Burnout is one of the major concepts of compassion fatigue. The signs of burnout, according to Espeland (2006), includes that the nurses are always exhausted, they are cynical and feel detached, and they feel that they are ineffective. They also exhibit signs that include anger, depression, paralysis, feeling stuck, irritability, cynicism, bitterness and negativity towards others, the self, and the world (Espeland, 2006).
Job stress is another concept of compassion fatigue, according to Chen et al. (2009). They state that signs of job stress include job absences, conflicts with staff members, depression, staff turnover, and inferior caregiving. The difference between job stress and burnout is that burnout is the result of unrelenting job stress, over a period of time, therefore job stress is a lessor version of burnout.
Compassion fatigue itself is an expanded version of burnout. As stated below, compassion fatigue is really burnout plus the fact that the nurses have to deal with very sick and dying patients, much of the time, as with oncology nurses, who exhibit high levels of compassion fatigue. According to Bush (2009), the signs of compassion fatigue are that the nurse identifies and integrates the grief, emotions and fears of their patients, and this means that their own stress and emotional pain are exacerbated. The nurses experience a kind of vicarious trauma in these situations, as they absorb the emotions of their patient, and this affects the nurse’s perceptions of trust, safety, self-esteem, control, and intimacy (Bush, 2009). Nature of the Problems and their Causes The nature of the problem of burnout is that it results in severe mental fatigue and is an energy drain, according to Espeland (2006). Espeland (2006) states that burnout also results in depersonalization and a reduced feeling of accomplishment. Espeland (2006) further states that there are five work situations which might contribute to job burnout. One is that there is ambiguity on the job, as there is a lack of goals and information. No-win situations represent another type of employment issue which contributes to burnout, and this means that the manager is always dissatisfied, no matter how well the nurses perform. Role overload is the third situation, and this means that the nurses have too many responsibilities. Role conflict is the fourth situation, which means that there are conflicting responsibilities and the nurses feel pulled in different directions. The fifth situation is when the nurses are underpaid, despite the fact that they work hard. Compassion fatigue is slightly different from burnout, but described by Bush (2009) as being an expanded form of burnout. In this case, it is distinguished from burnout, according to Bush (2009) by the fact that, in addition to there being stressors in the workplace, like between