specific to pediatric oncology nursing include complex treatments, the nature of cancer as a
diagnosis, high patient acuity, communication with family, ethical issues, lack of control, and
death and bereavement issues (Medland, Howard-Rubin, & Whitaker, 2004; Zander, Hutton, &
King, 2010).
The concept of compassion fatigue is relatively recent; it was coined by Joinson (Joinson,
1992) while studying burnout in nurses working in emergency departments. Compassion fatigue
differs from posttraumatic stress disorder in that it is precipitated by exposure to a traumatized or
suffering person rather than a traumatic event (Aycock & Boyle, 2008; Medland et al., 2004).
Compassion fatigue differs from the more general “burnout” in that it specifically is an
emotional response resulting from caring about and identifying with the suffering experienced by
patients and their families (Maytum, Heiman, & Garwick, 2004; Showalter, 2010).
The symptoms of compassion fatigue often follow classic stress patterns; consequently,
nurses and those around them may dismiss the signs. Difficulties may instead be attributed to
stressful scheduling, poor diet and exercise habits, or physical causes. Each nurse must assess his
or her emotional health and examine relationships to determine if compassion fatigue is present
(Joinson, 1992; Medland et al., 2004; Showalter, 2010). McHolm (2006) separates symptoms of
compassion fatigue into five dimensions: psychological, physical, professional, social, and
spiritual. Ironically, one of the recommended methods to avoid compassion fatigue is for nurses
to communicate with others who share their experiences, and one way to communicate is
through social media (Medland et al.; Perry, 2008). Many nurses who are members of social
networks are friends with patients, and their families. As a result, a connection with coworkers
through social media can also mean an inadvertent link to patients that extends beyond work
hours and can aggravate compassion fatigue.
An additional concern that arises from the nurse’s use of social media is its impact on
coworkers and care teams. Nurses who use social media to express negative feelings about
coworkers may be committing lateral violence, including bullying and intimidation. While there
may be legal protection for the nurse based on First Amendment rights, the nurse should consider
the potential detrimental effects of any form of lateral violence on team dynamics and
cohesiveness (NCSBN, 2018).
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