Abstract This quasi-experimental design study compared two small samples of Emergency medicine residents after one group had an educational intervention on death notification skills and the other did not. Comparisons were made on residents’ confidence in their communication, interpersonal skills and level of compassion fatigue/satisfaction and EM Residents’ level of Secondary Traumatic Stress after an event of patient death and subsequent notification of Secondary Patients. Residents were interviewed to gather recommendations for designing death notification curriculum. Over an eight month period, forty emergency medicine residents at two sites, control and intervention, completed surveys designed to provide quantitative data on self-confidence and stress related to recent patient deaths. Residents who participated in a death notification event completed the Secondary Traumatic Stress Scale. Interviews were conducted to gather information on the impact of the notification and recommend changes in curriculum at the experimental site. The data infer that an educational intervention on death notification skills increased residents’ confidence in their ability to give compassionate death notification to families as compared with the control group. Residents in the intervention and control group had no significant differences in their potential for compassion satisfaction. Residents who had the educational intervention showed less Secondary Traumatic Stress symptoms than their non-intervention counterparts. The intervention group showed less risk for burnout (although it would only be significant at p < 0.10). The overall conclusion is that there is some evidence for a positive effect of the intervention. However, due to the small sample size the conclusion is tentative and more research is needed to evaluate the training.

Purpose: Describe the meaning of compassion fatigue (CF) as experienced by the U.S. military registered nurse (RN) post-deployment from Iraq and Afghanistan. Background: CF is characterized by deep emotional and physical exhaustion, and may resemble posttraumatic stress disorder (PTSD). Often this causes a shift in confidence and clouds RN perceptions. Symptoms include difficulty concentrating, intrusive imagery, hopelessness, exhaustion, and irritability leading to profound alterations in one's view of the world, patients, family, and friends. Outcomes include depersonalizing patients, poor coping mechanisms, lowered standards, clinical errors, and blurring boundaries, all can contribute to a toxic work environment and RNs leaving the profession. Method: Hermeneutic phenomenological methodology facilitated a description of CF in words and meaning expressed by U.S. military RNs (i.e., Army, Navy). The sample was obtained through the snowball method and aided by key informants. Data were collected through interviews and observations with each active duty or reservist RN (N = 8) on three occasions. Participants described their military and nursing backgrounds and experiences of CF through hermeneutic interview. Analysis was ongoing during the interview process and included continual questioning, reflecting, and validating. This process allowed for understanding through engagement of text (e.g., dialogue, transcriptions). Journaling and self-reflection assisted with trustworthiness. Findings: Participants shared many experiences. While some had unique experiences, their feelings and perceptions resonated with other participants and informed the emergence of four shared meanings and shared concerns: (a) the term CF does not fit me, manifested by expressions of the meaning of CF; (b) compassion fatigue as all encompassing, manifested by physical, emotional, relational, and spiritual experiences; (c) compassion fatigue will not interfere with my military duty, manifested by the pervasive military lens that the meaning of the experiences are filtered, and (d) compassion fatigue affects people long after deployment . . . gone, but not forgotten, manifested by the lasting effects of CF. Implications: While CF among military RNs has many similarities with the general nursing population, the practice environment appears to create additional triggers and manifestations. This study provides an understanding of the progression of CF in this population. Implementing interventions before and after trauma exposure can preserve the care in military caregivers.

