Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Cynthia D. Connelly, PhD, RN, FAAN, Chair; Jane M. Georges, PhD, RN; Denise M. Boren, PhD, RN


communication patterns, compassion fatigue, compassion satisfaction, Emergency Department nurses, employee burnout, nursing, professional quality of life, Secondary trauma


The purpose of this mixed methods embedded design study was to examine relationships between compassion satisfaction, burnout, compassion fatigue/secondary trauma, and perceived levels of communication difficulty in emergency room nurses employed at a health care system. Quantitative data was collected from a purposive sample of 43 emergency room nurses using the Professional Quality of Life Scale (ProQOL), the Silencing Response Scale, and a demographic form. The study's embedded qualitative component was participants' experiences with traumatic cases in the emergency room. Qualitative data was collected via telephone interview with 10 emergency room nurses obtained from a subset of the original sample and snowball sampling. The majority of participants reported low levels of compassion satisfaction on the ProQOL subscale (M = 38.63, SD 9.47), low levels of burnout and compassion fatigue/secondary trauma (M=21.4, SD 6.3 and M= 21.1, SD 5.2, respectively). Participants who worked in an urgent care setting scored highest (M= 44.3, SD 4.3) in perceived professional satisfaction in their ability as caregivers. The Silencing Response instrument yielded a mean score of 59.3, indicative of a moderate risk of communication difficulties for the entire sample. A correlation matrix indicated significant positive relationships between subscales of compassion satisfaction, burnout, compassion fatigue/secondary trauma, and the Silencing scale. Multiple regressions were conducted to explore the accuracy of the independent variables of compassion satisfaction, resource availability, burnout, compassion fatigue/secondary trauma, and years of experience as predictors of silencing scores. Partial regression coefficients on three separate models indicate compassion satisfaction, burnout, and compassion fatigue/secondary trauma significantly contribute to the models of predicting silencing response. Telephone interviews themes included pediatric traumas, discomfort, maintaining emotional control, obstructed communication, and deflection. The related themes potential support systems and available resources also potentially addressed decreased professional quality of life in emergency department nurses. This study contributes to the understanding of the relationship between professional quality of life and communication. The identification of relationships between the subscale items in concert with the participant interviews helped justify how coping strategies are implemented and is a first step in addressing deficiencies in communication.

Document Type

Dissertation: Open Access



Included in

Nursing Commons