It is certainly no secret that nurses are as unique and diverse as the patients they see.

But if there is one quality that many nurses share, it is a high level of compassion—or the ability to empathize with their patients’ struggles.¹

As beautiful and even necessary as this may be, it can also lead to compassion fatigue symptoms. In fact, as many as 57% of clinical nurses are impacted by the issue, and those who work in especially challenging departments—such as oncology, pediatrics, psychiatry, or an emergency room—tend to be hit the hardest.²

The compassion fatigue nursing professionals face does not only affect them on a personal, professional, and social level; it can also influence patient care and patient outcomes. In other words, it is vital to do what you can to prevent compassion fatigue.

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What is Compassion Fatigue?

Compassion fatigue is broadly defined as the physical, psychological, and emotional exhaustion people experience from caring for others or from witnessing and absorbing others’ traumas.³ 

Also known as secondhand shock, secondary trauma, and vicarious trauma, compassion fatigue is often confused for “nurse burnout” or a cumulative sense of exhaustion and/or dissatisfaction.

While nurse burnout is one side effect of compassion fatigue, compassion fatigue stands in a category of its own. It occurs as a direct result of helping others and is widely characterized by a reduced ability to provide the compassionate, understanding care nurses are known for, especially when they strive to learn how to be a better nurse.  

Interprofessional collaboration in nursing can play a role here, as supportive teams can mitigate some effects of compassion fatigue by allowing nurses to share responsibilities and emotional burdens.

Causes of Compassion Fatigue

Watching a patient’s health rapidly deteriorate, informing a loved one of a patient’s passing, and being exposed to people in life-threatening situations can all contribute to moral distress and worsen compassion fatigue.⁴

Other triggers might include:

#1 Emotional Demands of the Job

Nursing may feel rewarding, from the chance to make a meaningful difference in the lives of others to choosing a specialty, leading to compassion satisfaction. However, caring for others and witnessing their pain, discomfort, and distress can take a substantial toll on your emotional health. This might be particularly true if you:

• Work with severely sick children or provide care to populations with high mortality rates
• Manage cases that involve complex care needs
• Offer patient care in dangerous environments
• Encounter verbal and/or physical threats from patients and/or their loved ones
• Deal with patients who suffer from depression or have voiced suicidal thoughts
• Handle long patient stays⁵

All of this may be compounded by the fact that registered nurses and other healthcare providers often handle a high rate of turnover. Meaning, they have very little time to absorb the shock of an event or experience before they must turn to their next patient. Over time, this may cause chronic compassion fatigue—and affect the relationships you have outside of your healthcare facility and with other healthcare providers.

#2  Work-Related Stress

Compassion fatigue is not caused solely by patients. Working long, excessive (or irregular) hours, receiving insufficient pay, and inadequate organizational support can play a part in compassion fatigue as well. A poor working environment, conflicts with colleagues, and a lack of resources might also contribute to compassion fatigue and affect the professional quality of your work.

#3 Personal Factors

Another term for compassion fatigue? Cost of care.

It is a fitting phrase, but stressors at home might also have a hand in developing compassion fatigue. These may include going through a divorce or separation, caring for a sick child or parent, or dealing with financial concerns and constraints. You might also be at a higher risk for compassion fatigue if you have encountered trauma in your past or tend to push self-care to the side when you are stressed.

Fortunately, there are several ways to not only avoid compassion fatigue but also treat it. The first step is recognizing its most common symptoms—a topic we will turn to next.

Signs and Symptoms of Compassion Fatigue

It can be all too easy to blow off feelings of anger, resentment, and exhaustion on a particularly challenging workweek or detachment from your patients as par for the course in any medical profession.

Compassion fatigue, however, is a very specific experience. It might make itself known through:

• Emotional changes – Are you noticing that you are extremely irritable or quick to anger? Or have you found yourself dreading the mere thought of going to work? If so, you are not alone: compassion fatigue often manifests through mood swings, resistance, oversensitivity, restlessness, depression, anxiety, and other emotional issues.⁶
• Physical symptoms – Compassion fatigue may also show up in your actual well-being. A few of the most prevalent physical signs of compassion fatigue include headaches, digestive issues, difficulty sleeping, dizziness, and nausea.
• Work performance and satisfaction – With compassion fatigue, you may have an increasingly harder time making fast, effective decisions. You might also feel a sense of helplessness when it comes to your patients and be less empathetic to their trials and tribulations. Reduced confidence in your work, impaired thinking and behavior, and decreased productivity and motivation may also be telltale signs of compassion fatigue. Another major sign? A sudden or gradual drop in job satisfaction.
• Addiction – Repeatedly enduring others’ pain and heartbreak might cause some nurses to self-medicate through addictive behaviors, like:
  • Drinking excessively
  • Using drugs
  • Gambling
  • Workaholism

Additionally, compassion fatigue may impact your worldview (and not for the better) and cause you to withdraw from your friends and family—a side effect that may deepen your feelings of detachment and isolation.

Consequences of Compassion Fatigue

Two of the biggest consequences of compassion are its effect on the personal, psychological, social, and physical well-being of nurses themselves and the quality of care they are able to offer to their patients. Untreated, ongoing compassion fatigue might also result in:⁷

• Chronic health conditions for nurses, such as obesity, cardiovascular disease, and diabetes
• A greater vulnerability to mental health conditions, again in nurses (i.e., clinical depression, eating disorders, personality disorders, and hypochondria)
• Higher nurse turnover rates
• Increased nurse shortages
• Decreased patient satisfaction and safety

All told, compassion fatigue can have far-reaching consequences and negatively affect healthcare as a whole.

