Nurses' perceived and actual caregiving roles: identifying factors that can contribute to job satisfaction.

AIMS AND OBJECTIVES To compare nurses' caring expectations with their caregiving experiences and to identify factors that could potentially be included in a preliminary conceptual model of job satisfaction and compassion fatigue. BACKGROUND Nurses often report emotional reward and satisfaction in their profession from compassionately caring for sick and injured patients. However, being in close proximity to trauma can eventually deplete a nurse's compassion and empathy for the patients they care for. This loss of compassion is further exacerbated by demanding work environments that involve administrative duties, attending to patients' psychosocial needs and interacting with patients' families. To date, the literature has tended to focus on pathology of compassion fatigue, rather than identifying its contributing factors. DESIGN A grounded theory approach was used to identify emerging themes in nurses' accounts of their caregiving roles. METHODS Open-ended interviews were conducted with nurses (n = 9) who were employed by a maritime district health authority for a minimum of five years. Interviews focused on beliefs of how to provide care, perceived caregiving responsibilities and perceived challenges in the provision of care. RESULTS Emerging from the data is a proposed model of job satisfaction. The concepts of monitoring and patient advocacy appeared to be key components in reported satisfaction or alienation. Discrepancies were found between care expectations outlined by management and nurses' perceptions of care provision. Additionally, type of nursing education was related to nurses' confidence in applying nursing skills. CONCLUSIONS These findings have implications for training programmes, hospital management and quality of patient care. RELEVANCE TO CLINICAL PRACTICE It is important to identify factors that could explain resilience to compassion fatigue because compassion fatigue has negative consequences not only for nurses themselves but for the patients in their care.