Compassion Fatigue: Nursing Overview and FAQ

The injuries and illnesses that drive patients to seek healthcare support can result in some of the most emotionally and physically taxing ordeals of their lives. For the people who care for these patients, the consistent secondhand trauma takes a toll on mental health, risking what’s known as compassion fatigue. Nursing and other direct caregivers are at high risk for this phenomenon of mental and physical exhaustion driven by ongoing exposure to others’ suffering. 

In fact, roughly 57% of nurses experience compassion fatigue at least once during their careers. With nursing shortages driven by issues like burnout — often a byproduct (or related outcome) of compassion fatigue — healthcare organizations have an obligation to address this nursing crisis. Here, we’ll answer some common questions about the problem while outlining practical solutions to help your nursing staff overcome and avoid compassion fatigue.

By harnessing the available information, resources, and solutions, you’ll be better equipped to protect not just your individual staff members, but your entire workforce and patients, too.

What Is Compassion Fatigue?

Compassion fatigue (nursing specific) refers to the decline in a nurse’s ability to deliver compassionate care due to the preoccupation with others’ suffering. It 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.

However, it’s important to note that empathy and compassion aren’t interchangeable terms. So, what’s the distinction between empathy fatigue vs. compassion fatigue? Where empathy is more self-centered to begin with (it involves finding an internal method to relate to someone’s pain), compassion is outwardly focused, resulting in warmth and active concern felt by the person suffering. Empathy fatigue is therefore less visible, experienced exclusively internally, where compassion fatigue is expressed in both the internal and external domains.

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

In the healthcare industry, burnout vs. compassion fatigue is an important distinction to understand. While they’re closely related — often intensifying one another — burnout more generally refers to physical and emotional exhaustion from work-related stress. This can occur in people working in 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 often contributes and worsens feelings of compassion fatigue. Nursing staff may also experience the reverse — where disengagement and emotional strain from compassion fatigue lead to burnout. 

What Are the Signs of Nursing Compassion Fatigue?

Compassion fatigue develops over a period of time and can manifest differently from person to person. However, there are some common warning signs. Examples of compassion fatigue in nursing — how it may be expressed in the workplace — 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 medical errors at work.
• 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 compassion fatigue red flags.

What Is the Cause of Nursing Compassion Fatigue?

Nurses are trained to maintain composure and a compassionate approach, even in highly stressful situations. This can make it difficult to set professional 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, facility-level factors such as understaffing and negative work cultures often prevent nurses from setting these boundaries on their own accord.

What Is the Impact of Compassion Fatigue in Nursing Teams?

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 well-being can worsen, leading to:

• Emotional and spiritual dysregulation.
• Desires to leave the job or leave nursing 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 Healthcare-Related Compassion Fatigue 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 by participating in evidence-based programs geared toward helping nurses. We’ll examine some of these programs’ focal points below.

Identifying the Symptoms

Compassion fatigue is experienced differently across individuals. Nurses need to learn how to identify their specific flags for growing detachment. Examples include:

• Becoming distracted more easily.
• Uncharacteristic or heightened stress responses.
• Withdrawing (or isolating).
• No longer finding enjoyment in previous hobbies or passions. 

Knowing these early indicators can help a nurse begin mitigation work before the effects impact safe patient care. 

Recognizing the Triggers

Like symptom expression, triggers vary by nurse. Examples include:

• High-stress work environments.
• Lack of self-care.
• Insufficient professional boundaries.

Knowing their specific triggers allows a nurse to avoid or manage them to avoid spiraling fatigue. 

Incorporating Healthy Coping

Many of healthcare’s stressors are unavoidable, but nurses can control their responses. Healthy coping mechanisms may include carrying out activities that promote self-care, including:

• Yoga.
• Mindfulness.
• Regular exercise.
• Protecting time away from work.

Practicing these regularly can help mitigate and prevent reoccurring compassion fatigue.

The takeaway: Because symptoms and triggers vary from person to person, the best mitigation efforts target individual needs, whether through a personalized compassion fatigue program or by consulting a mental health professional.

How to Prevent Compassion Fatigue: Nursing Considerations

While there is no one-size-fits all approach to preventing compassion fatigue in nursing, facilities can take steps to support the overall well-being 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 well-being 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 of a strong 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 any changes impacting their ability to deliver care.

Discover More Ways to Support Your Staff’s Wellbeing

With these crucial insights into compassion fatigue, nursing leadership can better protect their staff and, by extension, their patients. For the most up-to-date resources on maximizing your staff and patient experiences, rely on IntelyCare’s expert-backed facility guides and best practice recommendations — continuously updated to ensure you stay at the cutting edge of innovation.