Cumulative Stress Debriefings to Combat Compassion Fatigue in a Pediatric Intensive Care Unit

Abstract

Background Nurses working in pediatric intensive care units report high levels of compassion fatigue from exposure to critical and traumatic events. Cumulative stress debriefings can reduce compassion fatigue. Objective To evaluate the use of cumulative stress debriefings to alleviate symptoms of compassion fatigue and promote job satisfaction in nurses. Methods In this quality improvement study, a survey modified from the Self-Reporting Questionnaire-20 was distributed to pediatric intensive care unit nurses at a large, tertiary, freestanding children’s hospital on the US West Coast to measure compassion fatigue and job satisfaction. The survey revealed widespread symptoms of compassion fatigue. Subsequently, monthly 1-hour cumulative stress debriefing sessions were initiated in the pediatric intensive care unit. Between 149 and 168 nurses were eligible to participate across time points. Interprofessional team members were trained and paired to facilitate the debriefings. Follow-up surveys were distributed at 6, 9, and 12 months after implementation of the intervention. Results Survey response rates ranged from 22.6% to 49.7%, with responses declining over time. Nurses who attended 1 or more cumulative stress debriefings reported fewer symptoms of compassion fatigue and negative personal effects from work and were less likely to consider leaving their current position and the nursing profession. Results indicated a high level of acceptability of the intervention, with nearly 90% of participants at 9 and 12 months indicating that they were likely to attend a future session. Conclusion Initiation of cumulative stress debriefings may reduce compassion fatigue and improve job satisfaction in nurses.