1. Compassion fatigue and burnout in pediatric oncology nurses
UNIVERSITY OF CENTRAL FLORIDA
COLLEGE OF NURSING
NGR 5800
Anilady Casserino

2. Background
Compassion fatigue is often regarded as the “cost of caring” (Sabo, 2006). It is a concept that affects the psychological, emotional, social, spiritual, and physical health of nursing professionals (Coetzee & Klopper, 2010).
Burnout is defined by Merriam-Webster Dictionary (2011) as “the condition of someone who has become very physically and emotionally tired after doing a difficult job for a long time.”
Nurses deplete their protective factors that are typically used when faced with high demand patient care (Abendroth & Flannery, 2006).

3. The Problem
Pediatric oncology nursing is a field in which nurses are particularly vulnerable to burnout and compassion fatigue.
Pediatric oncology nurses are required to provide extensive care to children with cancer that face acute and chronic health issues, while also maintaining positive attitudes and attending to the children’s family needs; therefore many of these nurses experience fatigue and overwhelming stress in their work environments and are subject to suffering burnout (Cohen, Ferrell, Vrabel, Visovsky, & Scaefer, 2010).

4. Significance
Compassion fatigue and burnout are major contributors in the shortage of experienced nurses in hospitals and clinics (Caldwell, Gill, Fitzgerald, Sclafani, & Grandison, 2006).
Compassion fatigue and burnout have negative effects on patient’s quality of care.
Absenteeism increases as nurses begin to experience burnout (Sabo, 2006).
Retention of skilled nurses is both a safety concern and a financial concern for healthcare institutions, and attention to factors that affect nursing staff, is key for retaining them.

5. Specific Aims
Developing and practicing coping strategies reduces fatigue and burnout among nurses (Davis & Sorensen, 2009). Resilience and resilient practices can be established through learning/professional development in the form of support and education- such as supervision, reflective practice, and professional development. Resilience can be fostered via informal peer support groups, formal consuls, supervision, and reflective practice (Davis & Sorensen, 2009).

6. Theory of Self-Transcendence
The purpose of the theory of self- transcendence is to serve as a model for practice regarding promotion of well- being during times of life that present difficult situations; in particular when individuals are facing loss or life-limiting illness (Reed, 2014 ).
Self-transcendence is a form of maturity that is illustrated through an increased awareness of the surrounding environment and heightened perspectives about life.
The theory of self- transcendence relates the ability to gain well- being during times of vulnerability involved with a challenging health experience.  

7. Application of the theory
The Professional Quality of Life Scale and Self-Transcendence Scale can be applied to measure the nurse’s quality of life in the healthcare settings and levels of transcendence respectively.
Interventions
meditation
self-reflection
visualization
religious expression
counseling
journaling

8. The theory of self-transcendence provides a way for identifying well-being and promoting it.

9. The healthcare setting’s role
Resilience can be promoted and resilient practices can be established in healthcare settings with the development of support and education (Davis & Sorensen, 2009).
fostered via informal peer support groups, psychosocial and spiritual counseling, and reflective practices
Nurses would be able to self-transcend via their increased awareness of the surrounding environment and heightened perspectives about life. 
Compassion fatigue and burnout can be reduced, and nursing satisfaction and retention could increase if self-transcendence is achieved by pediatric oncology nurses

10. References
Abendroth, M., & Flannery, J. (2006). Predicting risk of compassion fatigue. Journal of Hospice and Palliative Nursing, 8 (6),
Caldwell, B.A., Gill, K.J., Fitzgerald, E., Sclafani, M., & Grandison, P. (2006.) American Journal of Psychiatric Rehabilitation, (2),
Coetzee, S.K. & Klopper, H.C. (2010). Compassion fatigue within nursing practice: A concept analysis. Nursing and Health Sciences, – 243.
Cohen, M.Z., Ferrell, B.R., Vrabel, M., Visovsky, C., & Schaefer, B. (2010). What does it mean to be an oncology nurse? Reexamining the life cycle concepts. Oncology Nursing Forum, 37, 561–570.
Davis, S., Lind, B.K., Sorensen, C. (2013). A comparison of burnout among oncology nurses working in adult and pediatric inpatient and outpatient settings. Oncology Nursing Forum, 40,
Reed, P.G. (2014). Theory of self-transcendence. In M.J. Smith and P.R. Lier (eds.) Middle range theory for nursing (3rd ed). New York: Springer Publishing Company.
Sabo, B.M. (2006). Compassion fatigue and nursing work: Can we accurately capture the consequences of caring work? International Journal of Nursing Practice: 12, 136 – 142.