Compassion Fatigue in Nursing: Overview and FAQ

Nurses care for patients who experience some of the most emotionally and physically taxing situations of their lives. Being exposed to this day in and day out can take a toll on mental health, potentially leading to what’s known as “compassion fatigue” in nursing.

With roughly 57% of nurses experiencing compassion fatigue during their careers, it’s crucial for facilities to find ways to support the mental wellbeing of their workforce. In this FAQ, we’ll describe the fundamentals of what this phenomenon is, how it can be identified, and ways to help treat and prevent it.

What Is Compassion Fatigue in Nursing?

Compassion fatigue is the decline in a nurse’s ability to deliver compassionate care because of prolonged exposure to others’ suffering. This is also known as secondary trauma, since it occurs from internalizing the emotional trauma of other people.

More simply put, compassion fatigue manifests when nurses work so hard to provide compassion that they eventually feel like they have no more to give. Nurses “run out” of their stores of empathy, leaving them feeling detached from what’s going on around them.

Compassion Fatigue vs. Burnout: What’s the Difference?

In the healthcare industry, burnout vs. compassion fatigue is an important distinction to understand. While these are closely related, burnout more generally refers to physical and emotional exhaustion from work-related stress. This can occur in people across all types of industries.

On the other hand, compassion fatigue is more unique to healthcare workers, since it refers to exhaustion from emotional caregiving. This can ultimately alter a healthcare provider’s ability to feel compassion. Burnout in nursing can often contribute to and worsen feelings of compassion fatigue among nurses who regularly deal with heavy patient loads.

What Are the Signs of Compassion Fatigue in Nurses?

Compassion fatigue develops over a period of time and can manifest differently from person to person. However, there are common warning signs — many of which are noticeable in the workplace. These include:

• Seeming distracted or hopeless in front of patients
• Uncharacteristic feelings of anxiety, anger, or irritability
• Social withdrawal or isolative behaviors
• Poor judgment or increased work errors
• Emotional disconnection or detachment

If a nurse is indicating unusual changes in their everyday behaviors — such as decreased appetite, worsened sleep, or a loss of enjoyment in hobbies — these could also be signs of compassion fatigue.

What Is The Cause of Compassion Fatigue in Nursing?

Nurses are trained to maintain composure and be compassionate toward patients in highly stressful situations. This can make it difficult to set boundaries that are necessary for self-care. Over time, expectations to set aside personal needs can leave nurses feeling physically and emotionally depleted.

While exposure to traumatic events is, unfortunately, recognized as part of the job, a lack of boundary setting is what gradually wears out a nurse. For instance, nurses who skip lunch breaks or pick up shifts on their days off are shown to be at higher risk of compassion fatigue. Additionally, many facility-level factors — such as understaffing and negative work cultures — often prevent nurses from setting these boundaries on their own accord.

What Are the Consequences of Compassion Fatigue?

There is a wide range of consequences that can arise from compassion fatigue. For nurses, it can be difficult to regain motivation in their day-to-day work without receiving proper mental health support. When left unaddressed, a nurse’s mental wellbeing can worsen, leading to:

• Emotional and spiritual dysregulation.
• Desires to leave the job or profession altogether.
• Reliance on unhealthy coping behaviors (e.g., alcohol use).

At the facility level, this can lead to many other consequences, such as workplace absenteeism, higher turnover, lower quality of care, and patient dissatisfaction.

How Is Compassion Fatigue in Nursing Treated?

When it comes to compassion fatigue, nursing professionals should be encouraged to seek treatment that provides a multifaceted approach to bolstering a nurse’s resilience and restoring their sense of self-worth. Research has shown that the most effective way to address compassion fatigue is participation in evidence-based programs geared toward helping nurses. Below are some of the strategies that these programs focus on.

1. Identify the Symptoms of Compassion Fatigue

Compassion fatigue is a very individualized experience, and many evidence-based programs help nurses reflect on how they feel (e.g., depressed, tired, irritable) when they’re starting to become detached. By pinpointing symptoms that are unique to them, nurses can take steps to reach out for help and prevent these symptoms from worsening.

2. Recognize the Triggers of Compassion Fatigue

Nurses are also encouraged to identify specific triggers that can lead to feelings of compassion fatigue. This can include high-stress work environments, a lack of self-care, or a lack of professional boundaries. Recognizing these triggers can help nurses manage aspects of their work life that may be contributing to their symptoms and their responses to these situations.

3. Utilize Healthy Coping Mechanisms

While some aspects of the job are uncontrollable, nurses being treated for compassion fatigue are often encouraged to find ways to practice healthy coping mechanisms. This may include carrying out activities that promote self care, such as yoga, mindfulness, and regular exercise. It may also include setting personal and professional boundaries, such as saying no to picking up last-minute shifts on their days off.

It’s important to remember that symptoms and triggers can vary from person to person, and what’s helpful for one nurse may not be as effective for another. Nurses should be encouraged to receive personalized help through compassion fatigue programs or by consulting a mental health professional.

What Can Facilities Do to Prevent Compassion Fatigue?

While there is no one-size-fits all approach to preventing compassion fatigue in nursing, facilities can take steps to support the overall wellbeing of their nurses. Implement these strategies and resources to promote a more balanced work life.

1. Assign Reasonable Patient Loads to Help Prevent Burnout

Since burnout can exacerbate feelings of compassion fatigue, it’s important to keep units adequately staffed. This will ensure that nurses are assigned manageable patient loads that allow for proper breaks. Additionally, finding alternative ways to fill vacant shifts will prevent you from having to call in nurses on their days off. This may include optimizing your float pool or working with a staffing partner who can help you temporarily fill shifts with qualified nurses.

2. Invest in Employer-Funded Mental Health Resources

It’s also important to provide robust mental health programs and resources for your staff. Offering employee assistance programs (EAPs), free counseling sessions, and comprehensive health insurance are all important ways to support the mental wellbeing of your nurses. You can also hire a chief wellness officer who can help voice and address the mental health concerns of nurses in your unit.

3. Focus on Creating and Maintaining a Healthy Work Environment

A healthy work environment is the foundation to a healthy workforce. Beyond adequately staffing your unit and providing mental health resources, it’s important to build a culture that promotes safety, collegiality, and transparency. Nurses should be able to turn to their leaders and colleagues for support, and they should also feel comfortable speaking up about anything impacting their ability to deliver care.

Discover More Ways to Support Your Staff’s Well Being

Now that you have additional insights into compassion fatigue in nursing, you may be looking for other ways to promote the wellbeing of your staff. Don’t miss out on IntelyCare’s other free tips and guides that can help you build a stronger healthcare workforce.