Without any doubt, the main aim of the hospital professionals and caregivers is to provide an effective treatment for the patients with showing devotion to others. However, an excessive medical care and nurse’s support can cause the exhaustion, tiredness, chronic physical ailments (stomach upset or back pains), and inability to cope with mental troubles and burnouts in the inner world. It will lead to the condition that is known as “burnout” or “combating compassion fatigue.” Historically, compassion fatigue or “cost of caring” was distinguished in 1950s as a stress disability, firstly among the nurses who were giving the care in the period of the crisis. According to the definition, combating compassion fatigue is a gradual reduction of a person’s ability to provide compassion. Moreover, combating compassion fatigue is characterized as a disorder that can result in emotional, physical, and spiritual depletion of the health professionals.
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In the medical history, the scholars identified combating compassion fatigue with the combination of following disorders, such as a secondary traumatic stress, burnout, secondary victimization, emotional hijacking, vicarious traumatization, and cumulative stress. Secondary traumatic stress is a condition when a caregiver feels the same trauma in the personal life as a patient. There is a feeling of the same experience that have deeply wind such emotional states of the caregiver as physical and emotional abuse, homelessness, and disease. Burnout is a subtle process that is characterized by the apathy for the job. According to Maslach (1982), “Burnout is a disorder that has the features of emotional exhaustion, reduction of personal accomplishment, and depression that can occur among caregivers.” Moreover, Wright (2003) identified burnout as personal discouragement when the healthcare providers cannot reach their unrealistic goals, and feel depletion of their energy. Potter (1998) paid attention to five work situations that have an impact on the rise of burnout: ambiguity (shortage of clear goals), no-win situations (the manager shows a negative attitude to nurse’s job), role overload (incapacity to object with the manager in order to reduce the responsibilities and work orders), role conflict (inability to recognize major and minor working duties), job dissatisfaction (it occurs when the nurses feel underpaid and disrespect to their own efforts). Secondary victimization is described as a disorder characterized by care providers’ feelings of experiencing the victim’s emotional, physical, or sexual abuse. However, they did not have this experience first-hand. Emotional hijacking, or amygdala hijacking, is a condition when the patient’s feelings and emotions deeply influence the caregivers. Vicarious traumatization is a state when the healthcare professionals feel the trauma of the patient second-hand. Finally, cumulative stress is a condition when the care providers feel heavy workload, poor communication, lack of basic comforts, and inability to take a rest.
It is generally true that there are five major concepts of compassion fatigue: physical exhaustion, emotional exhaustion, apathy, depression, and impaired judgment. Physical exhaustion is a condition when the care provider always has a feeling of physical drained, even at the rest time. For example, the health professionals may feel headaches, induced migraines, problems with stomach etc. Sherman (2004) pointed out that physical exercises, fresh air, meditation, massage therapy, and acupuncture will be helpful tools in the melioration of physical conditions. Emotional exhaustion is the state of isolation from the society, family, and friends. In this condition, the nurse can feel low spirits that can be followed by bad appetite, feeling of fault, self-murder thoughts, difficulty imagining that there is a future, and with sleeping. According to Sherman (2004), “Emotional health can be considerably improved by the peaceful thoughts and a calm mind.” Apathy is a lack of interest that the caregivers show to their job, patients, colleagues, and family. The scientists recommend laughing, thinking positively, and interacting with optimistic people every day, while these will lead to improvement of the emotional health. Depression is characterized by the feeling of the person’s negative attitude to himself/ herself and disappointment of self-realization. Impaired judgment is a condition when the nurse cannot express personal point of view or contradict with the manager’s orders.
It is worth mentioning that the coping strategies that are helpful in handling work-related stress. Recreative, reconstructive, and revaluating are the most common coping strategies. The recreative strategy is a transformational strategy that shows to what extent the spectrum of the handling the stress in the hospital is broad. This strategy is used at both work and home when the nurse feels comfortable in the showing negative feelings. The reconstructive strategy is used on the individual level when the existential questions are asked. In this case, the person who suffers from the stress, the event that has caused this stress, and the sacred are reconstructed. The revaluating strategy is employed in the framework of the relations between the hospital and the nurse, and between the nurses and their personal life. Moreover, the scientists distinguish boundary demarcation strategy that includes two subclasses ventilation and caritas oblivion coping strategies. It is necessary to point out that the recreative, reconstructive, and revaluating coping strategies were found on the individual level. To counterbalance it, the boundary demarcation strategy refers to the organizational level in which the nurse’s stress is explained through the concept of the “triple” relations between the nurse, patient, and the hospital. For instance, while applying the boundary demarcation coping strategy, the nurse is allowed to forget the patient who has died in order to provide the effective care for the new patient. Furthermore, one of the most frequent strategies is a religious coping strategy. The special place in this strategy occupies the prayer. According to psychoanalysis, the role of the prayer can perform the ego of the nurse. It can be amplified by the fact that the inner world of the nurse feels the special necessity to pray for the patients. For instance, while walking to the work the nurse can pray for the quick and complete cure of the patient. In this case the role of pray is fundamental, since it helps to manifest the professional role of the nurses and their vitality in the healthcare system.
Undoubtedly, the medical professionals should revitalize personal attitude to work and to patients in order to reduce the stress and fight against combating compassion fatigue. The first step that should be taken is a change. The person should change personal attitude to the situation that has caused burnout, and to people who have influenced the deterioration of the health. According to Martin (2002), “The personal power is very vital, since it helps to control professional and personal life in order.” Moreover, the healthcare providers should put the realistic goals in accordance to their work and after their realization; the medical workers feel job satisfaction. Raiger (2005) noticed that trustful relations, healthy communication, and respect will significantly foster the healthy surrounding for the care providers and protect against stresses. Additionally, the healthcare professionals should avoid negative communication and gossips, change their thinking process, and practice forgiveness. It is generally true that negative attitude, communication, and thinking lead to disaster on the psychological level, and collapse of the nervous system. On the contrary, the person should have positive affirmations, such as “I know that I can handle this,” or “I am sure I can do it.”
All in all, combating compassion fatigue is the emotional and physical fallout that can cause drug and alcohol addiction, depression, hatred to oneself, self destructiveness, and suicide among healthcare providers. In order to reduce the stress the care givers should find the reconciliation of own psychological spheres such as id, ego, and alter ego that will harmonize the process of work, thinking, self-satisfaction, and realization.
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