Preventing Compassion Fatigue

Luckily, experiencing compassion fatigue can be dodged proactively. This might involve adopting:

Self-Care Strategies

Self-care may fall to the wayside if you are preoccupied with your patients and working long hours (to say nothing of life’s demands away from your medical facility). Indeed, as Nurse Journal puts it, “So much of a nurse’s time is focused on helping others that it is easy for nurses to forget about their own health.”⁸

Every person has their own idea of self-care and their own understanding of what feels good and nourishing. In addition to the primary pillars of wellness—eating a nutritious diet, obtaining sound sleep, and exercising regularly—you may want to consider the value of:

• Spending time doing what you love, whether that is hiking in nature or enjoying a long dinner with your family
• Engaging in mindful activities, like yoga, Tai Chi, or meditating
• Finding an emotional outlet for workplace (and life) stress, such as painting, drawing, or dancing

Workplace Support

It is just as crucial to set boundaries at work. This might mean cutting down on your availability to work overtime or switching to day shifts if working at night proves to be too taxing. Nurses need work-life balance: It is one of the keys to preventing and combatting compassion fatigue.

Coping with Compassion Fatigue

Compassion fatigue is a fact of life for some nurses, but it is far from a life sentence.

If you feel that the nursing profession is impacting you, you may want to:

• Speak with a professional who has experience with compassion fatigue, especially among healthcare workers
• Uplevel your self-care routine
• Carve out time for a vacation
• Reconnect with loved ones
• Practice self-reflection
• Discuss non-work related matters with your colleagues, and prioritize off-site bonding.

Most of all? Make sure you recharge your batteries daily, whether that is decompressing with a movie at night or getting up early for a pre-work walk. Coping strategies like these can help you manage compassion fatigue effectively.

The Importance of Addressing Compassion Fatigue

The compassion fatigue nursing professionals experience dominated the headlines during the pandemic—and shone a spotlight on the importance of addressing it. Ignoring it may lead to the consequences outlined earlier and a loss of morale that may affect your enthusiasm for the nursing profession. As a result, your patients may suffer, which might go against your very reason for becoming (or striving to become) a nurse in the first place.

Here is the good news, though. The right nursing education can prepare you for the rigors of the job and show you how to give as much compassion and empathy to yourself as you do, or will, offer to others.

Your Nursing Career with Alliant International University

Taking a proactive approach to preventing and treating compassion fatigue may place you precisely where you want to be: In a healthy, vibrant, well-rested spot where your natural inclination towards empathetic care comes easily.

This is just one characteristic Alliant International University can help you uncover and refine. Whether you are interested in obtaining a bachelor of science in nursing or a master of science in nursing, direct entry, Alliant offers a range of health programs to launch your career in the medical profession. Plus, with online and in-person courses, you are bound to find a schedule that works with your own work-life balance.

Discover the education you need to succeed at Alliant.

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Sources: 

1. Alharbi, Jalal, Debra Jackson, and Kim Usher. “Compassion Fatigue in Critical Care Nurses. an Integrative Review of the Literature.” Saudi medical journal, November 2019. https://pmc.ncbi.nlm.nih.gov/articles/PMC6901773/. Accessed October 29, 2024.
2. Yi, Li-Juan, Jian Cai, Li Ma, Hang Lin, Juan Yang, Xu Tian, and Maria F Jiménez-Herrera. “Prevalence of Compassion Fatigue and Its Association with Professional Identity in Junior College Nursing Interns: A Cross-Sectional Study.” International journal of environmental research and public health, November 17, 2022. https://pmc.ncbi.nlm.nih.gov/articles/PMC9690934/. Accessed October 29, 2024.
3. “Compassion Fatigue: Symptoms to Look For.” WebMD.https://www.webmd.com/mental-health/signs-compassion-fatigue. Accessed October 29, 2024. 
4. Lord, Zara. “Compassion Fatigue in Nurses.” uPaged, June 26, 2024. https://upaged.com/blog/compassion-fatigue-in-nurses/. Accessed October 29, 2024.
5. Wang, Jia, Mei Su, Wenzhong Chang, Yuchong Hu, Yujia Ma, Peijuan Tang, and Jiaxin Sun. “Factors Associated with Compassion Fatigue and Compassion Satisfaction in Obstetrics and Gynaecology Nurses: A Cross-Sectional Study.” Nursing open, August 2023. https://pmc.ncbi.nlm.nih.gov/articles/PMC10333879/. 
6. Prevent compassion fatigue through self-compassion. https://www.myamericannurse.com/prevent-compassion-fatigue-through-self…. Accessed October 30, 2024. 
7. Stoewen, Debbie L. “Moving from Compassion Fatigue to Compassion Resilience Part 4: Signs and Consequences of Compassion Fatigue.” The Canadian veterinary journal = La revue veterinaire canadienne, November 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7560777/. Accessed October 29, 2024"
8.  “Self-Care for Nurses.” NurseJournal.org. https://nursejournal.org/resources/self-care-for-nurses/. Accessed October 29, 2024.