Exploring Death Anxiety and Burnout Among Staff Members Who Work In Outpatient Hemodialysis Units

Headnote

Outpatient hemodialysis unit staff members are at risk for psychological stress, including death anxiety, unresolved grieving, and burnout, due to frequent interactions with chronically ill patients who have a high mortality rate. Experiencing death anxiety and burnout may impair the ability to build interpersonal relationships, decrease job satisfaction, and impact quality of patient care. A quantitative study to evaluate the effect of educational classes on the level of death anxiety and burnout among hemodialysis care-givers revealed a decrease in participants' level of death anxiety and a decrease in emotional exhaustion in one area that was directly related to the work environment. Information from the study can be used to decrease psychological stress through education and support for staff members who work in the hemodialysis unit environment.

Key Words: Death anxiety, burnout, unresolved grieving, hemodialysis, end-oflife care.

Goal

To provide an overview of the impact unresolved psychological stress, primarily death anxiety and burnout, has on nephrology nurses and other staffmembers working in outpatient hemodialysis units.

Objectives

1. Explore the effect of an educational intervention on the level of death anxiety and burnout in caregivers who work in the outpatient HD environment.

2. Discuss the benefits to nurses and other dialysis staffof receiving education about the life expectancy and complicated health issues of patients with ESRD.

The outpatient hemodialysis (HD) unit is a fast-paced, technological environment that requires healthcare workers to receive special training for the development of a unique set of skills. Patients who receive HD treatments have been diagnosed with end stage renal disease (ESRD), are in a progressively declining state of health, and have an average life expectancy of 6.2 years (United States Renal Data System [USRDS], 2013). Registered nurses, patient care technicians, social workers, dietitians, and other staffmembers who work in HD units and provide life-supporting treatments three to four times per week over a period of months or years often develop close relationships with their patients. The intensity of work required to prolong life in this patient population can cause frustration, moral distress, compassion fatigue, de pression, and burnout in caregivers working in outpatient hemodialysis units (Ashker, Penprase, & Salman, 2012; Dermody & Bennett, 2008; Hayes & Bonner, 2010). The high patient death rate can lead to unresolved grieving (Gerow et...