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CME/CE

Compassion Fatigue and Burnout in Healthcare Providers Caring for Patients With Cancer

Authors: Linda Emanuel, MD, PhD; Frank D. Ferris, MD, FAAPHM; Charles F. von Gunten, MD, PhD; Jaime H. Von Roenn, MD
CME/CE Released: 12/6/2011
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 12/6/2012

Target Audience and Goal Statement

This activity is intended for physicians, nurse practitioners, and physician assistants (particularly those working in the field of oncology, family medicine, general medicine, and geriatrics) in either community or hospital settings, training program directors (particularly of oncology fellowships, palliative medicine fellowships, geriatric fellowships, and family practice residencies), oncology nurses, oncology social workers, palliative care nurses, and therapists treating patients with cancer.

Healthcare providers caring for persons with cancer will learn how to prevent, recognize, and deal with compassion fatigue and burnout in themselves.

Upon completion of this activity, participants will be able to:

Define burnout and compassion fatigue
Recognize associated signs, symptoms, and risk factors
Describe a model for organizational antecedents
Contrast burnout, compassion fatigue, and depression
Identify techniques to decrease burnout and compassion fatigue

Disclosures

As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.

Author(s)

Linda Emanuel, MD, PhD

Author, researcher, educator, previously practicing clinician; Principal, The EPEC Project; Director, Buehler Center on Aging, Heath and Society (where the EPEC Project and its derivatives are housed), Northwestern University Feinberg School of Medicine, Chicago, Illinois

Disclosures

Disclosure: Linda Emanuel, MD, PhD, has disclosed no relevant financial relationships.

Dr. Emanuel does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the US Food and Drug Administration (FDA) for use in the United States.

Dr. Emanuel does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Frank D. Ferris, MD

Director, International Programs, Institute for Palliative Medicine at San Diego Hospice, San Diego, California; Professor, Department of Family and Preventative Medicine, University of California School of Medicine, San Diego, California; Co-principal, The EPEC Project

Disclosures

Disclosure: Frank D. Ferris, MD, FAAPHM, has disclosed no relevant financial relationships.

Dr. Ferris does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics not approved by the US Food and Drug Administration (FDA) for use in the United States.

Dr. Ferris does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Charles F. von Gunten, MD, PhD

Medical Director, Center for Palliative Studies, San Diego Hospice & Palliative Care, San Diego, California; Associate Clinical Professor, University of California, San Diego, School of Medicine; Co-principal, The EPEC Project; Past Chairman, The American Board of Hospice and Palliative Medicine

Disclosures

Disclosure: Charles F. von Gunten, MD, PhD, has disclosed no relevant financial relationships.

Dr. von Gunten does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the US Food and Drug Administration (FDA) for use in the United States.

Dr. von Gunten does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Jaime H. Von Roenn, MD

Medical Director, Palliative Care and Home Hospice Program, Northwestern Memorial Hospital, Chicago, Illinois; Professor of Medicine, Division of Hematology/Oncology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Co-Principal, The EPEC Project; Editor, EPEC-O Curriculum; Editor-in-Chief, The Journal of Supportive Oncology

Disclosures

Disclosure: Jamie H. Von Roenn, MD, has disclosed the following relevant financial relationships:
Served as a director, officer, partner, employee, advisor, consultant, or trustee for: GTx; AstraZeneca
Received income in an amount equal to or greater than $250 from: GTx; AstraZeneca

Editor(s)

Cheryl Arenella, MD, MPH

Cancer Education Program Specialist, Contractor, National Cancer Institute, Office of Communications and Education, Office of Education and Special Initiatives, Rockville, Maryland

Disclosures

Disclosure: Cheryl Arenella, MD, MPH, has disclosed no relevant financial relationships.

CME Reviewer(s)

Nafeez Zawahir, MD

CME Clinical Director, Medscape, LLC

Disclosures

Disclosure: Nafeez Zawahir, MD, has disclosed no relevant financial relationships.

CNE Reviewer

Laurie Scudder, DNP, NP

Nurse Planner, Medscape, LLC

Disclosures

Disclosure: Laurie Scudder, DNP, NP, has disclosed no relevant financial relationships.

Nurse Planner

Susan B. Yox, RN, EdD

Director, Editorial Content; Editor, Medscape Infectious Diseases

Disclosures

Disclosure: Susan B. Yox, RN, EdD, has disclosed no relevant financial relationships.

