Professional quality of life in psychiatric nursing and nursing students: Implications for students and educators

Talk Tuesday - October 13, 2020

Presenter

Dr. Kathryn Chachula, RN PhD

Assistant Professor, Department of Nursing, Brandon University

Dr. Chachula is an Assistant Professor in the Department of Nursing at Brandon University. Her research program is focused on teaching and learning in nursing education and curricular strategies that prepare graduates for entry into the workforce. She is a Teaching Affiliate in the Centre for Teaching, Learning, and Technology at Brandon University and a Research Affiliate with the Manitoba Centre for Nursing and Health Research, and Centre for Critical Studies of Rural Mental Health at Brandon University. She also served as a Council Member on the College of Registered Nurses of Manitoba from August 2014-2020.

Summary

This session will provide participants with an overview of Professional Quality of Life that encompasses Compassion Satisfaction and Compassion Fatigue in relation to pre-licensure health studies students. The presentation will highlight prevalence scores and student characteristics that contribute toward Compassion Satisfaction development as well as tenets of Compassion Fatigue that are comprised of burnout and secondary traumatic stress in nursing and psychiatric nursing students.

Question and answer

1. Do you worry that framing nursing as a calling rather than a profession devalues the education and technical expertise of nursing?

Florence Nightingale said nursing was a calling and a vocation. I disagree about the vocation part. Nurses are highly intelligent and educated. I believe that nurses are not just trained. Given the high level of education that every person who enters the profession goes through as part of their preparational programming to gain that entry to practice.

2. It’s a gut wrenching feeling to work as hard as you can and know that your patients are receiving sub-par care because you don’t have enough staff and resources to provide good care. Does that fit more under burnout or compassion fatigue in the models you shared?

Burnout is part of compassion fatigue. There might be a role in the struggle to secure resources and how that can be depleting and draining that can contribute to burnout. Burnout is one piece in the Compassion Fatigue model. The other aspect is secondary traumatic stress, witnessing pain and suffering. When you mix the two - working with depleted resources and not being able to give the care you want to it really opens nurses up to not just compassion fatigue but also moral distress. When you know what the right thing to do is but you can't do that.
Moral distress is a bit different from compassion fatigue because compassion fatigue can occur even when you have done all the right things. Certainly, I can understand the person who has made this comment around not being able to deliver care at a level that they want because of a lack of resources. That is a big struggle within nursing. We’re in a climate of cuts and savings and one of the first things to go are people and funds that support nurses in doing their work

3. Can advocating for unit or systemic change be part of a coping strategy? Like, I want to feel less stressed out and anxious now, but if I worked in an adequately resourced setting I’d have less to cope with.

Advocacy is something we talk about within nursing, it’s within our code of ethics for registered nursing and aspects in the psychiatric nursing realm. Where nurses feel empowered is where you’re going to have greater compassion satisfaction. So, this is where leaders play a role in enabling and empowering nurses and healthcare professionals to be able to make changes where it benefits clients, where it benefits the nursing staff in that area. Whenever nurses are empowered, nurses are happy and if changes can occur that benefit the workplace and improves patient outcomes that’s the goal that we want for everyone while improving your professional quality of life.
Advocacy is a clear part of our mandate as nurses.
As a reminder to members. There is an Advocacy Toolkit in the Member Portal to help with this.

4. In my experience over the last two decades, present and recent students are not receptive to criticism and feedback. I worry that the future of our profession is rapidly declining as the newest generation of students and nurses cannot receive feedback, coaching and learning.

That’s an interesting comment. I think feedback is a two-way mechanism. Feedback first of all needs to occur in a timely manner for any learner. That’s a new nurse or a nurse with 30 years of experience who is now in a new area. There are good practices to adopt in terms of providing feedback - make sure it’s timely, make sure it’s specific and usually feedback is given with the ability for the person receiving it to improve. How that message is crafted and delivered can also play a role in how it lands. Teaching and learning is a craft that requires the creation of the teaching learning environment that is built on respect. When feedback and engaging in feedback is provided within that respectful dialogue back and forth learning can occur but it’s always hard. Even as an adult learner myself I have to take a step back and acknowledge it’s for my benefit and meant to help me improve.
It’s helpful to reframe criticism or feedback as coaching and as a back and forth dialogue.

5. Any tips on what to do when you are in a traumatic situation with a patient that brings back flashbacks from a different traumatic situation with a different patient?

Any cases around pediatrics and children can be very difficult to navigate through. It’s really important, if you’re trying to work through a traumatic event to access psychological supports if you need. Sometimes it’s a matter of having a third party just listen to your experiences and talk through it and verbalize to someone. If you're having flashbacks and this is an ongoing issue that you're struggling with perhaps accessing psychological counselling or support might be another avenue to help you develop tools in your arsenal to help you manage situations that keep recurring to you in flashbacks or dreams.
As I alluded to earlier, in a report published by the Manitoba Nurses Union in 2015, 25% of Manitoba nurses reported having PTSD-like symptoms so you're not along if this is happening to you.