Vicarious Trauma

Ruth Lourens

 Compassion Fatigue (CF) in healthcare workers was first coined by Carla Joinson in 1992, in almost three decades following copious amounts of research have been done on this subject. Findings of the research indicate an astronomical growing problem, yet very little has been done to curb this problem. Today researchers agree that one of the major causes of compassion fatigue in nursing is a lack of education. Nurse’s education doesn’t include subjects dealing with self-care, burnout, vicarious trauma, and CF. Francoise Mathieu, an expert on CF, notes that after completing her degree and several courses in three different countries, she had not once heard the words selfcare, burnout, and CF, and nor did I until it happened to me “Burnout is a depletion or exhaustion of a person’s mental and physical resources attributed to his or her prolonged yet unsuccessful striving toward unrealistic expectations, internally or externally derived” Burnout is not trauma related and could happen to anyone in all walks of life Vicarious Trauma (VT), also known as Secondary Traumatic Stress, describes a serious shift in the worker’s worldview. VT happens when the trauma and suffering of others are transferred onto us in such a way that we are also traumatized even though we did not experience the trauma ourselves. “VT is the accumulative process: we are not referring to the most difficult story you have ever heard; we are talking about the thousands of stories you don’t even remember hearing” CF is the deep emotional and physical erosion that occurs when helping professionals are unable to refuel and regenerate. “First, you should understand that it’s a process. It’s not a matter of one day, you’re living your life with a great deal of energy and enjoyment, and the next, you wake up exhausted and devoid of any energy-both physical and emotional. Compassion fatigue develops over time-taking weeks, sometimes years to surface. It’s a lowlevel, chronic clouding of caring and concern for others in your life whether you work in or outside the home. Compassion Fatigue and COVID-19 The C19 Pandemic has highlighted the importance of nurses, something that has always been true but has gone unappreciated for centuries. In doing research for this article I am again amazed at the amount of research that has been done to date on the effect of C19 on nurses, if all we are doing is research, we are missing the point! Another aspect of the research that I found incredible, is that most of the research done focuses on ICU nurses even though a study was done at a hospital in Wuhan comparing the frequency of burnout amongst frontline workers, clearly indicate that burnout frequency amongst ward nurses are significantly higher than ICU nurses, 39% versus 13% [2]. This was a small study of 220 frontline workers but the fact that the burnout frequency is 300% higher inward nurses should command our attention. Watching C19 related news coverage I have been struck by the lack of coverage of nursing fatalities. Physician’s deaths were headline news, interviews with family and colleagues, and then as an afterthought, oh yes, X number of nurses died. Nurse’s deaths where/are rarely a focus on the news and many nurses have taken to social media in an attempt to bring attention to the problems they are facing, as a 35- year veteran RN I find this disrespectful and so should all the nurses out there.

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