Critical Incident Stress Management CISM

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).

Cultural Dimensions of Compassion Fatigue

Several cultural dimensions of compassion fatigue affect the degree to which it develops and who is more vulnerable to its effects. People who are overly conscientious, perfectionists, and self-sacrificing are more likely to develop compassion fatigue than others (Najiar, 2009). Humanitarian aid workers, including those that pour into a disaster area after a critical incident, come from a variety of backgrounds and cultures. Workers in any culture that are not properly trained to deal with secondary stress are at risk for the development of compassion fatigue. No differences were found between various cultural groups in the development of secondary trauma in aid workers (Shaw, Garland, & Katz, 2007). The same study also found that the closer the worker was to the trauma at the time the incident, the more likely they are to develop compassion fatigue as time goes on.

When someone discusses cultural issues, often they are referring to those of different nationalities and backgrounds. However, cultural divisions also come into play within organizations. For instance, within firefighters, police officers, and EMS workers a culture exists within the organization that sets them aside from other members of society psychologically. First responders feel that they must be strong in a crisis because other members of the community look up to them. This can cause them to ignore symptoms of stress and because they are not resolved in the early stages, they are more likely to progress than with other members of the team. This also places their families and other staff members at greater risk of developing stress symptoms as they attempt to care for those who play an important role in their communities. There is often a sense of duty and obligation in caring for those who care for us (Clair, 2006).

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).