Oncology Final Exam. Questions and answers about coping with stress and trauma on nursing staff.

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ONCOLOGY FINAL EXAM        

Oncology Final Exam

Oncology Final Exam

Question 1: Briefly define and differentiate the following constructs: burnout, compassion fatigue, vicarious trauma, and secondary traumatic stress.

Burnout is a state of physical, emotional and intellectual exhaustion that is often encountered in healthcare professionals. It is causes for the prolonged exposure to demanding situations. It is characterized by physical, mental and emotional fatigue. There exists a detachment phenomenon where the person feels alienated and unable to have an emotional connection with others. It can reduce the quality of life of the person who suffers it, and it often causes a decrease in productivity. Its appearance is insidious and tends to become chromic, even irreversible.

Compassion Fatigue is the result of exhaustion produced by caring for others. Nurses face emotionally challenging situations every day, and they are vulnerable to it.  Nurses may feel helpless in front of those situations. Burnout is considered to be the result of a progressive emotional erosion. Compassion fatigue is a more immediate and specific response, and it is related more to traumatic events (Ullrich & Maye, 2007).

Vicarious Traumatization is the process of change in mentality that occurs when the caregiver sees a change in his or her worldview.  The empathy towards the people they care and the witnessing of their suffering can exert a enormous pressure on those caregivers. That can lead to psychological, physical or even physical change. The affected person seems to acquire a more pessimistic set of beliefs and a disturbed perception of meaning and hope.  

Secondary Traumatic Stress Disorder (STSD) is a similar condition to Post Traumatic Stress Disorder. The experience of stress and the continuous deterioration suffered through the burnt out continuum can be so severe that becomes pathological. The nurses own traumatic experiences combined with  the vicarious feeling of patients’ emotional pain exhaust coping mechanisms and conduce to  the appearance of symptoms of STSD.

Question 2: How do you deal with your own grief following a patient?

Death is not what distresses me the most, suffering is. I am an atheist. I am not a spiritual person. I do not believe in and afterlife. I do, however, acknowledge the influence of my catholic upbringing had on me.

 I believe that death is a part of life and ignoring it leads to an ineffective grief. The distress I suffer from the death of a patient is related to the suffering they leave behind. What I find more difficult to deal with is the pain of those families and loved ones. This has been more pronounced in the last few years, in the Emergency Department. The cases of unexpected death have been more frequent than in my previous job as intensive care nurse. There have been particularly hard moments with death of children, when I had the intrusive though of something happening to my own family.

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I have often reflected in the total absence of training that we have to deal with those situations. Nursing training prepares to “save lives” but it does not prepare us to face death. Death is almost considered a failure. I mostly refer to how to be more therapeutic to those grieving families. What do we say to them? What is the best way to act? What sign should we look for? Because the people who remain are the source of my own grief, I tend not to get excessively involved with them. I do feel my duty to alleviate their ...

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