I och med den utvecklade tekniska utrustningen överlever allt fler patienter som drabbats av trauma. Därför är det stor sannolikhet att vårdpersonal under sitt arbete kommer i kontakt med dessa patienter. När vårdpersonalen är i kontakt med patienter som drabbats av trauma är det många gånger omöjligt att själv bli påverkad. Detta kan leda till att vårdpersonalen själva får liknande symptom som patienten. För att undvika framtida obehag är det av överordnad betydelse att vårdpersonalen har kunskap om att omhändertagande av traumatiska patientfall på arbetsplatsen kan komma att påverka vårdpersonalens egen kropp och psyke samt hur vårdpersonalen kan lära sig uppmärksamma dessa symptom. Syftet med uppsatsen är att med hjälp av Evans (2003) metod för att analysera kvalitativa artiklar beskriva vårdpersonalens upplevelser av att utsättas för traumatiska händelser på arbetet. Resultatet består av tre huvudteman. Den första behandlar upplevelser av att vara i kaos, med underteman: upplevelser av triggers som utlöser stress, upplevelser av att känna moralisk plikt, upplevelser av övergivenhet samt upplevelser av att inte räcka till. Tema två berör att reagera på den traumatiska händelsen och behandlar att märka av somatiska och psykiska symptom, upplevelser av att bli alltför personligt involverad, upplevelser av skam och skuld samt att distansera sig. Tredje temat berör att bemästra den traumatiska händelsen och handlar om strävan att upprätthålla balans i livet. Resultatet visar att vårdpersonalens upplevelser stämde bra överens med aktuell forskning, att det finns ett stort behov av att bearbeta traumatiska händelser samt arbetsgivarens möjlighet att fånga upp vårdpersonalen innan de mår alltför dåligt. / <p>Program: Sjuksköterskeutbildning</p><p>Uppsatsnivå: C</p>

Social workers in child protective services often handle hundreds of cases regarding children traumatized by abuse and/or neglect. In time, social workers' experiences can become emotionally and psychologically challenging. A problem for supervising child protection social workers (SCPSWs) is that they might experience the same challenges; however, there was no research that described the lived experiences of SCPSWs. This phenomenological study explored the lived experiences of SCPSWs. Conceptually, constructivist self-development theory (CSDT) provided the framework for understanding how SCPSWs managed their lived experiences and the issues related to them. Ten SCPSWs volunteered their time for face-to-face interviews and provided data for this study. Saldana's coding manual was used to guide the identification and coding of key words and phrases. SCPSWs experienced occupational trauma in the form of vicarious trauma, compassion fatigue, secondary traumatic stress, and/or burnout similar to that experienced by front line workers. SCPSWs' experiences required them to set boundaries, stop taking work home and support each other in the workplace. Enhanced resources for training on self-care plus increased administrative and peer support could potentially improve the lives of these SCPSWs and increase their longevity and effectiveness in the workplace. Retaining experienced supervisors also has the potential to promote positive social change by improving the support supervisors can provide to front line staff, thus indirectly helping children, families, and communities they serve.

Compassion fatigue is a secondary stress reaction that results from providing care to those undergoing traumatic life events. Frequent exposure to dying patients with complex medical concerns has been identified as a contributing factor to compassion fatigue and resultant turnover among hospice nurses. The purpose of this project was to assess whether the provision of education to hospice nurses regarding compassion fatigue resulted in a demonstrable improvement in their levels of compassion fatigue. Watson's theory of human caring and Roy's adaptation model provided the theoretical foundation for this project. The practice-focused question for this project asked whether a reduction in compassion fatigue among hospice nurses would result after providing them with educational material focused on compassion fatigue. Twenty-three hospice nurse participants were administered Stamm's Professional Quality of Life Scale to measure their compassion fatigue levels before and after being presented with an educational booklet. Scores for this project were compared using a before-and-after quality improvement design and percent difference to measure the impact of the educational offering. Results demonstrated an 8.6% reduction in compassion fatigue among the hospice nurse participants, indicating that educational interventions support a positive effect in reducing compassion fatigue. Positive social change might result from this project by improving nurses' awareness of the need for self-care that contributes to resiliency and prevention of compassion fatigue.

Few existing studies have examined compassion fatigue among emergency responders even though firefighters and emergency medical service (EMS) professionals have repetitive direct exposure to traumatic events. This study focused on identifying predictor variables for the development of compassion fatigue in firefighters. Karasek's demand-control model, a commonly used work stress model, was the study's theoretical framework as it focuses on specific construct interactions that predict employee well-being. Accordingly, this correlational study examined the predictive nature of EMS license level, years of service, and personality type on the development of compassion fatigue in career firefighters. Data collection occurred with surveys incorporating the Professional Quality of Life Scale and the Big Five Inventory. Mid-Michigan fire departments participated with 129 career firefighters returning completed surveys with results analyzed using logistic regression. Findings revealed a significant predictive relationship between personality traits and the development of compassion fatigue. These findings can inform preventative measures that protect the psychological well-being of these emergency responders by informing and educating the professionals and organizations as to who is at greatest risk and ultimately providing opportunity for risk mediation.