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For Physicians

Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Medscape, LLC designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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From Medscape Education Family Medicine

CME/CE

Compassion Fatigue and Burnout in Healthcare Providers Caring for Patients With Cancer

Authors: Linda Emanuel, MD, PhD; Frank D. Ferris, MD, FAAPHM; Charles F. von Gunten, MD, PhD; Jaime H. Von Roenn, MDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME/CE Released: 12/6/2011

Valid for credit through: 12/6/2012

processing....

Editor's Note:

This text has been excerpted and adapted from: Emanuel LL, Ferris FD, von Gunten CF, Von Roenn J, eds. EPEC™-O: Education in Palliative and End-of-life Care for Oncology (Module 15: Cancer Doctors and Burnout), Copyright The EPEC™ Project, Chicago, IL, 2005). The EPEC™-O curriculum was produced by The EPEC™ Project, with major funding provided by the National Cancer Institute, and with supplemental funding provided by the Lance Armstrong Foundation.

Compassion Fatigue and Burnout in Cancer Care

Working as a healthcare provider with patients who have cancer has many rewards. It can also be challenging and stressful. Stressors from work with traumatized patients and families, organizational demands, and managed care can lead to symptoms of stress and burnout that can be manifested both at work and in the home environment. Lifestyle management techniques, changes in managerial environment, and educational interventions may limit the occurrence of burnout and compassion fatigue.

This oncologist is showing evidence of burnout -- anger, exhaustion, and detachment. His coworkers voice concerns.

Burnout

Burnout, a psychological syndrome, is a response to chronic interpersonal stressors on the job.^[1]The concept of burnout was first developed in the 1970s.^[2]

The 3 key dimensions of this response are:

Individual: overwhelming exhaustion; feelings of being overextended and depleted of one's emotional and physical resources;
Interpersonal: cynicism (or depersonalization) and detachment from the job. Cynicism refers to a negative, callous, or excessively detached response to various aspects of the job; and
Self-evaluative: sense of ineffectiveness and lack of accomplishment -- Ineffectiveness refers to feelings of incompetence and a lack of achievement and productivity at work.

Pines suggests, "The root cause of burnout lies in people's need to believe that their lives are meaningful, and that the things they do -- and consequently they themselves -- are important and significant."^[3]Most healthcare professionals who are treated for burnout do not come in saying they are burned out.^[4]Typically, they say, "There's something wrong with me. I don't care anymore. Terrible things happen in front of me, and I feel nothing."

Compassion Fatigue

Compassion fatigue is related to, but distinct from, burnout. Figley describes compassion fatigue as "a state experienced by those helping people in distress; it is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it is traumatizing for the helper."^[5] Compassion fatigue is conceptualized as consisting of 2 parts: 1) symptoms associated with burnout, such as exhaustion, frustration, anger and depression; and 2) secondary traumatic stress, the negative effects of which may include fear, sleep difficulties, intrusive images, or avoidance of reminders of past traumatic experiences.^[6] Healthcare workers are at increased risk for compassion fatigue, especially those involved with highly emotionally charged situations.

Page 1 of 6

How Common Are Burnout and Compassion Fatigue?

CME/CE Information

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References

Disclaimer

The material presented here does not necessarily reflect the views of Medscape, LLC, or companies that support educational programming on www.medscape.org. These materials may discuss therapeutic products that have not been approved by the US Food and Drug Administration and off-label uses of approved products. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or employing any therapies described in this educational activity.

References

Faculty and Disclosures

Author(s)

Linda Emanuel, MD, PhD

Frank D. Ferris, MD

Charles F. von Gunten, MD, PhD

Jaime H. Von Roenn, MD

Editor(s)

Cheryl Arenella, MD, MPH

CME Reviewer(s)

Nafeez Zawahir, MD

CNE Reviewer

Laurie Scudder, DNP, NP

Nurse Planner

Susan B. Yox, RN, EdD

CME/CE

Compassion Fatigue and Burnout in Healthcare Providers Caring for Patients With Cancer

Target Audience and Goal Statement

Disclosures

Author(s)

Linda Emanuel, MD, PhD

Frank D. Ferris, MD

Charles F. von Gunten, MD, PhD

Jaime H. Von Roenn, MD

Editor(s)

Cheryl Arenella, MD, MPH

CME Reviewer(s)

Nafeez Zawahir, MD

CNE Reviewer

Laurie Scudder, DNP, NP

Nurse Planner

Susan B. Yox, RN, EdD

Accreditation Statements

For Physicians

For Nurses

Instructions for Participation and Credit

Compassion Fatigue and Burnout in Healthcare Providers Caring for Patients With Cancer

Compassion Fatigue and Burnout in Cancer Care

Burnout

Compassion Fatigue