Abstract: "You're not just the nurse": Informal Roles of Hospice Nurses and Their Effects on Compassion Fatigue
Compassion fatigue is present in multiple nursing fields, but hospice poses a unique threat to nurses. Consistent proximity with patient suffering, death and dying, and constant communication with patients regarding their death culminate in an environment that is challenging to these nurses. Research has been conducted concerning the effects compassion fatigue can have on the quality of care received by the patient, but there has been very little research conducted analyzing the relationship between hospice nurse-patient communication and compassion fatigue. The aim of this study was to determine the many informal roles hospice nurses play as a result of working in such a distinctive field and how these roles impact the effects of compassion fatigue. 15 hospice nurses were interviewed regarding their experiences caring for patients using a semi-structured interview protocol. The results suggest hospice nurses occupy multiple informal roles for both the patients and the patients’ families while still fulfilling their formal role as caregiver. Participants most frequently described serving as an advocate, a provider of physical and emotional comfort, and as an overall “death guide” for the patient. For families, participants most often served as a provider of emotional support and as a guide throughout the dying process. The perception that hospice nurses are solely responsible for fulfilling each of these informal roles exacerbates the effects of compassion fatigue felt by hospice nurses and can have negative impacts on the overall quality of care received by patients. Future research should focus on determining how hospice and other healthcare organizations can provide support to these nurses to mitigate the number of informal roles hospice nurses must fulfill in order to feel they are providing patients and families with what they need.