Thesis (M.A. (Clinical Psychology) --University of Limpopo, 2008 / Police members of the South African Police Service (SAPS) work under constant physical, emotional and psychological stress due to the demands of their work. It is possible to assume that this profession could be more susceptible to trauma, depression and suicide ideation than a less demanding profession. The increase in suicides within the SAPS in the past years has created great concern worldwide. The literature review contributes to the understanding of vicarious trauma by providing evidence of its widespread existence and the impact on all professions that deal with trauma victims, as do the SAPS. A need for further research was highlighted. The aim of the study was to determine the prevalence of vicarious trauma within the SAPS; how rank, marital status, education, duration of service and workload affect the existence of vicarious trauma; and how the experience of vicarious trauma affects the lives of the SAPS member . A quantitative study was done with a sample comprising of 60 SAPS members from the Limpopo Province (Lebowakgomo and Mankweng stations). The inclusion criteria included: participants (both permanent and voluntary) had to be active, field working members of the SAPS and had to be in direct association with trauma victims. The conceptual framework: T rauma Theory guided the description and interpretation of the data. Findings revealed that there exist, at present, high levels of vicarious trauma within the SAPS. The duration of service and the marital status of the individual were found to have an influence on the existence of compassion fatigue, while rank, workload, education level and gender were found to have no direct relationship to the presence of vicarious trauma. Finally , this study concludes with recommendations for future studies into vicarious trauma within the SAPS.

Thesis (Ph. D.)--Brigham Young University Dept. of Marriage and Family Therapy, 2006. / Includes bibliographical references (p. 60-64).

This dissertation was an exploratory research study using a cross-sectional survey design to examine the impact of ecological, environmental, psychological, and financial hardship on counselors of the U.S. Gulf Region. Since 2005, the U.S. Gulf Region, unlike any other region of the United States, has faced multiple disasters including Hurricanes Katrina, Rita, Ike and Gustav (Walsh, 2010), the Great Recession (Conant, 2010), and the largest ecological disaster in the history of the United States, the BP Oil Spill (Gray, 2010). The purpose of this study was to explore the attitudes and characteristics of counselors in one U.S. Gulf State, specifically Mississippi, to obtain valuable information about compassion fatigue and compassion satisfaction of counselors as measured by the Professional Quality of Life (ProQOL) (Stamm, 2009). The researcher used a demographic survey and the ProQOL (Stamm) for analyses. The researcher collected the ProQOL (Stamm) sub-scale scores of 282 Mississippi counselors who attended the 60th Annual Mississippi Counseling Conference. The counselors recorded high compassion satisfaction scores, low burnout scores and low secondary traumatic stress scores. Additionally, the researcher used one-way MANOVAs to examine the main effects of counselor characteristics such as educational level, gender, geographic location, self-care methods, and years of experience on the ProQOL (Stamm) sub-scale means of compassion satisfaction, burnout, and secondary traumatic stress. The researcher found two statistically significant differences in gender and years of experience. Male participants’ burnout and secondary traumatic stress scores were significantly less than female participants’ burnout and secondary traumatic stress scores. Participants with 1-10 years of experience recorded statistically significant higher burnout scores and lower compassion satisfaction scores than participants with less than one year of experience, 10-20 years of experience, and more than 20 years of experience. In contrast to assumptions related to the ecological, environmental, psychological, and financial hardship present in this region, high levels of satisfaction was found in counselors who serve this region. The researcher found that despite the impact of these multiple traumatic events these counselors were satisfied with their work.

Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2009. / Includes bibliographical references (p. 99-102).