Compassion fatigue and secondary trauma in nuclear incident responders

Compassion Fatigue and Secondary Trauma

It is now six months after the attack on the nuclear power facility and low level radiation release. The critical incident stress management plan has been an affect and long-term intervention strategies are now in place. However, it is now time to consider the effects of long-term stress from managing those that have stress related to the critical incident. This research will consider the effects of compassion fatigue on staff and secondary stress on those who have to treat first responders and in their families.

Symptoms of Secondary Trauma Among Family Members and Staff

The issue of secondary trauma among family members was addressed previously in the overall critical incident stress management plan. Family members were offered services when requested by them. At the time of the incident, supervisors were requested to schedule workers on rotating shifts with adequate time off for rest and stress management. However, it is now a time to address long-term planning issues involved was secondary trauma and compassion fatigue, not only among workers, but among family members.

Family members are important part of the long-term care of first responders and their psychological needs. Their families are there 24/7, often without support. They are there when other supports are not available and they often do not get time off from their caregiving roles. Family members must often listen to their loved ones retelling of the trauma over and over. As they listen to the stories, and attempt to be supportive to their loved ones, they can develop secondary trauma from fear of losing their loved one, or fear of the incident as relate to them by their loved one. Being a supportive family member for one has suffered trauma is an exhausting role.

As far as the staff is concerned, they often fall into the role as a caregiver through a desire to help others. However, listening to traumatic stories can become tiring after a time. Like family members, they must often listen to the same renditions of the trauma told over and over again. In addition, the staff members may have been close to the incident themselves, and must deal with their own trauma, while dealing with the trauma of others.

This signs of compassion fatigue and secondary stress are similar to burnout. The signs of compassion fatigue can include depression, anxiety, distancing themselves emotionally from their work, chronic fatigue, irritability, and boredom (Najiar, 2009). It is not that the worker does not care about their patients, or the family members do not care either, it is just that they are developing their own set of symptoms secondary to those of their patients. Compassion fatigue can set in when patients do not respond to the caregiver's efforts. They can develop a sense that there is nothing more they can do and this can lead to compassion fatigue and secondary stress (Najair, 2009).

Symptoms of compassion fatigue may manifest themselves in a dread of going to work, dread of walking into the treatment area, a lack of joy in life, a feeling of being trapped, drinking more, drug use, overeating, or an exacerbation of existing physical conditions or ailments. Body aches and headaches are not uncommon symptoms of this syndrome (Najiar, 2009).

Interventions

The goal of the intervention program is for family members and staff to recognize and master their symptoms. Education is the first component of this process. All members of the staff and family must be educated as to how to recognize the symptoms of compassion fatigue and secondary stress in themselves and those around them. They must also be educated as to how to care for themselves and seek help if they need it. A program designed to fill these needs should be offered at a six-month interval after the critical incident for family members and staff workers. Awareness of the effects of secondary stress and compassion fatigue is the first step in the ability to treat it (Figley, 1995).

The level of job satisfaction can be a determining factor in the level of compassion fatigue that develops. However, high levels of job satisfaction do not necessarily lead to protection from compassion fatigue. Compassion fatigue and has been shown to lead to lower levels of work satisfaction and nurses and other emergency responders (Lombardo & Eyre, 2011).

Self-care strategies for compassion fatigue and secondary trauma involve taking breaks often and in internalization of the idea that one cannot help others if they are feeling burnout. Programs need a stress self-care and the need to take a break from the stressful situation. As part of the larger CISM strategy, education on the importance of self-care in relation to prevention of compassion fatigue and secondary trauma needs to be incorporated. A formal education strategy needs to go beyond the initial critical incident and extend into the future. The course needs to include how to recognize symptoms and strategies to reduce those symptoms.

For workers that must provide care for those who have undergone a trauma, an education program must be continual and an ongoing process within the work environment. It is not likely that this single critical incident will be the only source of secondary trauma and their lives and they need to learn strategies for coping as a part of ongoing health and well being. Support groups can be helpful, as well as training for individuals to develop a coping strategies needed to deal with the trauma. Programs to help manage compassion fatigue and secondary trauma need to be a part of the CISM program, but they also need to be incorporated into the normal working environment.