Date of Award

Spring 5-22-2021

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Michael Terry, DNP, FNP, PMHNP

Abstract

Purpose: The purpose of this evidence-based practice project is to improve secondary traumatic stress (STS), compassion satisfaction, and burnout amongst providers—physicians, residents, and nurse practitioners—within the acute psychiatry units of the La Jolla Veterans Health Administration (VHA) through a one-time educational training session.

Background: Mental health providers at the VHA acute psychiatry units experience one of the highest risks for the development of STS, CF, and burnout amongst all professions due to a number of individual and institutional factors. STS is characterized by secondhand traumatization with symptoms similar to that of Post-Traumatic Stress Disorder—difficulty sleeping, mood changes, upsetting images appearing in one’s mind, etc.—from repeated vicarious exposures via direct patient. CF results in a mental and/or physical detachment and a reduced ability to remain empathetic following repeated or prolonged interactions demanding high amounts of empathetic engagement. Both STS and CF significantly contribute to the development of burnout syndrome, which exacts a physical and psychological toll on the individual, is associated with poorer patient outcomes, and is costly to an organization.

Methods: The intervention consists of a one-time educational class delivered to mental health providers designed to increase resilience against STS, CF, and burnout. The Professional Quality of Life (ProQOL), a 30-item Likert scale questionnaire with sub-scales for compassion satisfaction, burnout, and CF, was administered pre- and 30-day post-intervention. Results were gathered and entered into Intellectus Statistics online computer software for analysis, and a t-test was conducted between each pre- and post-intervention ProQOL sub-scale.

Results: Prior to the intervention, the group (n=13) had mean scores of compassion satisfaction that fell within the moderate levels, burnout scores within the upper end of low levels, and STS scores within low levels. Results from post-test scores (n=10) indicate very mild improvements in STS scores with no statistically significant changes in any sub-scale.

Implications: This project underscores the importance of holistic health and the benefits of self-care and is congruent with past studies showing STS, CF, and burnout are challenging problems to address. Though this intervention failed to produce significant changes to ProQOL scores amongst the VA’s acute psychiatric provider population, burnout remains a pervasive issue, and further individual and/or institutional interventions are warranted.

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