Nurses' perceived and actual caregiving roles: identifying factors that can contribute to job satisfaction.
To compare nurses' caring expectations with their caregiving experiences and to identify factors that could potentially be included in a preliminary conceptual model of job satisfaction and compassion fatigue.
Nurses often report emotional reward and satisfaction in their profession from compassionately caring for sick and injured patients. However, being in close proximity to trauma can eventually deplete a nurse's compassion and empathy for the patients they care for. This loss of compassion is further exacerbated by demanding work environments that involve administrative duties, attending to patients' psychosocial needs and interacting with patients' families. To date, the literature has tended to focus on pathology of compassion fatigue, rather than identifying its contributing factors.
A grounded theory approach was used to identify emerging themes in nurses' accounts of their caregiving roles.
Open-ended interviews were conducted with nurses (n = 9) who were employed by a maritime district health authority for a minimum of five years. Interviews focused on beliefs of how to provide care, perceived caregiving responsibilities and perceived challenges in the provision of care.
Emerging from the data is a proposed model of job satisfaction. The concepts of monitoring and patient advocacy appeared to be key components in reported satisfaction or alienation. Discrepancies were found between care expectations outlined by management and nurses' perceptions of care provision. Additionally, type of nursing education was related to nurses' confidence in applying nursing skills.
These findings have implications for training programmes, hospital management and quality of patient care.
It is important to identify factors that could explain resilience to compassion fatigue because compassion fatigue has negative consequences not only for nurses themselves but for the patients in their care.
Morrison KB
，Korol SA
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Insights on compassion and patient-centred nursing in intensive care: A constructivist grounded theory.
To explore patient-centred nursing, compassion satisfaction and compassion fatigue from intensive care nurses' perspectives.
Compassion satisfaction and compassion fatigue can influence critical care nurses' decisions to either continue or leave the profession, and could impact the compassionate patient-centred nursing care patients receive during their ICU admission.
This qualitative research design was informed by Charmaz's Grounded Theory Constructivist methodology.
In-depth interviews were conducted with 21 critical care nurses of two ICUs in Australia during 2016. Interview data were analysed using grounded theory processes.
Findings reflected positive and negative impacts on critical care nurses' ability to deal compassionately with their patients. Effects on patient-centred nursing and critical care nurses' own well-being were revealed. A core category of "Expectations" emerged, explaining the tension between critical care nurses' biomedical, clinical skills and knowledge versus compassionate, patient-centred nursing care. This tension was clarified and expanded in subcategories of "Life in the Balance," "Passion and Pressure," "Understanding and Advocacy" and "Tenacity and Fragility".
Providing patient-centred nursing may enhance critical care nurses' experience of compassion satisfaction, in turn impacting delivery of compassionate patient-centred nursing to generate a virtuous circle. Critical care nurses who feel respected and supported by their management team and colleagues experience feelings of compassion satisfaction, leading to greater engagement and care towards their patient.
Systematically addressing critical care nurses' needs to successfully balance biomedical with compassionate nursing care may lead to greater well-being in the critical care nursing workforce and improve patient experience of intensive care.
Jakimowicz S
，Perry L
，Lewis J
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Work environmental factors associated with compassion satisfaction and end-of-life care quality among nurses in general wards, palliative care units, and home care settings: A cross-sectional survey.
Nurses providing end-of-life care experience not only burnout and compassion fatigue, but also positive effects such as compassion satisfaction. Nurses' compassion satisfaction was shown to be related to job satisfaction, work engagement, and nurse caring. Studies in emergency departments, intensive care units, oncology wards, and general wards have identified work environmental factors associated with nurses' compassion satisfaction, but no similar studies have been conducted in palliative care units or home care settings. It is also unknown whether work environmental factors associated with compassion satisfaction contribute to end-of-life care quality.
To explore work environmental factors associated with nurses' compassion satisfaction and end-of-life care quality in three types of workplaces: general wards, palliative care units, and home care settings.
A cross-sectional survey of nurses providing end-of-life care.
Sixteen general wards, 14 palliative care units, and 25 home-visit nursing agencies in Japan.
There were 347 study participants: 95 nurses in general wards, 128 in palliative care units, and 124 in home care settings.
Compassion satisfaction was assessed using the Professional Quality of Life Scale, and end-of-life care quality was rated on a 4-point scale. Work environments were assessed using the Areas of Worklife Survey, which measures the fit between an individual and their work environment in six areas: workload, control, reward, community, fairness, and values.
Compared to nurses in general wards and palliative care units, home care nurses scored statistically significantly higher on all work environmental factors except reward. Work environmental factors that were significantly positively associated with higher compassion satisfaction were values in general wards (β = 0.335, P = 0.007), reward and workload in palliative care units (β = 0.266, P = 0.009 and β = 0.179, P = 0.035), and community and control in home care settings (β = 0.325, P = 0.001 and β = 0.261, P = 0.004). In addition, higher scores for workload in general wards (odds ratio = 5.321; 95 % confidence interval, 1.688-16.775) and for community in palliative units (odds ratio = 2.872; 95 % confidence interval, 1.161-7.102) were associated with higher end-of-life care quality. No associated work environmental factors were found in home care settings.
Work environmental factors associated with nurses' compassion satisfaction and end-of-life care quality varied between workplaces. These results may contribute to creating work environments that are appropriate for each workplace type to maintain both nurses' compassion satisfaction and end-of-life care quality.
Work environmental factors associated with nurses' compassion satisfaction and end-of-life care quality were identified in three workplaces.
Higashibata T
，Hamano J
，Nagaoka H
，Sasahara T
，Fukumori T
，Arahata T
，Kazama I
，Maeno T
，Kizawa Y
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